Episode 83 – Available Resources for Pittsburgh Seniors: Where To Turn For Help with guest Maxine Horn

Episode: 83
Originally Aired: July 29, 2014
Topic: Available Resources for Pittsburgh Seniors: Where To Turn For Help with guest Maxine Horn

The Lange Money Hour - Where Smart Money Talks

The Lange Money Hour: Where Smart Money Talks
James Lange, CPA/Attorney
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Available Resources for Pittsburgh Seniors: Where To Turn For Help
James Lange, CPA/Attorney
Guest: Maxine Horn
Episode 83

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  1. Introduction of Guest – Maxine Horn
  2. What is AgeWell Pittsburgh?
  3. Which Service Is Most Requested?
  4. Dealing With Social Isolation
  5. AgeWell’s Measurable Successes
  6. What’s The Fee?
  7. Examples Of Past Situations

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1. Introduction of Guest – Maxine Horn

David:  Hello, and welcome to this edition of The Lange Money Hour, Where Smart Money Talks.  I’m your host, David Bear, here in the KQV studio with James Lange, CPA/Attorney and author of two best-selling books, “Retire Secure!” and “The Roth Revolution: Pay Taxes Once and Never Again.”  Tonight’s topic is available services for seniors.  Finding and identifying available resources can be a difficult maze to navigate for both older adults and adult children concerned about their aging parents and relatives.  How can older adults stay active and engaged in their community?  How does an adult child know when it’s time to intervene for the safety and well being of their elderly parents and relatives?  To answer these questions, we welcome Maxine Horn from the Jewish Family and Children’s Service of Pittsburgh.  Maxine is also the information and referral specialist for AgeWell Pittsburgh, a collaborative program between the JF&CS, Jewish Association on Aging and the Jewish Community Center.  AgeWell Pittsburgh is a network of services designed to help all older adults remain healthy and independent, regardless of their race, religion, ancestry, sexual orientation, handicap or disability.  Listeners, since our show is live, Jim and Maxine are available to answer your questions.  To join the conversation, call KQV studios at (412) 333-9385.  Hello, Jim, and welcome, Maxine.

Maxine:  Thank you.

Jim:  I should mention that I have had two significant personal needs that were addressed very well by AgeWell Pittsburgh and its predecessor, and specifically by Maxine.  One time, my wife actually had thyroid cancer, and there was a treatment course that was a little bit tricky to implement.  It meant a certain separation from our young daughter at the time, and we needed additional help, and actually, my wife called not even knowing that Maxine was a relative (and I’ll get to that in a minute), and she was given fabulous advice and it worked out very well.  My mother was also a client of Jewish Family Health and Children’s Services.  My mom just passed this past March at age 95, but she had a wonderful social worker, and she was very well taken care of, but towards the end, she actually had a stroke, and when she had a stroke, that obviously was a huge shock to the family, and I needed somewhere to go for a lot of things, and I called AgeWell and specifically, Maxine Horn, who was just wonderful, both after the stroke for that surviving period between when my mom had the stroke and she died, and then even after death, how to handle a lot of these things, and she just was a pillar of strength and of great information.  Now, I also should mention, out of full disclosure, that Maxine Horn is a relative of mine.  She is my first cousin once removed.  Her mother, my deceased mother, who I know as Aunt Sarah, was one of the sweetest women you could ever meet, and as a little aside, shared the same birthday as I, September 12th.

David:  Oh, coming up here soon?  Remember that, listeners.

Jim:  Coming up.  56, if you’re curious.

David:  56.

2. What is AgeWell Pittsburgh?

Jim:  All right.  So, Maxine, could you just tell us a little bit of an introduction, what is AgeWell Pittsburgh?

