Over 109 million people are reaching retirement age. This means that the stresses that they’re facing, whether they’re physical or mental, are taking more of a toll on families than ever before. Finding the right care and facilities for aging adults is becoming a bigger challenge than ever before, but David Piontek is working to give back.
As a Placement Coordinator with Integrity Placement, he effectively provides comprehensive real estate services for older adults. Through an in-depth assessment process, he connects families to vetted and trusted homes and facilities in Scottsdale, Paradise, and the Phoenix Metro Area.
David Piontek is a native of northern Illinois and a 20 year Air Force Veteran. After a successful military career, David went on to receive his Bachelor’s degree in Health Care Administration and Master’s degree in Gerontology from the University of Nebraska at Omaha.
As a former Case manager in long-term-care, assisted living, Hospice, and memory care, David brings great knowledge and experience to the Integrity Placement team. He assists families in understanding their options for living should the need arise. He is an expert in determining psycho-social needs as well as financial, and health care options.
Today, David joins the podcast to explain his step-by-step process for finding the right care for family members, how young people can make financial plans to protect themselves later in life, and what you can do to help ensure that your spouse or parents are placed correctly in a home or care facility that works with their financial situation.
In this podcast interview, you’ll learn:
If you enjoyed this podcast, be sure to rate and review, and send us all your questions at email@example.com – it may become the topic of an upcoming episode!
[00:00:32] Andrew: Welcome back to another episode of Your Wealth & Beyond. In today’s episode, unfortunately, is going to be relevant for the majority of us and that is how to properly coordinate the care for a loved one, whether to a spouse, a partner, mom or dad. Usually, we as the caretakers are thrust into the mix and are scrambling trying to coordinate the doctors, the specialists, the assisted living facilities, do we want in-home healthcare. So, that’s why I brought on today David Piontek who is a placement specialist with Integrity Placement which was founded by Reina McRae, a local firm that is dedicated to educating and helping each of us facilitate the proper care. David brings with him a plethora of experience in the long-term care, assisted living, hospice, and memory care industry. He’s got great knowledge and he’s going to help break down what we need to do as we care for our loved ones.
This is an episode that I think we’re going to get so much great content out of, take notes, and as always, if you have questions, please reach out. Without further ado, my episode with David Piontek.
[00:01:45] Andrew: Welcome, everybody, to a brand-new episode of Your Wealth & Beyond. Very, very excited today to have on David Piontek who is one of the founders of AZ Integrity. Today we’re going to talk about a topic that’s going to hit home for all of us. David, welcome to the show. How are you?
[00:02:05] David: I’m great. Thank you, Andrew.
[00:02:08] Andrew: And as I know you’re here in Arizona with me, the summer doldrums are kicking in. How are you handling the heat?
[00:02:14] David: I’m doing okay. I lived in the Midwest most all my life so I’m okay with the summers here in Arizona.
[00:02:00] Andrew: So, today’s topic as we look at the graying of the baby boomers and whether you as a listener are getting close to that period where you’re retired and trying to focus on this next chapter or you have parents or grandparents, the one thing, David, I think we all know is as we’re living longer, our health is a key component and finding the right care, the right facilities, the right communities can be daunting for all of us. So, before we jump in, what’s your why? Why have you and Reina created this company? What’s your passion behind helping families find the right places and connections?
[00:03:02] David: Well, I think our passion is our love of people wanting to give back. Both of us really have the same values as far as working with our elderly. Both of us have always had an affinity with older adults and I think a lot of it is just based on trying to do the right thing, doing all that we can to help especially with the baby boomers now which is the largest segment of the older population and giving back and doing what we can to get the word out there about options that are available and educating people on what the future could hold for them and so they are empowered with the knowledge of all of their options. So, it’s really just a passion of loving people and caring about people. We know it’s a business. We get it, but we also are very keen on the people aspect and are very hands-on with our patients and our client.
[00:03:57] Andrew: Yeah. When we think about I think over the next 40 years I just read that there’s going to be over almost 98 million that are over 65 and so when we think about that and some of the stress that as we get older and our health deteriorates whether it be physically, mentally, or combination, the stress that whether the spouse or the family faces, those of the listeners that don’t really know what a senior placement agency does, high level what is it? What’s the value they can bring, companies like yours? Walk us through what that looks like and then we’ll dig in deeper.
