Senior Care Confidential

Hospital care is designed to treat illness. But for older adults, it often creates a new problem: decline.Research shows that up to 50% of seniors lose physical or cognitive function during a hospital stay, and the majority never recover it. At the same time, nearly 1 in 5 Medicare patients are readmitted within 30 days, with a large portion of those readmissions occurring within the first few days after discharge.In this episode, we sit down with Dr. Joseph Flaherty, Regional Medical Director of Geriatrics at Envision Physician Services, to unpack what is actually happening inside hospitals and why well-intentioned care often accelerates frailty.Dr. Flaherty has spent his career redesigning hospital systems for older adults, including developing Acute Care for the Elderly (ACE) Units and now leading efforts toward one of the first dedicated geriatric hospitals in the United States, set to open in Plano in 2027.We explore the concept of hospital-acquired frailty, often described as the cascade of dependency, and why simple factors like immobility, medication use, and workflow constraints create downstream functional collapse.This conversation goes beyond theory. Dr. Flaherty shares what works in practice, including his current model at Medical City Plano, where a dedicated geriatric unit prioritizes mobility, minimizes high-risk medications, and actively works to preserve independence during hospitalization.Guest and credentials: Dr. Joseph Flaherty, MD; Regional Medical Director of Geriatrics at Envision Physician ServicesMain points to deliver to audience:-Why hospitals unintentionally cause decline.-Hospital-acquired frailty and the cascade of dependency (multi-system decline)-The critical role of mobility during hospitalization-Medication-driven decline-Real-world constraints inside hospitals and what a better model looks likePractical take-aways for audience:-Immobility is one of the biggest risks in healthcare-Medication decisions have functional consequences-Families and providers should advocate for function, not just treatment-Shift toward prevention of loss of function before irreversible decline occurs.​-What’s good for the body is good for the brain. What can we do to preserve cognitive function during a hospitalization?

Did you know that in one county in the U.S., hundreds of hospice agencies were recently shut down for fraud? In this episode of Senior Care Confidential, we uncover shocking stories from the senior care world, including cases where people were enrolled in hospice without their knowledge, doctors allegedly signing orders for patients they never treated, and one region that holds about 2% of the nation’s home health licenses but nearly 10% of the spending.We also discuss how families can protect themselves in a system that can feel like the “wild west.” From understanding patient choice after a hospital stay to knowing what red flags to watch for and who to call if something doesn’t feel right, this episode sheds light on the good, the bad, and the ugly inside Medicare-funded care.

Did you know most adult children end up managing a parent’s aging like an “operations crisis,” even though the real win is having a playbook before the fall, hospitalization, or scary diagnosis? In this guest-takeover episode, Tradition Senior Living COO, Vanessa Randall, flips the script and interviews Brian and Jo on the earliest warning signs families miss, like subtle mobility changes, weight loss, isolation, and medication confusion, plus how to start the conversations families avoid until it’s too late.They also tackle what makes caregiving so hard right now: longer lifespans, the “sandwich generation,” and the hidden burden that often lands on one daughter or spouse. The episode gets practical on dementia and dignity, how to balance safety with autonomy, and why connection is not a “nice to have,” it is protective. If you are caring for a parent (especially from a distance), this one will change how you think about prevention, planning, and getting help early.http://vanessarandall.com/

Joy Care Management is now offering faith-based end-of-life doula training that most other training programs do not offer. Jo shares why the end-of-life doula is an important adjunct to palliative and hospice care.

According to The Florida Quality Improvement Organization from 2023, 18.4% of seniors are re-admitted to the hospital in the first 30 days. Other studies show 11.1% are readmitted within the first 2 weeks. There are numerous causes for this: residual illness, newly acquired frailty, medication changes, poor transition of care, etc. This is where Segue Health comes in.During your first 30 days home, they bridge the gap between you, your medical team and your loved ones. Whether it's coordinating with your primary physician, specialists, home health agencies, or pharmacist, they are actively involved. The Segue transitional care team is at your service 24/7, ready to address not only your physical condition, but also your emotional and spiritual needs.