Maxine:  Well, AgeWell Pittsburgh is not the easiest thing to understand, so bear with me for just a second.  AgeWell Pittsburgh is a collaboration, a partnership, of three nonprofit agencies, each with their own senior service departments who have formed an alliance, an umbrella, I would like to call it, and we serve over 6,000 seniors per year, and the sole purpose of doing that is to help these seniors remain independent in the community.  We formed almost ten year ago.  That’s a whole story in itself.  I’ll tell you another time.  But we did form because there were confusions about services and how to access them, and we wanted to create somehow a single point of entry into all of the services that were available under these three agency roofs, so that people didn’t have to make multiple stops and multiple calls.  We call it ‘one-stop shopping.’  So, what happened was we formed together.  We call ourselves AgeWell Pittsburgh, and it’s been a very successful collaboration.  We have been recognized nationally, we have received the United Way award for excellence, the United Way of Allegheny County, who are very strong supporters of ours, and it’s been a wonderful collaboration, very interesting because these were three independent, very independent, organizations that managed to put aside their territorialism and join together for a common good.

David:  Can you just give a sense of what those organizations are for listeners?

Maxine:  Jewish Family and Children’s Service is an organization that is dedicated mostly to social services for seniors, which I can go into.  Some counseling is available, care management is available, in-home care is available, support groups.  Care management is a big component of what we do.  So that’s social services.  The Jewish Community Center is the arm that provides most of the social and recreational programs for seniors.  What do I mean?  I mean there is programming that’s directed specifically for seniors.  For those who have Highmark products, there is a very huge SilverSneakers program.  The Jewish Community Center is also at the area Agency on Aging Senior Center, so that seniors can get there.

David:  That’s both in Squirrel Hill and, I think, in Mt. Lebanon?

Maxine:  There is a Jewish Community Center in Mt. Lebanon; however, it does not have the senior programming that is available in Squirrel Hill.

David:  Okay.

Jim:  So, if I understand this right, is AgeWell Pittsburgh kind of the gatekeeper that somebody would call or approach, and then be directed to one of these three agencies, or maybe something that you could handle if it’s, say, a quick question on your own?  Is that correct?

Maxine:  It is absolutely correct.  I don’t want to shortchange, actually, the JAA, which is the third arm.  And then, I’ll answer your question directly, Jim.  The Jewish Association on Aging also provides some home and community-based services.  For example, there is a meals-on-wheels program.  There is an outpatient physical therapy program.  There is a service for people with mild to moderate dementia that they can go for day services.  We also have, not quite under the umbrella, but there is a nursing home and two assisted livings that fall under those auspices.  Now, to get back to your question, Jim, yes, that’s exactly the way AgeWell was envisioned that the call would come to AgeWell and I would field those calls.  If it was possible, I would refer the caller to services underneath the AgeWell umbrella, that is, two of the three ‘J’ organizations.  If that was not going to be a good referral, then, of course, I go outside.

David:  So you are free to go outside?

Maxine:  Absolutely, and I do, often.  I have I don’t know how many hundreds of referrals in my database.  I refer a lot to the Area Agency on Aging, which is another very big organization that provides services to citizens in Allegheny County.

David:  All citizens?

Maxine:  All citizens in Allegheny County who are over sixty.

Jim:  All right, and that’s probably an important point for our listeners because when they hear names like ‘Jewish Family Health and Children’s Services,’ etc., that they might think, “Well, I’m not Jewish.  This doesn’t apply to me.”

Maxine:  That comes up, and I am quick to reassure everybody that that is not true.  All services are completely non-sectarian.  We are Jewish in origin, but our mission has evolved over time, and we are anxious to serve the entire community and we do serve the entire community of Allegheny County.

David:  These are three old organizations we’re talking about, well established.

Maxine:  Well, over a hundred years apiece.

David:  Right, apiece.  Three hundred years of service.

Maxine:  Three hundred years of service, right, providing, essentially, twenty-one different programs to the community.  And the easiest way to access those services is to do the one-stop shop, just call me and I will direct your call.

Jim:  And I can imagine…you said that there were three very independent organizations.  I could imagine a little bit of infighting or problems or, to use your own word, territoriality, of some people who certainly mean well, but like many of us, including myself, have our own certain territory, and you must be one of the great diplomats to a) get this thing off the ground, and b) to keep it going.  And plus, I know that you have…what is your experience?  Twenty-five years doing this type of work?  And you’re starting, and I’ll tell the audience, as a very bright, capable, caring woman, I would imagine that that might be a little bit of a juggling act?