[00:05:53] David: Well, high level for us would be we’re kind of like real estate for older adults, and you made a good point a few minutes ago with all the big population going out there, but one of the big things that Reina and I get a lot is we didn’t know people like you existed so that’s why we’re excited to be on your, you know, we’re happy to spread our word on your program. But what we do is we go in and do a psychosocial evaluation on a patient, we work with the family, we work with the client, and we look at everything. We look at their finances, we look at their background, we look at what they’re looking for, and then we discuss options, location.
Kind of like real estate but the big difference with us is that we’re very into the people aspect of it, making sure that wherever we move a person it’s their forever home but we basically go and do the evaluations and then we go from there and we come up with what options might be best for the family. We stay with the family from the beginning until after we even place an individual. If they were going to an assisted living or independent living or memory care or whatever it might encompass, we stay with them. So, it’s like real estate, but it’s on a much more broader spectrum because we have such a background in the healthcare field as well.
[00:06:01] Andrew: So, then let’s take even a step back. When do I find you? Is it me, the individual, that needs the care or is it only like I’m waiting to find you until things start getting a little out of control and is it more so, is it the family that’s searching you out versus me as the potential person that you’re helping to connect and find the right care, the right community, the right doctors, all of those things?
[00:06:28] David: Good question. More times than not, and unfortunately, Reina and I get clients who are normally it is the child, it is the child of an older adult, and normally people they wait until they’re in 911 mode is what normally happens. Now, what we’re finding is with the different segments of baby boomers, there’s a generational gap, of course, between 1964, the early baby boomers, where as we are finding that younger baby boomers who a lot of us know are very into knowledge and knowledge is power and all that and we’re finding younger baby boomers will seek us out before it gets to 911 mode, but unfortunately, right now the case is people wait until it’s too late, and normally is a child of a person who needs help.
The other part I would say the second would be the spouse. So, a spouse would call us and say, “David, Reina, I’ve got this situation. My husband has A, B, C, and D going on. What are my options?” So, that’s normally the way it goes, unfortunately, but we kind of change that. And like I said, with the younger baby boomers that we definitely see a difference in people sneaking out that knowledge prior to.
[00:07:50] Andrew: And you talk about this assessment. So, when somebody connects with you and there’s obviously going to be some underlying issues that are of both the health and maybe it’s not so much an issue where it’s going to be imminent death. It’s this unable to take care of themselves, unable to maybe dress themselves, unable to go shopping, those type of things but like when you talk about this assessment, walk us through like what does that look like? So, do you come to the house and you got the family there and you’re sitting with everybody and are you trying to dig into – besides the help the financial side, do they have long-term care insurance? What type of assets that they do have? What does that assessment look like?
[00:08:28] David: Right. Well, the assessment looks like us going, for example, I’m going to see a family this Monday and it’s a husband, a daughter, and two daughters. One of them lives out of state which is not unusual for Arizona, of course, but a lot of times families are out. They’re geographically separated, and the mother has dementia. So, I’ve already kind of talked to them on the phone and you kind of get a feel for what’s going on and you try to make sure that you’re a right fit for what they’re looking for. And so, when I go in on Monday I’m going to talk. All three of them are going to be there. The mother is not going to be there because we’ve already decided that she’s got probably mid-stage dementia and this type of a setting probably wouldn’t be appropriate for her. She’s going to get more confused and etcetera. So, one of the things that we focus on in our initial interview is level of care and you kind of brought that up with the health aspects.
So, one of the biggest things we need to make sure of is that wherever we look to place this individual that the level of care needs are going to be met. So, we’re going to talk to the family about what can mom do, what can she not do. You mentioned dressing, bathing, those are called activities of daily living. What are things that she can or can’t do? We’re going to review her cognition levels. Where is she at? Is she confused? Are there behaviors involved? And Reina and I are trained. As you know, I’m a former case manager and I used to work in a continuing care retirement community so I’m very aware of those kinds of things. And so, when we’re in there, it’s not only the things that we’re asking them we get a definitive question. It’s we’re also looking for what we’re not hearing, and that’s something that’s very important is there something going on underneath the surface? Is there a family dynamic going on? Are they trying to maybe mask some of the things that the person can and can’t do? So, we delve into all of this through a conversation then we segue into financial.
