The Power of Proactive Planning in Aging and Care Management with Joan Harris (Ep. 25)

What does planning for a fulfilling future look like? 

Abbey Henderson, CFP®, CEO Wealth Advisor & Coach, connects with Joan Harris, founder of Symphony Care Management. They explore practical strategies for managing the present and preparing for the future, especially concerning aging well.

In this insightful discussion, Joan Harris unpacks her unique Aging GPS program designed to proactively assist older adults in aligning their time, finances, health, relationships, and mindset with a fulfilling vision for the future. They also shed light on common misconceptions about Medicare and financial planning for long-term care.

Key discussion points include:

• The importance of early planning and the Aging GPS approach 
• Navigating the spectrum of retirement living options 
• Understanding the role of advocates in medical settings
• Debunking myths about financial requirements for elder care 
• Encouraging family involvement without sacrificing personal lives 
• And more!

Connect with Abbey Henderson: 

• LinkedIn: Abbey Henderson
• Abbey@AbarisFinancialGroup.com 
• Website: Abaris Financial Group
• Facebook: Abaris Financial Group
• Facebook: Abbey Henderson: Trusted Financial Advisor & Coach
• Instagram: @trustedadvisor_coach
• LinkedIn: Abaris Financial Group
• X (Twitter): Abaris Financial Group

Connect with Joan Harris:

• Symphony Care Management, LLC.
• LinkedIn: Joan Harris, LSW, MBA, CMC
• Facebook: Symphony Care Management

About Joan Harris:

After graduating from Boston College, Joan started her 40-year career in elder care as a Case Manager for a Massachusetts state-funded Area Agency on Aging. This fundamental and valuable experience helping vulnerable seniors to remain in their homes avoiding premature institutionalization, training in case work as well as protective services ignited her lifelong passion for working to benefit the lives of older adults and their families.

Joan has a dedicated focus on working with adults over 60 who have complex life issues, mental health challenges and Alzheimer’s Disease and related disorders. As a highly skilled Social Worker, she advocates for her clients, mediates family dynamics, and empowers her clients to participate in their decision making. She provides coaching and creative strategies to support her clients’ care partners with a focus on meeting the client’s goals. Her varied experience as a Discharge Planner in a hospital, marketing sub-acute services in a skilled nursing facility, and marketing retirement and assisted living communities.

Respected by her peers, she served on the Board of Directors for The New England Chapter of the Aging Life Care Association from 2017 through 2023 serving as president in 2018. Joan was awarded the highest designation in her association, a Fellow of the Leadership Academy currently given to only 34 out of 1700 Nationally Certified Care Managers across the country. This title requires Joan to continue her dedication to the education about elder care in the community at large and mentorship of newer colleagues.

Joan enjoys spending time outdoors with her family, seeing what will grow in her garden, and traveling to new destinations.

Transcript

00:00:01  

Voiceover

Welcome to Wealth Beyond Riches with Abbey Henderson, CEO, Wealth Advisor, and coach at Abaris Financial Group. In this podcast, we help generous, fun, and passionate professionals overcome their biggest financial concerns while leveling up their lifestyles based on their values. We do this by exploring the five levers, which represent the diverse resources each person possesses throughout their lifetime. These levers encompass finances, health, mindset, relationships, and time, offering a holistic approach to personal development and growth. Join us on this transformative journey as Abbey and her guests draw from years of experience to guide you in achieving your life goals while staying true to your values. But that's not all. This podcast will equip you not just to build personal wealth, but also to understand how your prosperity can contribute to the betterment of the world around you. By exploring strategies for giving back and making a positive impact, we'll empower you to create a life of significance and leave a lasting legacy of positive change.

00:01:08  

Wendy McConnell  

Hello and welcome to the Wealth Beyond Riches podcast with your host, Abbey Henderson, where we talk about enriching your life in every way. I'm Wendy McConnell. Well, hey Abbey. How are you?

00:01:19  

Abbey Henderson  

I am well. How are you? And Happy New Year.

00:01:22  

Wendy McConnell  

I'm good. We're getting right into the midst of the new year. We should be all settled in and down to our new resolutions and routines, right?

00:01:31  

Abbey Henderson  

I have my list.

00:01:35  

Wendy McConnell  

Good for you, good for you.