Hear Author and Executive Director of a successful assisted living share tips on how to find the right community for your loved one.

Over 25% of seniors are considered frail or pre-fail. Frailty is NOT just ‘getting old’. It's a diagnosable condition with signs: unintentional weight loss, weakness, slow walking, low activity. Frail seniors are 5 times more likely to become disabled. The good news is that frailty is manageable and often reversible with proper interventions.

When dementia is no longer manageable, is it time for a care manager to step in? Hear tips from two dementia specialists on how to make necessary changes for your loved ones suffering from dementia.

Medicare Advantage market is still growing, though slower, but has some legal and PR challenges they are currently facing. Reports of upcoding to increase revenue from Medicare, significant increase in denial rates, and some new congressional investigations and legislation are causing the public to reconsider these plans. In today’s show, we’re discussing some plan details, the trade-offs with these plans, and some specific case studies from a healthcare provider’s perspective.

Peter Abraham, BSN, RN, Author of over 50 books discusses the difference between hospice and a death doula, as well as how to become a death doula.

Medicare is introducing the GUIDE program to assist loved ones and patients affected by dementia and alzheimer's. Arcy Healthcare of Flowermound, TX is one of the selected companies rolling out this program starting July 1st.

Heavy sedation and immobilization is an antiquated approach for those critical patients in the ICU. We know how bad immobilization is in hospitals, it’s even worse in ICUs where the stakes are higher. Today we are joined by Kali Dayton, who teaches around the country how changing our approach to patients in the ICU can lead to profoundly better outcomes for patients.

In the U.S. alone, approximately 800,000 people suffer from a stroke each year. There are 300,000 Americans living with a spinal cord injury. Traditional treatments, including physical therapy may provide limited success in some cases. Incorporating the Neuro20 PRO System can be a highly effective way to improve your overall movement potential. Whether you are suffering with a neuromuscular condition, having difficulty following a surgery, or are recovering from an injury, the advanced technology of the Neuro20 PRO System will help you achieve your goals.

Meet Dr. Hari Raja, an internal medicine physician practicing 30+ years, and hear about his concierge house call practice. It is no longer difficult to see the doctor when he can come to you. Labs, X-rays, and EKGs are just a few of the services that can be brought to you at home.

Did you know that approximately 10 million people worldwide are living with Parkinson’s Disease? Nearly 1 million in the US alone. This is expected to double in the next 15 years. Today, we are joined by Leisha Phipps, MSW and Executive Director of the Dallas Area Parkinson Society to discuss how their organization helps patients and families affected by this disease.

On this episode, we speak with Bob Bacheler, a Registered Nurse and Managing Director of Flying Angels, a company that transports patients domestically and internationally. Listen as he shares stories of escorting medically compromised patients to their preferred destination, whether it be home or a nursing facility.

Immobility in hospitals leads to significant decline across multiple body systems. This often leads senior patients to have poor outcomes long term. Today, Lesley Williamson joins our show to discuss preventative strategies in the hospital, including the ICU.

Jo and Brian discuss the increased number of claims being denied by health insurance companies. They share tips on how to appeal and overturn invalid claim denials.

All seniors prefer to live at home and age in place. On this episode, we speak with Girish Sabari about telehealth and remote patient monitoring in the home, creating a pathway of communication between the patient and the doctor.  This helps prevent unnecessary ER visits and medical crisis situations.

Hospital Acquired Frailty is a precipitous multi-system decline due to immobility while in a hospital that is often preventable. This lack of movement creates a cascading ‘doom loop’ that can happen with breathtaking speed. Learn what it is as well as how to avoid it on this episode.

28% of seniors live alone in the United States, and there are great ways to stay at home and avoid moving to a nursing home. Laurie Miller, with Apple Care and Companion & Age Tech Now, discusses safe ways to stay in your home as you age using technology, community resources, and Medicare services.