[00:10:28] David: You made a great point, long-term care policy. We’d love to see more and more people have long-term care policies. I know in your world you probably get that question quite a bit but, unfortunately, older adults, that older segment right now of the population, which is what we deal with, 75 to 90, most of them we’re finding do not have long-term care policy. So, Reina and I have found out through our work that we know that a lot of younger people just don’t think about that and it’s so important to think about your future because when you’re younger, people tend to go, “Well, I’m going to live to be, you know, I got infinity years that have in me,” but we all know as we get older, time flies by, but long-term care we look at military. I am a former veteran, a 20-year veteran. Of course, I’m very keen on the veteran aspects. Are there veteran benefits available? Why is the spouse the veteran? Is the wife a surviving spouse? There are definitely benefits out there that could be available.
The other part of the financial thing that Reina and I always look at is we don’t want to move somebody again. So, we want to make sure that we get all this right so we can keep people in their home for the rest of their life. The other part of the financial part of it would be what are their assets? You brought that point out. What do they have? Are they going to run out of money? Do they have enough money? And so, we want to make sure that we plan all of that out. So, for example, if an individual has $60,000 in their bank account and that’s their only assets and down the road, they’re going to run out of money, we have to look at that and we’re not just going to place them in a home and have their 60,000 run out. We’re going to say, “Well, maybe we need to look at are they going to have to go to Medicaid?” In Arizona, we call it Arizona Long-Term Care System, but in other states, they would know it is Medicaid and there are certain requirements for that.
[00:12:25] David: And so, we look at all of those things because we want to make sure that there’s only certain places will only take Medicaid, so we want to look at that whole big picture on the financial aspect of it. And then the other part with the psychosocial is talking to the people. What is mom and dad all about? Are they outgoing? Are they people that like to be around other people? What do they like to do in their life? Because the big part for us, we want them to have the best quality of life and that’s so important for us that they not only get the level of care that they need, but that they live a good quality of life for the rest of their life.
[00:13:04] Andrew: And you talk about the financial side of it and I think there’s a lot of confusion out there with regards to what Medicare pays, what potentially a supplemental plan pays in regards to a certain type of care but when it comes to long-term care or home healthcare or caregivers, there’s kind of that misconception a lot of people have at least we see is, “Okay. I got Medicare. I’m covered.”
[00:13:30] David: It used to be right.
[00:13:32] Andrew: But we know that that’s not true, correct? So, real quickly, what is Medicare in the scope when we look at some of the placement and the housing and the things to that nature? Is Medicare going to cover that?
[00:13:41] David: No. Shorting, Medicare will not cover it. I get that a lot, especially when I’m with Reina and we’re like, “Well, will Medicare cover my this, my that?” No. Medicare will not cover it. You know, that’s the short of it. Medicare does not cover private duty caregiving, for example. We could get into different aspects of that. I mean, if you get on to, for example, there is a military aid and attendance benefit where you could get that, a private duty, a caregiver come in the home. Also, like you said, if you don’t have a long-term care policy there, nothing’s going to cover the rent so to speak on a community or a group home. Medicare doesn’t cover any of that.
[00:14:21] Andrew: Okay. And when we think about covering this care like you had mentioned, most of those that are in their 80s now or above, they don’t have long-term care so a lot of our clients, whether they’re business owners or retirees, they look at it as, well, there are so many ways in how you can fund for this potential care. There’s self-funding, which is the hope that I never needed and if so the hope that I have the assets to have the care that I want. There’s the traditional long-term care planning which what we’re seeing as you probably see too, a lot of these companies are getting out of the business. They priced it wrong. So, what the mandate I think what we see is why people are purchasing these policies as people hate paying for something that they hope will never use and what if they don’t ever use it, that’s a lot of money to spend and then the premiums keep increasing, right?
[00:15:04] David: Exactly.
[00:15:05] Andrew: So, what we’re seeing more and more of over the last decade is these hybrid type policies, ones that we call somebody’s going to win. They may be a life insurance with the ability to accelerate the death benefit in the case of qualifying for healthcare or long-term care so that way the client knows either they’re going to die or they’re going to get sick so there’s going to be a return of that money. Now, again, it’s not maybe a long-term care policy, but getting access to the death benefit for long-term care frees up other assets. So, listeners, if you’re not having this conversation with your financial advisory team, your planner, you got to know what’s out there because what’s right for one isn’t right for the other but the key is as we look at care, I don’t know if you have the stat, David, but like when we think about where in Arizona on what the average cost for somebody who’s in a facility or a home healthcare situation. Is there any round numbers that we can get the listeners?
[00:15:57] David: Well, you mean, are you talking about like if for a placement like if somebody were to go into like an independent living or assisted living you mean?
[00:16:05] Andrew: Correct, yes.