00:01:36  

Abbey Henderson  

We'll see what happens with the list, but I've got it. All right, all right.

00:01:40  

Wendy McConnell  

We do have a guest today.

00:01:42  

Abbey Henderson  

We do. And as always, I am so excited because I happen to know some of the most fantastic people. This week we are going to touch on the topic of managing the present and planning for the future in aging well. As most of our listeners know, here at Abaris, we really believe in the importance of aligning your resources, which we consider to be time, finances, health, relationships, and mindset, with your values, vision, and purpose. I can't think of a better person who really lives this with her clients than Joan Harris. Joan, we're so excited to see you.

00:02:31  

Joan Harris  

Thank you for having me. I'm excited to be here.

00:02:34  

Abbey Henderson  

Yeah, of course. So let me sing your praises first and then I will turn it over to you. Joan Harris began her 40-year career as a case manager for the Massachusetts State-funded Area Agency on Aging. Since then, her diverse experience has included work as a licensed social worker, discharge planner in a hospital, marketing in both skilled nursing facilities and assisted living communities, and geriatric care management. In 2017, she founded her company, Symphony Care Management, which is a concierge care management firm that specializes in helping older adults and families work through complex diagnoses and the challenges of aging and meeting their goals. You've covered a lot of ground in your career, Joan.

00:03:32  

Joan Harris  

Yeah, I mean, I think one thing leads to another, which is the journey that many of us are on. For me, when I fell into elder care, I had kind of found my people. It's just, you know, my passion and my love. I think every experience you have, you learn. The other environment I was also in was the private home care industry, which is really interesting so that the body of experience then allows me to understand what my clients need and advocate for them. It is that cumulative, as with any consultant, that cumulative knowledge of an industry and about a certain type of stage of life and people that gives us the opportunity to really work for the client.

00:04:23  

Abbey Henderson  

And, you know, I know in your firm you have a special approach to working through all of this with clients, and I believe you call it your aging GPS program, is that right?

00:04:33  

Joan Harris  

Yeah. So that is one program that I've developed in more recent years. Concierge care management is kind of our bread and butter. We're jumping into the situation. Over so many years I've done this where people haven't planned and it's kind of a mess, and people come to us because they're stuck or they're in a crisis. At this stage of my career, when I opened my own practice, I really wanted to try to get to people before then. That's when I developed aging GPS: Goals, Strategies, Priorities. Actually the other way, rather. Sorry. It really is about prevention and being proactive. I know that really resonates for people like yourself who are helping your clients to plan ahead. My whole theory is, and it has really proven, that when people understand deeply what their needs are, what their vision is, and what their options are, they have so many more choices and they have better outcomes because they can avoid a lot of the crisis that we see in day-to-day care management. As I developed this program, I have found that people in their 60s and 70s are actually quite anxious about the future. Maybe their kids live out of state, so they don't have a robust support system. They don't really understand what the options are because it is not a user-friendly type of industry. To have someone come in who, because we're nationally certified care managers, we can never benefit from any referral that we make. We truly work for the older adult. We can look at, after my 40 years, I can really look at the person and all the data around them, their financial picture, what their cultural context is, you know, what kind of environment they want. Just really the path of what's going to be helpful for them opens up to me. I can put that together in a way that educates them. We go on this journey of really identifying a plan. But the big piece that I don't think people realize is that, you know, there's so much they can do before they make big transitions to really prevent problems. That's really my mission with aging GPS is to be planning and educating and preventing problems.

00:07:00  

Abbey Henderson  

And so tell me a little bit about sort of when you think the ideal moment is for someone to explore this with someone like you.