Did you know that 90% of people with Parkinson’s are at risk of developing a weak voice that can lead to life-threatening swallowing complications? Aspiration, choking, reduced cough reflex and even malnutrition can be consequences of weakened muscles that control speech and swallowing. To make matters worse, some studies show that over half of adults with communication disorders experience suicidal ideation. On today’s episode, we’re talking about the Parkinson’s Voice Project with their COO, Hilary Byatt. We’ll learn people with Parkinson’s have much more control over their movements than they might think. Understanding the role of dopamine and the concept of INTENT can help people with Parkinson’s and their families live better lives.

Since the onset of COVID, standards of care have been compromised. What was once not acceptable, is now often the norm. How do you protect your loved ones with dementia living in memory care communities?

There is no such thing as a free lunch, or in this case ‘free or lower premiums’. There is ALWAYS a cost. Open enrollment is about to begin for Medicare and Advantage plans. As providers, we handle a lot of questions around these plans…specifically: Why they are no longer on Medicare when they were told they were being signed up for a ‘cheaper Medicare plan’? Why are there denials when my plan was supposed to cover everything Medicare covers? How can I change back to my original Medicare plan? We’ve gotten to see firsthand the tradeoffs of these plans that many seniors were not prepared for. This show will uncover the history of Medicare and Advantage plans, their intended use, as well as the hidden side of the actual costs of these plans.

There are 8.2 Million seniors are affected by wounds in the U.S. annually. Medicare spends $97 Billion dollars per year to treat them. We’re seeing more wounds and higher severity since the pandemic. Today, we are joined by Dr. Jenna Wishnew and Marina Lakhmanchuk, PT, DPT to discuss prevention, treatment strategies, as well as when to call in the specialist.

Medicare has been prohibited from paying for weight-loss medication since 2003. The Treat & Reduce Obesity Act of 2023 is opening up discussions to make Ozempic available.

In this episode, we'll dive into best practices, strategies, and real world examples that demonstrate how effective case management can improve patient outcomes, streamline hospital operations, and reduce costs. Our expert guest, Lesley Williamson, RN will share their experiences and insights on coordinating care, navigating complex healthcare systems, and how to find the best resources in order to enhance patient outcomes. Tune in to learn how hospitals can optimize patient care and achieve better health outcomes through effective case management.

Did you know that approximately 1 in 1,000 people worldwide are affected by lymphedema, with over 200 million individuals suffering from this chronic condition? In this episode, we dive deep into the world of lymphedema, a condition causing painful and persistent swelling, often in the arms or legs. We'll be joined by a leading expert who will discuss the latest statistics, uncover the root causes, and reveal innovative treatments offering hope and relief. Whether you're a patient, caregiver, or healthcare professional, you won't want to miss this insightful and empowering conversation on lymphedema and the groundbreaking therapies transforming lives.

What if comorbidities (multiple medical issues) aren’t isolated events requiring numerous medical specialists to treat? What if there is a root cause that is the culprit in many of these? Today, Jo Alch and I delve into the concept of metabolic dysfunction and talk about a new book, Good Energy, by Dr. Casey Means.

No one ever says, "When I get old, put me in a nursing home." Many seniors have disabilities that make it no longer safe for them to be at home. Assisted living communities are a great option for seniors who want to stay active and independent. There are some challenges with moving in that can be avoided by working with the right professional individuals.

Listen as Dr. Peralta discusses hospice, palliative care, palliative sedation, and euthanasia.

Financial fraud against the elderly has doubled in the last couple years to more than $3 billion annually. Perverse individuals and companies are taking advantage of seniors, stealing their hard earned money they need for their sunset years. Many older adults and their families have no idea until it’s too late. On today’s show, Melissa George, a gerontological nurse practitioner, joins us to discuss situations her own patients have been exposed to and some simple steps families can take to prevent this happening to their loved ones.

While there are a lot of resources in helping care for an aging loved one, the variety of care options, rules and who pays for what can create a maze of confusion. We get common questions on what Medicare and medical insurance covers as well as some misconceptions. For example, what is the difference between home care and home health? Who pays for it? How long does Medicare cover care? And many more…On today’s show, Jo and Brian discuss some of these misunderstandings as well as some myths about senior care.