Maxine:  Well, it wasn’t for me because I came in and I watched the others do the juggling.  I understood where we were going, but you are entirely correct.  Each of these agencies is a proud agency with tremendous history and tremendous success, each one of them, and when you say, “Okay, now we’re going to put all that identity aside and just be known as AgeWell Pittsburgh,” for the senior population, of course.  This doesn’t apply to the rest of the community, but for the senior population, this is no longer going to be this, this and this.  This is going to be AgeWell Pittsburgh.  Well, that does take a little doing, and in fact, the first couple of years were a little touchy, and to that end, we did bring in some experts to help us along the path.

Jim:  All right.  And the other thing is, you said that this is geared for people who are sixty years and older, but you also said that this is available for children of aging parents.  So, in my own case, I’m not yet sixty, but my mom was ninety-five.  She was not in the position that she could contact you, but I did on her behalf.  So, this is not only just for the sixty and older.  This is for caretakers and relatives of the ultimate end patient.  Is that right?

Maxine:  Absolutely.  People call all the time about their parents, and the callers themselves are clearly under sixty or approaching sixty, and even grandchildren call, or nieces and nephews call.  This is not the least bit uncommon.  So, it’s definitely a service for everybody.

Jim:  All right.  And before we go much further, if somebody is interested in AgeWell, could you give them, perhaps, a website and a telephone number, and, you know, where they would start the process with a question or an issue?  And we’ll probably do this once or twice more throughout the show.

Maxine:  Sure, sure.  My direct line is (412) 422-0400.  That is my direct line right into my office, and I’m the one who answers that phone.

Jim:  Not a secretary?

Maxine:  Not a secretary.

Jim:  Not a machine?

Maxine:  Not a machine.  Just me. And if I don’t answer, that means I’m either out of the office or on the phone, and I always return my calls, always, always.  There is also a website, which is www.AgeWellPGH.org.

3. Which Service Is Most Requested?

Jim:  What kinds of services are offered?  You did a little bit of each one, but what do you think are some of the important services that you can picture a lot of our listeners to taking advantage of?

Maxine:  Probably the most common call that we have has to do with in-home care.  People are aging and the whole focus of people who are over sixty, if you’re looking at a child’s perspective or a spouse’s perspective, you want to know that this person can stay at home as long as possible and remain independent while doing so.  Now, independence sometimes requires some help.  So, I would say that in-home help, if you want to call it in-home help rather than in-home care, would be probably what I get called about the most, and we do have a very fine registry of in-home caregivers who have been very carefully screened and trained and vouched for by us who are available to go into the home.

Jim:  And I’ll take it a step further because I contacted…back then, they either didn’t have or I didn’t know of AgeWell, and I contacted the Jewish Family Health and Children’s Services as my mom was aging and we needed some help to help keep her in her home, and the social worker that was assigned to her was a woman named Pearl Averbach, who was just, I consider, the social worker from heaven.  She was just so terrific, and she came in and she met with my mother at various times, and she made some recommendations for refitting the bathroom, things to do on the floor, railings, things that, in retrospect, seem like common sense, but things that I hadn’t thought of, and then, later on, when my mom actually needed somebody to spend time with her during the day and somebody to help maybe cook some meals and help get her around and take her to doctor’s appointments and things like that, Pearl was able to suggest a team of caregivers who were wonderful, and I was just so impressed when she was able to do that.  So, I can personally vouch…again, I obviously can’t vouch for everybody, but I can for Pearl and Lisa, and Lisa, by the way, what a wonderful woman.  I hope you’re out there listening, Lisa.  She actually…when my mom was literally, after the stroke and couldn’t communicate much at all, Lisa actually came to visit her on her own time and actually came to her funeral.  So, these are people who really care.  They really are.

Maxine:  They do.

David:  Is this a good place for a break?  Well, when we return, Jim and Maxine will continue the conversation, and remember, since we’re live, please call with questions at (412) 333-9385.


David:  And welcome back to The Lange Money Hour, I’m David Bear here with Jim Lange and Maxine Horn from AgeWell Pittsburgh.  If you have a question for either, call us at (412) 333-9385.

Jim:  Maxine, you were telling us a little bit about some of the services that you provide.  Who would be a typical caller, or who does actually call AgeWell Pittsburgh?