00:07:11  

Joan Harris  

So that is the big question and the big definitive answer is now. It is absolutely never too early because before you have a problem, you're much more able to learn when you're in a crisis that window of opportunity to really learn about your options is gone. You're just grabbing at something that is available that may or may not be the quality that you need and want. I am happy to get to people in their 50s, 60s, 70s, and oftentimes I find, well, healthy, independent older adults that are living an independent life. But maybe there's a diagnosis of, you know, macular degeneration, they're losing their vision and maybe the spouse had cancer in the past and she's okay, but they just feel anxious because even though they're independent now, they don't know what the future holds. The interesting part of that has been that I created this program as a one-off, give you the plan, hand it off to you, you understand all the keys to the kingdom, all the things you need to age in place and be well, and then what your options are as well as your emergency backup plan. But for people who don't have a support system, and there's a lot of studies out about the solo ager or people who just they have not a lot of people in their life for whatever reasons they have said to me, but now I know you, is there any way that, you know, we could just keep it. You can be there for us if we need you. That's the beauty of having your own practice and is that we've now created a program for people who then want to just be on board with us so they can reach out to us. We reassess quarterly, we have ongoing conversations. They can call us anytime. We can go to the ER. If they go to the ER, we can jump in. So now we have the solo agent membership program. So for those people who have a plan, who don't have a support system, they know that they have help if they need it. That's the fun part about all of this, is that we can create whatever support system people need at any point in time along their journey. Sometimes our independent folks then need care management because they have a new diagnosis or, you know, 85% of our caseload in care management there's some form of dementing illness. We have a dementia expert in our practice, we have a nurse care manager in our practice. We can support people from independent through the end of life. That's really our goal.

00:10:03  

Abbey Henderson  

I did not prepare you for this question, but I'm curious.

00:10:08  

Joan Harris  

Bring it on.

00:10:09  

Abbey Henderson  

I'm excited to talk about our sort of case studies and examples, but I'm curious if you had like what your process is for helping people come up with a vision for what it is that they want.

00:10:23  

Joan Harris  

So I know that there are lots of people out there who are doing really in-depth visioning exercises. But for me it really is about going to someone's home and really understanding and seeing who they are and asking those open-ended questions without thinking about it. When you think about 10 years from now, what does that look like? Have them write a letter to their future self, where are they? What does that look like? Very specifically, what's the environment? Is it rural? Is it country? Is it state, city? Is it a large community? Is it a small? Because they do have some idea, but they just need to tease it out and start to talk about it. Do they want to be near their daughter who lives in New York? Okay, we can do that. Once they start to really understand it, then we can put it together. It's all about the fit between what they need and what they want and then what is out there for them. Once we understand what they're going to need, for example, a married couple, she has Parkinson's, he's pretty healthy, they're early 80s, they're active. But we know because we have so many clients with Parkinson's disease in our practice over the years, we know what that path looks like, we know what she's going to need down the road. To put her in that community, which might be really good, community A versus knowing what community B will offer to her when her disease progresses, there is a whole thought process behind why we're steering people in certain directions and making sure they have that scaffolding, those layers of support to keep them really independent and make sure they have the support that they need. I think the conversation and helping people to understand either what they don't know or what they realize they really want, they haven't really said it out loud is really the starting point for me.

00:12:32  

Abbey Henderson  

Yeah, I love that. I love the fact that you go to their home because I think you can learn so much just being in someone's environment and also that you look at this as a long-term relationship because I'm sure this all evolves over time in ways that your client and maybe even you didn't necessarily foresee.

00:12:52  

Joan Harris  

Yeah. I think sometimes people say, great, you gave me what I want, I'm good, and we're going to close. They know the door's open. Oftentimes six months or a year down the road, when something changes, they're back. From my practice, we have that kind of open door. In fact, that happened today. Somebody came back and we welcomed them back because they need to know that they have the flexibility to create the scope of work when they're ready to do so.

00:13:24  

Abbey Henderson  

Yeah, yeah. So let's pivot to some of the common misconceptions that I'm sure you hear all the time. I hear it as well in my office, and perhaps the biggest one, probably more so early on, but a lot of people think that should they need services, that Medicare will take care of it. Do you hear that a lot?

00:13:55  

Joan Harris  

Yeah. Oh my God. They're so shocked that the hospital, especially when we jump into someone who's hospitalized, who needs discharge planning, and often they are surprised that the government isn't going to arrange and pay for someone to be at home for them. The certified agencies, which we used to call visiting nurses, that come in with nursing and physical therapy and occupational therapy, which is part of the Medicare system, is, you know, three times a week for an hour. It's short term. That is a rude awakening to them that they have to pay to have the care at home. In our practice, we work with people who have little to no money, all the way to people who have a lot of money. That shock factor is still there because until you're in that situation, if you haven't had the education and the plan ahead of time, you just, you know, we all have these bubbles of assumption. Right. Unfortunately, that bubble is burst and people understand that we can set up private care services and create a care plan and support people home or get them into the best possible rehab and then home. But they are that Medicare is part of medical, and it pays for doctors and rehabs, but it will not take care of you at home. That's really hard for people who have plans for that.