Unfortunately for many people suffering from dementia, treatments with medications have provided limited success. What if dementia wasn’t a diagnosis, but a symptom? And our current treatment strategies are aimed at fixing a symptom vs root cause. What if there are other there are other treatments that aren’t found in the big pharma sponsored studies in the major publications?Priscilla Romans of Graithcare joins us today to discuss these as well as the success many people are seeing through the use of hyperbarics.

Hear Jenni Knutson, Senior Life Care Manager, discuss the difference in assisted living options and how to advocate against suspicious behaviors and possible abuse.

The hip is one of the hardest working joints in the human body, tasked with supporting the weight of our upper torso and giving us the ability to walk and move. So, when things go wrong, the consequences can be serious. Historically, the only solution to hip pain may have been a total hip. Now with hip preserving procedures, there are options with good long-term outcomes other than a total hip.  The goal is to get patients up and moving quicker to a faster recovery.

Alzheimer's affects 6 million Americans, with another 12 million Americans that are unpaid caregivers. The cost of these unpaid caregivers is approximately $100 billion annually. McDonald's corporate revenue was only $23.8 billion in 2022.

DispatchHealth is an in-home acute care option for those that would like to avoid long waits at the ER. Bringing the power of the hospital to the comfort of your home.

A New England Journal of Medicine study showed 1 in 4 patients experienced harm after being admitted to the hospital. Another study showed those that were admitted after an ER visit had nearly a 4x higher risk for adverse events. These stats are alarming, but it’s even worse…adverse events are things like preventable infections, falls, etc. But while we can’t find statistics on this, negligence seems to be on the rise and these numbers are sometimes not included in data for adverse events. A so-called Cascade of Dependency results from the hospitals not ensuring enough time out of bed.

The cost of senior living continues to explode. How can adult children prepare for the cost involved with caring for their aging loved ones?

Much like health insurance plans, there's a lot of confusion around long term care insurance plans. Unfortunately, when someone needs to access these long term care insurance plans, they are often struggling physically and sometimes cognitively. Today, Eric vanGoethem and I discuss details of these plans, questions to ask, and local resources to connect with.

Nurses are assaulted by patients every hour. How can we protect ourselves while still providing the best care for our patients.

Too often, veterans and their spouses or families are unaware of eligibility for financial assistance from the government through the VA. Recent stats show that roughly 25% of Americans over 65 y/o can qualify, but many are unaware.On today’s show, Brian and Eric vanGoethem discuss this important benefit for the men and women who sacrificed for our country.

Ozempic is the latest craze for quick weight loss... but is it healthy? And is it right for seniors?

Funeral planning is inevitable, whether you are ready or not, and it should be a part of the estate planning process. Logan Roberts, Social Worker, discusses how to make funeral planning less scary.

Tina Thompson, Director of Sales And Business Development with Amatus Hospice shares how keeping a positive outlook, even when terminally ill, can help you find purpose.

Our world is looking a lot more like the Jetsons every day. Robot vacuums, 3D printers, drones, and all of these wonderful technologies make our lives even better. ‘Age tech’ is also gaining some steam and companies are coming up with innovative solutions to help seniors stay in their homes longer. However, there is a major problem with this…of all of the solutions out there, how does one know which ones will work best for your loved one? Laurie Miller joins me today to discuss some really amazing technologies and how she curates them for her clients.

Billy Chemirmir was found convicted for murdering two seniors and is suspected in the murder of two dozen others. Today, we are joined by Robert MacPhee, son of one of the victims and Partner with Secure Our Seniors Safety, an organization that works with legislatures to improve safety for seniors.

Before signing up for your Medicare services, always consult an expert. Commercials aren't always what they appear.

Being a patient in a hospital or healthcare environment can feel a lot like being a passenger who’s simply along for the ride. Multiple departments and specialties, confusing paperwork, sometimes conflicting medical advice, errors, etc. all can contribute to increased stress, and in some cases, poor outcomes. Today’s guest, Priscilla Romans, has built a company to help families address these issues by helping them navigate and advocate for themselves in these situations.