[00:16:06] David: Okay. Always remember for your listeners when you get older, what drives everything in our industry is what you cannot do. So, it’s level of care. So, the more that an individual can’t do, they will tack on more money to it. So, to answer your question, a lot of these it’s kind of like real estate. You can go on the high-end that you could go to a place. There are places around Phoenix, Scottsdale, Paradise Valley, the Valley in general, you could go in for $7,000 a month. You could get into a place, a lower-end place. You could go get in for like $3,000 a month. Now, keep in mind the level of care has to be included in that. Now, that’s just a community and most times I got excited. People, their mouths drop open. They’re just like, “Holy cow! That is like I never imagined it would be that much,” etcetera. etcetera. But, yeah, I mean, if you want to go into a place and listing your level of care, you’re at a pretty decent level of care and you can do most things yourself, you could go into a lower end place for $3,000 a month.
We can find a place like that, but you can also go I would say the average is probably going to be more around $4,500 a month would be more of an average. And then what happens when you get into these communities, if you go in at a certain level, they have different levels of care. So, in three or four years if you are not able to do – you need assistance with bathing or showering or you need medication management or whatever that might be, communities they’ll bump you up to another level. So, I would say a decent, a nice place, monthly, $4,500 to $5,000 I would say.
[00:17:46] Andrew: And you’ve talked about this assessment, but to dig in further, I’m like what a placement agency select? What Integrity Placement does? Where we act a quarterback in a lot of cases where we help build a plan, help on investments, but we’re not tax planners, we’re not estate planning attorneys. So, what we do is we help coordinate and bring those people, the right people in for each client so that we can have a guided plan. Is that similar to what you guys do with vetting different communities and care levels and things of that nature that me as the individual trying to help mom or dad? I’m like, “Where do I go? Where I’m going to look in the phone book? Obviously, phonebooks don’t exist, but Google like I don’t know who to go to.” Is that the value that we can find from somebody like you who can bring me the right person?
[00:18:34] David: Right. Absolutely. One of the things, Reina started Integrity Placement because she saw a lot of things that weren’t being done right in the community, in our area here in Phoenix, and she wanted to do it the right way, which I know it sounds cliché, but that’s why she called it Integrity Placement because we always try to do the right thing. And in doing the right thing, we investigate all of these communities. We check their stated valuations. We vet them in the fact that we go to every place we go. We always say we wouldn’t bring anybody to a place we wouldn’t bring our mom and dad and that’s true. Really, we stand by that, but we check their stated valuations. We visit the communities. We’ve been doing this long enough. Reina’s been doing placement longer than me, about seven, eight years but we have relationships with all these communities. And as I mentioned earlier, we follow up with families. We don’t just drop them off at the front door and say, “Have a nice life.” We follow up with them. We, “How’s it going? What’s going on?” We want feedback about the community.
So, when we talk to the family like when I talk to this family on Monday, for example, I’m going to talk to them and I want them to have a comfort level with Reina and I that they know that we’re doing the best job that we can, and in doing that, we do all the investigating and so they don’t have to do it. And basically, we set up the tours, we go with them. We are another set of ears and eyes for them. We are advocates for their loved one. We’re advocates for them and making sure that they’re getting everything that they want for their level of care, the pricing, the location, etcetera, etcetera. So, yeah, we do all of that with all of these communities and there are communities we won’t go to if they do have that stated valuations, if we are getting bad feedback, if we have had people that are giving us bad experiences, etcetera, etcetera. We’re also a member of Passers which is an organization in Arizona. Well, actually they’re kind of all over the country now.
[00:20:34] David: That’s the organization where all of the placement people get together once a month and they share ideas and share common concerns and etcetera, etcetera. So, we get feedback from a lot of different venues but, yeah, we do all that for the people and we don’t want anybody anywhere where there’s going to be a problem down the road.
[00:20:56] Andrew: You know, somebody’s going to probably, “Okay. You’re doing all this work. You’re vetting the relationships. You’re ongoing making sure that things are in order and checking in. What am I paying you? What am I paying these placement agencies for all this work that you’re doing?
[00:21:11] David: Well, our placement agency you don’t pay us anything. What we do is we have contracts with group homes which we haven’t talked about and communities and we negotiate a percentage with those places. It’s done by, it’s a contractual agreement so we do not – whatever Reina and I do does not affect the price of the individual. It does not affect, you know, if you go into any of these places, it has no effect at all, and we don’t charge you. We don’t give you a bill. We are required by the State of Arizona which we have always done, we have a legal document that we present. So, when I go Monday, for example, I will present this document. I’ve already gone over this with the family and I said, “This is how we get paid,” and we’re required to show this to them, and they have to sign that we showed them. So, we’re very strict about the rules that we have to go by, by the state. So, they know right up front that we’re not charging them.