00:15:32  

Abbey Henderson  

Well, and I know one of my recent misconceptions was that a hospital will do a great job at your discharge plans as well. I think we all make assumptions about what I think these institutions are going to do and how they're going to do it. To have someone like you as part of that process, I think is priceless.

00:16:01  

Joan Harris  

Well, it's unfortunate. We have good people as discharge planners, case managers. There's a lot of terminology that's also really confusing to people. Case managers, social workers in the hospital, they work from the hospital. Their job, unfortunately, is to get you out when Medicare says you no longer need to be in that setting, no matter what your needs are. A big role of care managers is we are patient advocates, so we will put up a hand and say, this is unsafe. We know the words that need to be said that will keep that person in an acute care setting until we can set up the appropriate discharge plan. Unfortunately, post-Covid, it's even worse. I had a client who lives in a memory support program in assisted living be sent in the middle of the night in a taxi back to the assisted living from the hospital. These things are happening. What's really important is no matter how old you are or how mentally sharp you are, if you're the person in the bed, you need an advocate. When you're having a medical event, you can't be that advocate for yourself. Whether it's a family member or a care manager, it is a systemic problem. It is not because the social workers don't want to help. I can make myself sound really old to say back when I was a case manager, I mean, we had time in the early 90s, we could dig for resources, we could put a whole plan together. Unfortunately, Medicare has cut all of that out. These very good people in the hospitals do not have the time. Basically, what they do is get an order for certified services. That's what they do. Or send you to whatever skilled rehab facility has an open bed. You may land where you may land. What we do as care managers is we have relationships, meaning we have credibility and we know the good facilities and we can support our clients going to the high-quality places. Sometimes if there's no bed available, there's no bed available. I think for families who are struggling with these systems for their loved ones, having a professional stand by your side and say, we can do it this way, or here's what you need to do to help your loved one is just a really good support system, even if it's a short-term need. Those are many, many of the ways that we can help.

00:18:44  

Abbey Henderson  

Well, and you also mentioned earlier that it's about a good fit and that can be very nuanced judgment that, you know, certainly for families where this is their first time in these, dealing with these institutions, in this situation, there would be no way really of knowing the nuances that are part of that.

00:19:10  

Joan Harris  

Right?

00:19:12  

Abbey Henderson  

So you alluded to the next misconception was that people think that they need a lot of money to plan like this. Is that true?

00:19:21  

Joan Harris  

Yeah. So this is a really interesting question because certainly how much money you have does determine kind of what options are open to you, but there are always options. I think the message I want to get across to people is that there are low and moderate income programs in both independent living and assisted living communities that nobody knows about. You can have an assessment from a care manager. We understand income assets, we don't get involved in finances, but we understand kind of that ballpark so that we know that if somebody is going to go long term somewhere to a community setting and they may not have enough funds to take them the whole way, then we need to make sure that we're educating them about the communities that do have some options that they can transition to. These are really important conversations because I've often gotten cases from elder law attorneys who are working with people on, you know, mass health eligibility and so forth. But the family will come to me and say, we thought she'd qualify for a program. She doesn't. We don't have any more money. We have to get her to a nursing home. I'm like, nope, you don't. There's a community that has a PACE program which is a government-funded program that she can get on and we can keep her out of a nursing home. It's just really hard for the consumer to know all these programs. But I think people only want to move once. We want to make the right move and we never want people to go to a setting where they would have to leave where they're thriving and living their best life because they're running out of funds. Having the education on this end, even if it's, I'm in an independent living community, but I know what the steps are down the road, and I don't have to worry that I would have to leave. Those are really important conversations. It may limit some of the options, but there are options.

00:21:31  

Abbey Henderson  

Could you maybe say a quick word about, because you mentioned independent living and then assisted living. Just say a quick word about maybe what the spectrum of options are and some of these terms that people might not be familiar with.

00:21:46  

Joan Harris  

Yes, we'll do retirement living 101 in 60 seconds. Let's do that.