Maxine:  Who calls AgeWell Pittsburgh is just about anybody.  It could be the person himself, or herself, somebody who is aging and knows there is something that is needed.  It could be a child who perhaps has been home after a long break, maybe after a vacation of some sort, or after a holiday when there’s been a long separation, comes home and sees that something’s not quite right with mom.  She’s not the same as she used to be.  I get calls from professionals, people who know that my database goes pretty deep, and I will work and work and work until I find the appropriate referral for that person.  If I can’t find it, if it’s not in my database and it’s not in my drawer of files, I will keep working at it until I find it.

Jim:  And how do people find out about AgeWell Pittsburgh?  Very frankly, I’ll tell you something that’s a little bit interesting, I was talking to one of my clients, and she was telling me…now, she lived downtown, and she said, “You know, I kind of wanted to come back to Squirrel Hill, but I wasn’t really sure if I was able to get services, if I could stay in an apartment on my own, what kind of community there would be, and then there was this wonderful collaboration of these various social groups who got together, and that really convinced me I should move to Squirrel Hill, and I’m able to take advantage.”  And I said, “Oh, really?  And who’s the coordinator?”  And then they said, “Maxine Horn.”  I thought, “Oh my goodness, that’s my first cousin!”  Once removed!  But here I was in the community and I have actually given out names of different social workers and I’ve given out Pearl’s name plenty of times.  How do people find out about you guys?  Are you a well-kept secret?

Maxine:  I think we are a well-kept secret, but we hope that that will change, certainly with an opportunity like you have given us today on this program.  I’m certainly hoping that that is true.  But we do have the website.  We do know that people Google services.  We are in the phone book.  We do have print material.  I do go, you know, make presentations around.  So, we do our best.  We are a nonprofit agency, so we don’t have extra dollars for advertising.

Jim:  Well, you just said that you give talks, so let’s say that I am in charge of bringing in guests, and let’s say that my audience, the people who usually come to my events, are seniors.  They should perhaps consider having you come in and give a little talk, and you would be able to give seniors resources that would enable to help them live better lives, presumably staying at home.

Maxine:  I would hope so.  That’s my goal.  That’s all of our goals.

4. Dealing With Social Isolation

Jim:  What are some of the common questions that you get?

Maxine:  Well, there are two kinds of questions that I get.  I divide them into simple questions and complex questions.  Simple questions are questions about in-home care, which I’ve just described to you, but they’re simple because there’s an answer that I can deal with right away.  Transportation is a simple question because there are finite means of transportation.  Housing, home-delivered meals, adult day services, these are very specific answers.  They’re easy to come up with.  Not easy for the families to ask, by the way, but I know what the answers are.  The more complex calls, I can hear by the information that the caller gives me that there are many dynamics at work, for example, social isolation on the part of the mom who insists on staying in her own home but doesn’t get out anymore.  It’s harder and harder to get out, doesn’t have any social interaction with people, and this, in turn, may bring on a depression, or maybe part of the depression that she seems to be having right now.  Caregiver stress is a very big problem that we see often, and this is when a caregiver has so much on her plate, or his plate, a lot of male caregivers, that they are overwhelmed, they are tired, they don’t have people to share responsibilities with, and it’s very difficult.  These are very complicated questions.

Jim:  And some of the men are related because I was thinking of my mom’s own case, and she lived independently, literally, until she died, but she did have some help, and I was always trying to get her out to a bridge game, to a concert, and even to her doctor’s office visits, and one of the things that you were able to do was to help coordinate a driver who was able to take her to these places.  So, I would imagine some of these things, what might sound like a simple question, might end up being interrelated.  So, you could say, “Well, here’s a couple places that she might consider going, and by the way, here’s how we can get her there.”