[00:22:08] Andrew: And you talk about the name of your company, Reina created Integrity Placement, you guys have a passion for taking really good care of the client, but there’s some stories out there about in any industry. What are some of the concerns that we have with agencies out there that maybe aren’t putting their client’s interest first? What are some of these red flags that we can look for as we’re trying to find a guide, a navigator, somebody to help us through this difficult time when we’re trying to help mom or dad?
[00:22:35] David: Well, I think number one would be not providing enough information and we’ve seen where some placement agencies which we get feedback because we get calls to come in and replace people which we don’t like, believe it or not. We don’t like it because we know that that’s causing havoc for the family and they have to go through the whole process again. So, I would say number one would be lack of information. A lot of times placement agencies don’t provide enough information to families with all the things I just, you know, I’m an Irish bigmouth so I’m blabbering here and I’ve been talking about a lot of different things, but all the different things I’ve been blabbing about regarding whether the financial aspects, whether they’re military, whether they’re this, the money, we find that they don’t ask them. They don’t provide enough information. The second thing we see a lot of is in direct correlation to that, people are placed incorrectly. It may be because of their level of care is not analyzed correctly. They place them in the wrong situation. That could also be due to finances.
We had somebody recently that should not have been placed in a particular home. We actually found out they had a long-term care policy which the previous placement person didn’t even discuss with the family. So, again, not delving enough into all of these different areas play. Incorrect placement I would say would be the second, putting them in a place where they shouldn’t be. And then I think the other thing that we do, I don’t know, I just think what we do differently we’re just so hands-on and we’ve seen a lot where placement people don’t follow up and they don’t keep in touch with the families. And also, like Reina and I, and then the other thing we see a lot of is placement people cherry-pick. Reina and I pride ourselves and we help everybody. We don’t turn anybody down. It doesn’t matter if they’ve got $1 or $5 million. We help people. And so, we see a lot of that going on, the cherry-picking. So, I would say that’s probably enough.
[00:24:40] Andrew: Yeah. That’s great. And again, it’s daunting information out there and like you said earlier, most families aren’t digging into this until it’s almost nuts, I would say too late, but the train has left the station, and now they’re just trying to not only take care of mom or dad and may have let’s say signs of dementia, but now I’m trying to gather all the information, maybe have to take care of their kids, still have to work. It’s like we need a partner and that’s where having that right team approach is so important. So, when we look at some of the things that you see or like before the kids and we’re looking at mom or dad and we’re starting to see some things that maybe don’t seem right, what are a couple of points that you can help us gauge if mom and dad are going down the path or aunt, uncle, grandfather, whatever it may be, what are some of those potential red flags that would cause for potentially contacting you or doctor to make sure that we’re keeping their care on track?
[00:25:43] David: Okay. Great question. I think one thing would be a new diagnosis of a progressive disease. For example, about a month or so ago, I got a call from a lady and said, “David, my husband was just diagnosed with Parkinson’s disease,” and she said, “I’d love for you guys to come over and sit and talk with me and my husband and let’s talk about what the future may or may not hold. I want you to kind of go over. I’ve got a long-term care policy. I want to look at my finances. I want to know what options are available out there.” And we love when that happens. And so, it was great, and we went in and we talked to her and him and we went over everything. So, definitely, a new diagnosis of a disease would definitely be one. Certainly, with a dementia whether it may be Alzheimer’s is a form of dementia, whether it’s a dementia, Alzheimer’s, many people are diagnosed with mild cognitive impairment. A lot of people would recognize that.
Short-term memory is the first thing that will normally have a challenge for an older adult as they get older but definitely, confusion, getting lost, going out in their car and not knowing where they’re going and just maybe repetitive stories, things like that. A lot of times when people are in the situation, families are in it, they don’t see it as clearly as maybe somebody else does. So, if there’s different, a lot of times we’ll get calls from family members that come from out of town and they’re like, “Oh my gosh, I can’t believe I’m noticing this about my mom, that about my mom.” So, definitely, I think any change in behavior that a family member or a friend is noticing I think would definitely be appropriate. And then more times than none, what happens is we get calls from skilled nursing facilities. Mom and dad had a fall or one of the other has had a fall. That’s normally what happens.