00:21:50  

Abbey Henderson  

I love that. Perfect.

00:21:52  

Joan Harris  

So retirement living encompasses different ways of paying for things. If we start from the top, it is a deposit community where you hand over basically money from your asset of your home or a big chunk of money, and you go into independent living. They may have some assisted care or assisted living and a nursing home attached. We call those continuing care retirement communities. But for many people, they could go to an independent living community that's a rental and hold onto their finances. They would really work with you on what was the best way to utilize their money and their funds. But independent living means that there are amenities and services like meals and programming and transportation and housekeeping, but no personal care services. If you need assistance with bathing or showering or dressing or medication reminders, and you are living in an independent living community, they don't offer that. You would have to bring that in from the outside. Oftentimes people age in place in their home and they don't choose to move to an independent community. They move when they really need that holistic personal care support so that they can live in a residential setting, which is what assisted living is, but have assistance with daily living tasks like bathing, showering, dressing, medication reminders, help with transfers, escorts to meals. Those are not reasons for someone to be in a nursing home, because it is. Those aren't things that require a nurse. The good news is, is that over the past, you know, 30 years or 40 years, that assisted living has grown nationwide. We've been able to keep people out of nursing homes. Sometimes people need to go at the end of life if they really need that medical model to keep them comfortable. They need nursing, medical intervention to keep them from being in and out of the hospital. They're medically complex, but oftentimes we can bring hospice in to assisted living and even add some private care and keep people in their home setting through the end of life. We have independent living, assisted living, and skilled nursing facilities which are nursing homes. Rehab, rehabilitation takes place in nursing homes short term or some people live in nursing homes long term. That's the continuum.

00:24:30  

Abbey Henderson  

And your description just drives home the point. I think that there's just so many different ways to put these pieces together and to have someone who really knows how to navigate it. It can just be so helpful in finding the right solution.

00:24:45  

Joan Harris  

You know, oftentimes I'll tour a community with a client, as will my team. They know the minute they walk into a community in their gut how it feels like people know. But you have to get out there and you. It's very experiential. You need to do that before you need it.

00:25:06  

Abbey Henderson  

Which is the perfect segue into my last misconception and the one I try to avoid with my clients and get ahead of. But I do hear it a lot. I don't need to plan right now. I'm healthy, I have plenty of time.

00:25:25  

Joan Harris  

That's what we call the head in the sand, the ostrich approach.

00:25:29  

Abbey Henderson  

Yes.

00:25:30  

Joan Harris  

I think it's human nature. I mean, people don't want to think about it. Right. Some people, I think just by nature, and I'm sure you see this, are planners and some are not. We have many people who just don't want to think about it. For us, one of our superpowers is how we frame things in a way that just feels safer to people. I think there is this fear that if I look at these communities or if I start to think about it, then it's going to happen. Like if I had a nickel for every client who said, you know, I'm leaving my home first, you know, I'd be retired by now. I mean, people want to be at home. Change is so difficult. The other thing to understand is that when people do have a neurodegenerative disorder like Alzheimer's, even early onset or early stage, it's not that they're in denial. They actually can't see their deficits. Why do I need something if I don't think I need it? It's a really difficult equation for a family who doesn't have the strategic skill set to work around the resistance. That's really where we come in. As the objective outside expert, because we understand the resistance, we can see what the needs are. But every time you try and talk someone into something, you're going to fail because they may not have the reality orientation or that it, they're just resistant. We deal with a lot of mental health issues. People have anxiety, depression, the whole gamut and all the combinations thereof. I think part of it is just that's a very emotional statement because I don't want to think about it. If we can just have a meeting with someone and say, you know, we're planning for way down the road and start the conversations and engage the families on how to have those conversations, then we find that we can move things forward to start that process of planning.

00:27:48  

Abbey Henderson  

And, you know, I think it's a reality. We all have to acknowledge that there is plenty of time until there's not. Sometimes things can sneak up very unexpectedly. I think sometimes in our heads we imagine maybe a slow decline towards this scenario, but it can happen in a matter of weeks.