Maxine:  You’re right, and I want to exemplify that by this little call that I had.  Let’s call her Ethel, who called…her daughter called about her.  She’s an 80-year old woman who’s moved back to Pittsburgh from Florida, where she had lived for many years, to be near her daughter.  Her husband had passed away in the meantime, and her friends had kind of disappeared.  Either they’d moved back to their families, or they had died, or whatever.  So, she’s lonely.  All of her friends are gone.  She’s back in Pittsburgh where she hasn’t lived for a long time.  She’s depressed.  In addition, she is becoming more isolated because her hearing is bad, which is causing more anxiety.  So, the daughter says, “What am I going to do?  What am I going to do with mom?  This is really tough!”  So, what we did was we recommended one of our programs.  It’s called ‘CheckMates.’  And CheckMates is a volunteer-driven program that works out of the Jewish Community Center in which peers, older adults themselves, take on the responsibility of calling a person like Ethel, or many hundreds other like her, once a week to check in on her to see how she’s doing.  Now, you see how this works both ways: first, it’s a wonderful thing.  Ethel knows that Margaret is going to call her on Thursday, and she looks forward to that conversation, and pretty soon, what happens is Margaret says, “Ethel, you know what?  You shouldn’t be staying at home all this time.  Why don’t you come up and have lunch with me at the JCC?”  So, Ethel maybe takes a few weeks to make up her mind that she’s going to do that, but eventually, she comes to the JCC.  Now she knows not only Margaret, but she meets all of these other people who are around with her, and she sees that people are participating in exercise classes and listening to lectures every now and then.  And so, she’s already doing well.  I don’t recall at this point whether this particular person I might have referred for psychological services, but that’s certainly within my capabilities to do if I think that this woman is really not responding.  Let’s say she refuses services.  So, if she’s refusing services, then for sure I may ask for psychological services.

Jim:  And the other question that I had there was…you mentioned hearing aid.  You said Ethel has a hearing problem, and by the way, that was a fight that I had with my mom for years.  I eventually “won.”  She finally agreed to put them in when I went there, and for a while, it was won.  How do you work on that one?  Because I could picture a lot of children with parents not completely deaf, but partially deaf, who would substantially benefit from a hearing aid.  What wisdom do you have there, or is that just too tough?

Maxine:  That verges on the too tough question because not all hearing loss is the same.  Some of it is very difficult to have help for.  Some of it is much more straightforward.  But there are other things that are available that can be accessed through one of my referrals, which has nothing to do with AgeWell Pittsburgh.  It’s outside the boundaries of AgeWell Pittsburgh.  But there are wonderful resources in Pittsburgh.  For example, you can get, at very low cost, a headset that’s similar to what you might get at the theater, or a concert, which has an infrared system so that if you put that on, you don’t have to turn the television set up loud.  You put it on and the sound from the television goes directly into your ears, and you can turn it up as loud as it needs to be to gain enough volume so that you can hear.  It is a wonderful thing.  May I tell you that I have one in my own house?  I do!  I do.  It’s the truth.  And I would not be without it.  It allows me, because I do have a hearing loss, it allows me to hear very clearly what’s going on on the television screen.  But there are other devices, as well, that just project sound a little bit better.  They’re definitely not as sophisticated as hearing aids.  And also, there are special telephones with special amplifications that you have to get in a place that really knows what they’re doing.  There’s doorbells that flash lights rather than ring, so that the person can see that somebody’s at the door.  There are some ways, I’m not going to say it’s going to bring wonderful hearing to the person, and also brings up a whole other question of cost.  Hearing aids are very expensive, and the resources for hearing aids for people who cannot afford them are few and far between.  There are some, but they’re not easy to access.

David:  But you have referrals for those other products?  Yeah?  Good.

Maxine:  I do, I do.  Absolutely.

5. AgeWell’s Measurable Successes

Jim:  How do you know that this program is successful?  How do you measure?  I mean, I would imagine that there’s some personal satisfaction for you, you know, having somebody have a problem, you helping them either on the spot or with a referral, but on the other hand, are there any, let’s say, measurement tools, any ways for AgeWell and the three aligned organizations to keep score, if you will?

Maxine:  Boy, I was hoping you wouldn’t ask me that question!

David:  That’s why he wrote it down!