[00:27:42] David: And then the other situation that I think is a red flag is a husband and wife living together where both of them have health challenges and one of them is taking care of the other. I could tell you all kinds of stories of, you know, what ends up happening is that one of the spouses is caring for another, and they end up they both getting hurt because one of them shouldn’t be taking care of the other. So, I think another red flag would be a spouse that is overwhelmed taking care of their husband or wife and the danger that one of them may get hurt. I also think the other part is that families need to be keenly aware of the mom and dad situation when they’re both living together where I think when taking care of another spouse, that is definitely a warning sign. And I think just families being aware of a husband and wife, a mom and dad living together where one is taking care of the other, understanding what their limitations are. A lot of times we see families just kind of let mom and dad live there and go on their merry way when there’s a lot of things going on in the house that could harm either one of them. So, I would say that would be the last thing I would say would be more of a warning sign to give us a call.
[00:28:57] Andrew: And I’ve been working with clients for now almost two decades so a lot of my clients who I was working with in their late 50s, early 60s, now they’re at that point where they may need services like yours and their health is deteriorating. One thing that I think we’re pretty good at is keeping our antenna up. If there’s a potential family member that maybe has their own interests rather than mom or dad’s, what can you guys do or what do you do to help figure out who is really on the side they should be and when you sense some potential issues, or a sibling or a son, daughter, that’s maybe looking out for their own interests, what do you guys do in that case?
[00:29:41] David: Well, what we do is again going back to that initial assessment and then the interaction with the family, you bring up a really good point. So, a lot of times, kids think that there are kids out there, believe it or not, ha-ha, that they try to control, they tried to get overly involved in what’s going on. And one of the things we always are aware of is, has someone been deemed incompetent? And so, a lot of kids have this misconception that if they have a power of attorney that they can call the shots over mom and dad and that is not true. If a mom or dad is alert and oriented, they have not been deemed incompetent, they are still master of their own domain, they call the shots. And so, one of the things that we are very, very keen on is a patient’s rights or a person’s rights, a client’s right, wherever setting they were in is that they have the right, they have the right to say no, they have the right to choose. They have the right to fall, for example. They can do what they want to do. That’s their choice.
So, we kind of feel things out and it’s through our conversations with the family and if it gets to that point, we’ll talk to the mom and dad and we’ll just say, “Hey, what’s going on? What do you want?” We go back to them. There’s a lot of times we have to educate. We educate the family member and say, “Look, here’s the deal. Mom and dad can make their own decisions,” or whatever it might be but, yes, we do run into that. Unfortunately, it’s not always a good thing because we do see it where people are out for money and etcetera but the biggest advice I can give there would be have everything in order when you’re younger, living will whether it’s your advanced directives, all of those things, get them all squared away when you are not in a crisis mode.
[00:31:35] Andrew: Right. And, David, you bring up a good point there on the – we call it the fiscal house and the roof is the protection and when you’re younger and estate planning is important for everybody but ultimately, when you’re younger and life insurance comes into play you need some term insurance to protect the loved ones if you’re unable to, if you pass away and your income goes away, but also estate planning is so important. So, you bring up some, some very good points there, whether you do it on your own. We always recommend utilizing an attorney and again, we’re not giving legal advice, but something as important as durable powers of attorney. Obviously, since ’05, HIPAA documents are very important, but the key, listeners, is especially if you’re married, sound mind, and body, most of the time we see, David, that our clients will make it immediate with the spouse. So, that means one can make a decision for the other. There’s no proof of incapacity, but as you bring in a child or a loved one or a family member or a partner, somebody that maybe you don’t want to step in immediately the key component there is make sure that you work with the attorney to have it set up so it’s deemed upon incapacity.
And I know that definition can be different in each state, but you want to kind of create that protection. Not to say they’re going to do something they shouldn’t do, but we really don’t want somebody to step in until like as you stated they are truly unable to make those decisions at diagnosed by whether be the primary physician and the specialist, but it’s usually somebody working outside the scope of the primary and outside of the family. So, you want to have those provisions. You mentioned the living will, which sometimes gets confused with a living trust, but a living will is just going to dictate your wishes that if on life support or termed to be terminal how you want those end of days whether you want to keep going or you want them to do everything they can but ultimately, at the end of the day go as peacefully as possible.
[00:33:29] Andrew: These are things we don’t like talking about, our invincibility, but whether you’re 30 or 70 if you don’t have things in order, guess what, the state’s going to probably step in and that’s going to be a whole bigger mess and we got to go get then through the attorneys and jump through the court systems, and that’s not anything that you want to do. So, if you take one thing away from this episode, guys, it’s make sure your estate planning is in order, especially in the healthcare side so that the loved ones can jump in and make those right decision so great point you brought up earlier.