00:28:11  

Joan Harris  

Yeah, yeah. I think what we find a lot with people who have memory impairment is that they're fine in their routine and they're in their long-term environment, so they can access their long-term memory in that environment and they're in their routine, but they have an illness, they're in the hospital and all of a sudden they're confused and, you know, they're not going to get back to where they were. I know I'm talking a lot about memory impairment. It is very pervasive. But, you know, a broken hip. I have a wonderful client who, she was recovering from a broken pelvis. We were doing all sorts of planning and she was on the phone and getting everything in place and she, a couple of weeks later she took a walk in her family room and her hip gave out. Oh, and she has osteoporosis. Here she is, you know, planning for the future and she's kind of back at square one. But who could have expected that? Things are in place now. We're moving forward because we had already started those very robust conversations. But you know, unfortunately life is unpredictable. The other thing is that as people get beyond kind of mid-80s, they don't have the bounce back when they have an incident that they might have when they were in their 70s. Statistically it is not, you know, if you're going to have decline, it's a matter of when. Focusing on how we can be well and healthy now, which I know is your mantra, is really going to help people to meet their goals. Whether that's staying in their beautiful old home that isn't designed for older adults or making that transition to a retirement community. It's all what they're doing early on that is going to make a huge difference.

00:30:13  

Abbey Henderson  

Well, I could talk to you all day about this, I think, but we need to bring this to a close at least for this episode. What would you want listeners to take away from this episode if they could only take away one thing?

00:30:30  

Joan Harris  

Don't struggle on your own. So many adult children are really giving up the best years of their life with their families because they're doing so much for their parents and yet there's so much help available. I talked to a woman today who, you know, dad is failing with Parkinson's. They now really need placement. I was so glad she called because she has really sacrificed so much of her life to help her parents. I want people to know that we can support you this much or that much, but the help is there and it's available. I think, you know, the Aging Life Care Association, aginglifecare.org is our national association. You can plug in a zip code and find a nationally certified ethical care manager anywhere in the country and help is available. We're all different. We all have different backgrounds, but don't struggle on your own and don't wait until things are really a mess. Get help early on.

00:31:37  

Abbey Henderson  

I love that. So where can our listeners find more information about you and your company?

00:31:45  

Joan Harris  

So we are here. We're available, we're growing, and we'd love to hear from people. We actually always make sure that people who call us who are not in an area that we can serve, we're always going to connect them. We love to be a resource. They will get me when they call. It's symphonycaremanagement.com.

00:32:08  

Abbey Henderson  

Perfect. And I know we can also find you on LinkedIn because I have found you there myself.

00:32:13  

Joan Harris  

Yes, definitely. It's a great community.

00:32:17  

Abbey Henderson  

Well, thank you so much for joining us today. I so hope our listeners really take to heart your message to not struggle alone because I think that's such an important thing for people to take permission to do.

00:32:33  

Joan Harris  

Thank you so much for having me. Anytime we can get the word out that care managers exist and help is available, it's a great day for us. So thank you so much.

00:32:44  

Abbey Henderson  

Yeah, you're so welcome.

00:32:45  

Wendy McConnell  

Abbey, if somebody has some more questions for you, like how do we get in touch with Joan or anything else that we've talked about? How do they do that?

00:32:53  

Abbey Henderson  

Well, I love to hear from people, so email is probably the fastest, most direct option and that's Abbey@abarisfinancialgroup.com. Otherwise, you can find us on all the places. So Facebook, Instagram, LinkedIn. Our website is www.abarisfinancialgroup.com and like I said, we would love to hear from people.

00:33:15  

Wendy McConnell  

All right, well thank you both of you and thank you for listening today. Please like, follow, and share this podcast with your friends.

00:33:23  

Voiceover

Until next time, thank you for listening to Wealth Beyond Riches. Click the Follow button to be notified when new episodes become available and be sure to visit our website at www.abarisfinancialgroup.com. The information covered and posted represents the views and opinions of the guest and does not necessarily represent the views or opinions of Abaris Financial Group. The opinions voiced in Wealth Beyond Riches with Abbey Henderson are for general information only and are not intended to provide specific advice or recommendations for any individual. To determine what may be appropriate for you, consult with your attorney, accountant, financial, or tax advisor prior to investing. Guests on Wealth Beyond Riches are not affiliated with Abaris Financial Group or New Edge Advisors, LLC. Advisory services offered through New Edge Advisors, LLC, a registered investment advisor.