Maxine:  The first thing is that, yeah, you mentioned personal satisfaction, and although that was not on my list of things to say, but the fact is I do get personal satisfaction because I call everybody back who has called me.  So, if you have called me and we have talked about an issue and I have given you some referrals, in two or three weeks, I will call back to see how that referral worked.  If it worked well, wonderful!  I’m on cloud nine.  If it didn’t work, then I have to look some more and kind of try to figure out what the person…why that didn’t work.  Very often, the person just hasn’t started to do it yet.  Sometimes it takes a long time for that to get moving.  But other than my personal satisfaction, we do have satisfaction surveys that go out to our clients, but we also have, not that long ago, within the last couple of years, gone into a whole other field of measuring, actually measuring statistically, what happens to everybody who’s involved in AgeWell.  We have a system of risk factor assessments that are associated with losing independence and what we can to do prevent or delay this loss, and in fact, the statistics coming out now are just really wonderful.  For example, AgeWell Pittsburgh clients have an estimated 26 emergency department visits per hundred clients per year, which is about half of the estimated 54 per hundred clients that Medicare recipients in general have.  And the same thing is for hospital admissions, much lower rate than just the general population.  And these are measurable things, and it’s wonderful and it’s been so successful that other agencies around the country are asking how we are doing this.

Jim:  Well, it’s interesting that you said that because when I first started to get an idea of what Agewell did, I was so excited about the concept that I just assumed that this was going on in many other areas, and Pittsburgh, and you specifically, were the, let’s call it, local representative, but that this was going on in New York and Los Angeles and Cleveland and Philadelphia, etc., and then you said, “No.  Pittsburgh’s really the anchor city.”  Is that right?

Maxine:  It was the first city.  It remains the primary city.  There are a couple of places that have sprung up around the country, Rhode Island, most specifically.  But there are a couple of other places around.  As you said yourself, this is not an easy concept to get off the ground.  Everybody loves the idea of a collaboration, loves it, and the more you go on and hear about funding sources and funding streams, people hear ‘collaboration’ and they get all excited about it.  So, on paper, it’s wonderful; in practice, it’s a whole other story, and we work at it.  Every month, we have a collaborative meeting of all staff.  We all come together.  We talk about issues.  We keep ourselves informed.  We have a representative from each agency who’s like the immediate head of the program.  So, we have ‘the triumvirate,’ we call them, that heads every meeting, and we keep up to date on things and keep each other well informed about our mission.

6. What’s The Fee?

Jim:  Well, I guess, you know, to me, this show was not about money, and of course, the vast majority of the shows are about money, but could you talk a little bit about what type of expenses there might be in, let’s say, two areas?  One that the agencies might incur, and b), and perhaps more relevant to our listeners, what kind of fees that they might anticipate?  I assume that when they call you, you don’t say, “What’s your credit card before I tell you the answer?”  But what are some of the costs involved, let’s say, specifically for our listeners, of services that you might provide, or you might refer?

Maxine:  Okay.  First of all, the information and referral line, which is my line, has no cost associated with it.  So, I provide information to anybody at no cost.  In Pittsburgh, out of Pittsburgh, it doesn’t matter.  Some of the other services do have price tags involved with them.  Now, for example, day services, which I mentioned was people with dementia, family members can send their loved one, who is suffering and becoming isolated at home with dementia providing other problems, can send them to a day service program.  We have one that’s called Anathan Club.  It’s right on Murray Avenue in Squirrel Hill across from the library.  It’s wonderful, wonderful.

Jim:  Right up Murray and Aylesboro?

Maxine:  Murray and, well..catercorner from the library is where it is.

David:  And that’s been there a long time?

Maxine:  That’s been there a long time.  And that is a fee for service.  That costs, I think it’s $52 a day.  A day!  A whole day, which includes snacks, lunch, stimulation and supervised programming.  So that’s an example of a cost.  In-home care, there is a cost to that.  It’s a cost per hour, which is, generally speaking, better than what you’d get from another agency, but it is a cost nonetheless.  Physical therapy, which is available at our physical therapy facility at the corner of Forbes and Shady, the JAA sponsors that, and that’s usually taken care of by insurance.  So, your insurance is accepted, all major insurances are accepted there.  There will be fees and some are sliding scale fees.  For example, as far as care management is concerned, that’s done on a sliding scale fee.  So, if the fee is $75 an hour, but you can’t afford $75 an hour, we take that into consideration, and maybe your fee will only be $25 an hour.