[00:33:59] David: Yes, I totally agree with all that. We see a lot of that. We’re seeing more and more people doing that and we’re happy to see that. But you’re right, it’s all, you know, people just kind of live for the here and now that that’s why people like you and I are trying to change that through education and information.
[00:34:17] Andrew: And then, you know, as the industry continues to change, we’re seeing it here in Arizona and you’re kind of it at the pulse of it all, right? Let’s talk a listener through as we come to somewhat of a close on today, these newer types of developments where we pay an upfront cost and we got whether it’s a house, a townhouse, but we’re basically paying. Here’s a lump sum and then you, as time goes on, you transition to a second phase, which may be an independent type of facility and then you got your third phase, which is this true assisted living and I know that this isn’t in everybody’s realm of what they can afford, but what have you seen in this regard and do you think that this is a trend that’s going to continue this kind of this tri-care of moving from one cycle to the next?
[00:35:08] David: Well, yeah, I mean, your continuing care retirement communities they’re up-and-coming, there’s a lot more of those being built, and they’re huge. So, the concept is you go in independent which I worked at one and it was great. You stay independent as long as you can and then on the same campus, you have an assisted living. So, if a husband or wife’s health deteriorates and they need more assistance that they could potentially move to assisted living. Now, even in independent living, a lot of these communities now you can still stay there. You can still stay an independent and they have nursing staff there, etcetera, that can come in and help. So, let’s say mom is doing great but dad needs help with bathing or whatever. They can have somebody come in. So, it’s not necessarily that you have to move to another location.
So, on those communities then you’ve got, you have memory care, you’ve got assisted living memory care, and you’ve got skilled nursing. So, let’s say for example, in the same community you have a person in independent living that falls and breaks the hip. They will stay on the same campus, once they’re done with the hospital bill, go into their skilled nursing. So, yeah, that is a very popular concept that’s getting bigger and bigger and I think it’s a great concept because you don’t have to move. You stay in the same place. You get to know the same people. You get a comfort level with everyone and I think it’s great but you’re right though. They can be pricey. Again, it just kind of depends on the type of the location and what services are there, etcetera, etcetera. Some of them are buy-ins where you buy in. Initially, other ones are not buy-ins. More of the ones we deal with are not buy-ins so you don’t have a, you know, it’s not a contractual thing where you’re kind of there for the long term, but it just kind of depends on what you want and what you’re looking for.
[00:37:11] Andrew: And then do you, guys, you also help with end-of-life hospice care, helping the family find the right facility or the right agency?
[00:37:20] David: We do. We provide feedback to all of our clients if they request it. Hospice care, definitely, I actually started my career in hospice, so I definitely have had a lot of experiences in hospice. Going back to what you just said a couple of minutes ago about the advance directives, that’s so important regarding hospice because if a loved one gets to a point where they can’t make a decision, what were their wishes when they were alert and oriented, so that comes into play with hospice but, yes, we do that many times. People will talk to us about hospice. So, with Reina and I, we have such a varied background in social services that we have experiences so we are able to give good solid advice we feel on good companies or with their contemplating hospice which can be a very delicate subject to talk about. Also, private duty caregivers, we have companies that we like that we think consistently do a really good job. The same with home health companies.
So, we can provide all that. We’ve also got people that we work with that are experts in military benefits and Arizona Long-Term Care System for Arizona Medicaid type thing. So, yeah, we provide a lot of those behind-the-scenes advice, services that we can provide for our clients as well.
[00:38:42] Andrew: And having spent 20 years in the Air Force and thank you for serving this great country, you had mentioned earlier that veterans may have some type of care or level of service that others might not. So, for those veterans that are listening, I know it can run the gamut based on where they live and the type of service that they had but what‘s one or two things that somebody who was in the service may not know that they have covered from the government that a normal regular civilian does not?
[00:39:15] David: Well, eight in attendance would be huge and, of course, any military people out there everybody knows what a DD Form 214 is. I know where mine’s at. That’s your discharge paper and the first thing you’re going to want to do is you’re going to want to produce that. And so, what it is, is it’s the benefit that can go into in over $2,000 a month and what they based it upon is when you were, what the dates you were in the military, where you in during the time of war. You don’t have to be in combat, but there’s a benefit that you can get. You can also get a benefit for private duty caregivers that a lot of people don’t know about. I just went out and saw. We get tons of veterans that don’t know anything about this. Kind of funny. We always wonder the government doesn’t tend to advertise a lot of that. I’m not sure why but that’s one. And then a spousal benefit too, that a surviving spouse of a military member, there is a benefit up to like $1,200 for a surviving spouse.