Jim:  And I will tell you this, just speaking personally, because we were billed with Jewish Family and Children’s Services.  I considered that one of the great bargains.  I mean, Pearl Averbach at $75 an hour, that is an unbelievable bargain.

Maxine:  Yeah, it is.

Jim:  I mean, in terms of the amount of value that she provides.

Maxine:  Well, and they provide 100%.

David:  Well, let’s take one more break.  Jim and Maxine will continue the conversation when we return, and since tonight’s show is live, if you have a question, there’s still time to call us at (412) 333-9385.


7. Examples Of Past Situations

David:  And welcome back to The Lange Money Hour with Jim Lange and Maxine Horn from AgeWell Pittsburgh.

Jim:  Maxine, can you give us some examples of how you might proceed with a caller?  So, somebody calls and maybe there’s a quick answer and maybe there isn’t.  What would be a natural course?  And, of course, it’s going to be different for each situation, but maybe a typical one, or one or two scenarios.

Maxine:  Okay.  I’ll give you a good scenario because it involves a number of possibilities.  Let’s just say that Carol is a devoted out-of-town daughter.  She doesn’t live here.  And she calls me because she’s at home visiting, and her father had fallen and broken his ankle.  But he’s now home.  He’s home from the hospital, but trying to help her mother, who has serious macular degeneration.  Carol will need to return to her job in New York soon.  What shall she do?  So, this is a multi-faceted question.  Again, not an unusual scenario, but one that we would approach bit by bit.  First of all, we would suggest some in-home care for a limited period of time until the father regains some stability.  We hope that he would go to our outpatient rehab clinic because they live in Oakland and there is transportation, free transportation to our clinic from his residence.  So that’s a terrific thing.

Jim:  So you’re going to get some rehab for dad?

Maxine:  Rehab for dad, and some in-home care so that mom doesn’t have to worry and he doesn’t have to worry so much when he has to get up, maybe in the middle of the night to go to the bathroom.  There’s somebody there to help him until he gets to the point where he can manage a little bit better by himself.  So, let’s say that mom’s not feeling like cooking now because life is tough for her right this minute, so we’ll get some home-delivered meals in to her.  AgeWell Pittsburgh has a home-delivered meal program called Mollies Meal.  It’s the only kosher meals-on-wheels program in Allegheny County, and it’s well-respected and well-used.  Here is a very important thing that I would encourage then to get, and that’s a personal emergency response system.  Now, this is one of those deals, ‘I’ve fallen and I can’t get up’ kind of thing.  Well, we don’t promote that particular unit, but we do promote another unit that we do call Elder Alert.  It works very much the same way, but it’s a local company, and we like to do business with local companies, and by having an Elder Alert, if, after the in-home care person leaves, if dad has a moment of panic or pain or he falls again, he’ll push the button and help will be on its way in an amazingly short amount of time.  I would recommend some reading material for mom from the Library for the Blind and Physically Handicapped, and I would recommend certainly some training by Blind and Vision Services.  These are all very respected organizations that are perfect for this situation.  The very last thing I would talk to them about would be since Carol does not live in Pittsburgh and since there’s a lot of dependency there, I would recommend a care manager for this family, and a care manager is a geriatric social worker, a trained, licensed, clinical, geriatric social worker, like Pearl, that you mentioned…

Jim:  I was just thinking I can’t imagine anybody better than Pearl.

Maxine:  Well, there are two others that are on par with Pearl that I love very dearly because they’re so good at what they do, and I would recommend services by one of them because the daughter can keep in touch with this care manager because the care manager’s going to go and check up on the family and talk to them frequently and get them drivers if they need to go to the doctor, or make sure that their checkbook is in good shape because they will do that as well.  Things of that nature.  This is the daughter in town that you wish you had.  That’s what care management is all about.

Jim:  Well, I’m just thinking what an enormous relief it must be for the daughter to have some of these services in place, and what a difference that potential one call made, and frankly, your ability to diagnose all these different problems and to provide potential solutions just can make an enormous difference in the quality of life for the patients, or your clients, or whoever you look at.

David:  Everyone.

Maxine:  I certainly hope so, yeah.  Well, I’ve been doing it for a long time now, so I’m getting pretty good at the listening part!