And there are people that will they’ll go in, they’ll do the paperwork for you, they’ll take care of all of it, and it’s going to be based upon your income. There’s criteria, of course, but a lot of people qualify there. They don’t even know that it exists. So, those kinds of things we go over with people.
[00:40:35] Andrew: Very, very important because just like with pension benefits and optimizing Social Security. If you don’t have the information, you may be missing out on lots and lots of benefit. So, listeners, if you serve this great country, make sure that you find out what’s rightfully yours. I know here in AZ, a lot of our clients have TRICARE which has been a great, great vehicle for them and it’s cost-effective and it allows and gives them the type of treatment and different type of medical servicing that others don’t get.
[00:41:08] David: Yeah. I have TRICARE, I agree with you totally.
[00:41:11] Andrew: So, throughout the show notes, listeners, you’re going to have that, all the items that we discussed and obviously those that are listening here in the Phoenix area, if questions arise, you’ll have the ability to reach out to Integrity Placement. You guys have some great reviews from a lot of happy, happy clients so that’s an important component there. So, I think if we take away today, it’s be proactive everybody. Don’t wait to the 23rd hour. If you’re sensing things, if you have questions, reach out to Reina, reach out to David, reach out to their team because information is power and that’s your passion. You guys are there. Whether it’s maybe somebody you can’t help immediately but you know if you could provide good info that they’re going to be able to make good decisions and then they’re going to lead more people to you.
[00:42:00] David: Yeah. Exactly. It’s well said. I couldn’t have done it better.
[00:42:05] Andrew: So, anything that we missed today? As we end, I think we’ve covered a lot of things high level. This is a topic that it’s not black and white. It’s gray. Lots of variations depending upon your situation, but anything we missed that you want to close with today?
[00:42:20] David: No. I think you said it all. I mean, I think that I know it’s an old cliché, but knowledge is power. I would just encourage even if you called us and just said, “Hey, can we just sit down and chat?” or whatever. Just, you know, tell me what’s out there and just be proactive like you said. I think that’s really, really important and not to wait until you’re in panic mode and we’re doing a lot, you know, venues like yours which we appreciate and we’re trying to get out the community and we do a lot of talks on aging and place and things like that throughout our community, trying to get the word out. So, I think the more we talk about it the more that we’re going to be aware and I think that’s really important for all of us, for our loved ones, and for us as we get older as well.
[00:43:06] Andrew: I love the passion that you and Reina bring. That’s something that you can’t fake. There’s a certain level of passion that’s going to help dedicate your craft, so you guys get better. You’ve been in this industry for a long time and I think that just on our end too when we help a client get to and through retirement by having a proper plan, just that piece of mind that they have, that sleeping well at night and the same connotation with the healthcare planning and that’s why although at Bayntree we do a lot of things well, I don’t know your world and that’s why we bring the right professionals in because I think from the planning side of things, healthcare planning is going to be an ever more critical piece to solving the retirement puzzle and having firms and team members like Integrity Placement is going to help us provide our clients the best advice possible.
So, I really appreciate what you guys are doing. I think Reina and I we talked about later this year getting together, putting together a workshop where we have you come and talk to some of our clients, which I think would be awesome. But this platform’s been great. You’ve said it all and in the show notes, guys, will be a way to contact Reina and David and just learn from them because they’ve been out there. They’ve seen it all and I think they can provide and guide you guys through. And it doesn’t even have – if you live in California, you could still call. It’s 10 minutes of conversation may help lead you there. So, we appreciate it, David. Have a wonderful rest of the summer.
[00:44:28] David: Thank you. Well, I appreciate you giving me the opportunity to talk to the listeners and, yeah, that’s awesome. Thank you so much, Andrew. I appreciate it.
[00:44:37] Andrew: You are welcome. Keep doing what you’re doing and, listeners, tune in later this month for another episode of Your Wealth & Beyond. Happy planning, everybody.
[00:44:50] Andrew: Thank you for joining me for today’s episode of Your Wealth & Beyond. To get access to all the resources mentioned during today’s podcast, please visit Bayntree.com/Podcast, and be sure to tune in later this month for another episode of Your Wealth & Beyond.