Jim:  So, why don’t you tell us about some of the tough ones that you’ve had?  By the way, to me, that sounded like a tough one!

Maxine:  Well, that was tough because it was complex, but it wasn’t the same kind of difficult that I’m going to tell you about now.  Here’s where it gets very tricky: when we’ve got mom or dad, or often mom and dad, who are living at home, and the children come in and the children will say, “Mom and dad, you have to move out of this house, and you have to move out next month.  You can’t be here another minute.”  And then they go back to their comfortable apartment in Savannah, and mom and dad get hysterical because they want to stay in their home.  There’s a clear disagreement.  There’s anger.  There are all kinds of feelings that get put into this that are very, very difficult.  That’s difficult.  Another thing that’s difficult is when there are children and the parent who want to go different directions.  Susie wants mom to do ‘X,’ Barbara wants mom to do ‘Y,’ and Billy doesn’t care one way or the other because he’s not involved.  He really doesn’t care.  These are very difficult problems, and one of the best ways to address those is to ask the family to come in for a family consult, and this is…well, mediate is not a really good word, but these are meetings with a social worker who is objective.  That’s the key word here.  This is an objective person with lots and lots of knowledge at her command who will sit and listen to all sides of the situation, and hope that by her guidance, by her help, by having them listen to each other in real time, that some sort of compromise can be reached.

Jim:  Let me ask you another question.  We don’t have much time left, but I think that this is important.  You obviously have a lot of resources.  How do you find them all?  I mean, is this something that came with the three different agencies, or is this something that you have put together?  Is there a national register?  Although, you did say that you have a preference for local companies.  Where do you get your resources and referral sources?

Maxine:  Well, I inherited a number of them from my predecessor, who, when it was not AgeWell, but there was another information and referral line called ElderLink, but that was quite small by comparison.  I probably tripled the number of resources, and the reason that I can do that is because if somebody ask me a question, and I start Googling, and one Google leads to another Google, I find resources.  I also go to community meetings, the Area Agency on Aging has terrific meetings that provide me with a lot of information.  I get print material.  I read, I listen, I represent AgeWell on a couple of citywide and countywide committees.  So, I hear and I put them down, yeah.

Jim:  All right, and could you again tell our audience how they could contact AgeWell, both by telephone number and by website?  Why don’t we start with a phone number first?

Maxine:  Absolutely.  The phone number first is (412) 422-0400, and the website is www.AgeWellPGH.org.

David:  Well, thanks for listening to this edition of The Lange Money Hour, Where Smart Money Talks, and thanks to Maxine Horn from AgeWell Pittsburgh for her excellent information and resources.  As always, you can hear an encore broadcast of today’s show at 9:05 this Sunday morning here on KQV, and you can always access the archive of past shows, including written transcripts, on Lange Financial Group’s website, www.retiresecure.com.  Please join us for the next new Lange Money Hour next Wednesday, September 15th at 7:05 pm right here on KQV.  Our guest will be estate planning transition expert Roy Williams, who’ll offer advice on preparing your heirs to be good stewarts of the assets they’ll receive someday.  I’m David Bear.


jim_photo_smJames Lange, CPA

Jim is a nationally-recognized tax, retirement and estate planning CPA with a thriving registered investment advisory practice in Pittsburgh, Pennsylvania.  He is the President and Founder of The Roth IRA Institute™ and the bestselling author of Retire Secure! Pay Taxes Later (first and second editions) and The Roth Revolution: Pay Taxes Once and Never Again.  He offers well-researched, time-tested recommendations focusing on the unique needs of individuals with appreciable assets in their IRAs and 401(k) plans.  His plans include tax-savvy advice, and intricate beneficiary designations for IRAs and other retirement plans.  Jim’s advice and recommendations have received national attention from syndicated columnist Jane Bryant Quinn, his recommendations frequently appear in The Wall Street Journal, and his articles have been published in Financial Planning, Kiplinger’s Retirement Reports and The Tax Adviser (AICPA).  Both of Jim’s books have been acclaimed by over 60 industry experts including Charles Schwab, Roger Ibbotson, Natalie Choate, Ed Slott, and Bob Keebler.