Jaime Estremera-Fitzgerald is a CEO on a mission.  As head of South Florida’s Area Agency on Aging (known locally as Your Aging and Disability Resource Center), Jaime leads a team that serves seniors, adults with disabilities and the people who care for them in Palm Beach, the Treasure Coast and Okeechobee Counties.  Jaime explains how the Center connects people with a vast array of home and community-based services designed to help people continue to age in their homes. Their services include directing people to respite care services, providing tools to fight the exploitation of elders and guiding people through the maze of Medicare and Medicaid enrollment. Jaime also talks about caring for his own parents, his complex emotions around moving his father into an assisted living facility (ALF) and how his father’s Cuban and Puerto Rican heritage influenced their choice of ALF.  There is an Area Agency on Aging in every county in America. Find yours here: Local AAA.  Note: this episode originally aired December 15, 2016.

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INTERVIEW TRANSCRIPT

SOUND OF PHONE RINGING

JAIME:  Good morning, Jana!

JANA:  Good morning, Jaime! How are you?

JAIME:  Hey, I’m incredible. I tell you, I feel blessed. Especially when I got off the freeway today and I was parking my car in my back of the building, and I went to my trunk to get my case and notice my left rear tire had a bulge coming out of it. I took my car right to the dealership right here. I gave it to him to fix whatever the heck it is, but they told me, wow, good news it didn’t pop on you on the freeway going 80 miles an hour. So I feel extremely blessed this morning. I could be on I-95 with a flat tire, let alone, who knows what might have happened.

JANA:  You started the day on a good foot.

JAIME:  I did and now I’m even– now with your voice and talking to you, I’m even better.

SHOW INTRO/MUSIC

JANA:  By the year 2030, more than 70 million Americans will be age 65 or older. Right now, 90% of folks in this age group say they want to stay in their homes for as long as possible, which means now and going forward, there will be a huge demand for home and community-based services, which are a fraction of the cost of institutional options like nursing homes and skilled nursing facilities. These home and community-based services are provided by America’s vast network of Area Agencies on Aging: local organizations tailored to the communities they serve, making it possible for Americans to age in place. Here to talk about South Florida’s version of the Area Agency on Aging is Jaime Estremera-Fitzgerald, CEO of Your Aging and Disability Resource Center, which is dedicated to serving seniors, adults with disabilities, and those who care for them in five highly diverse counties of South Florida. I’m going to let Jaime tell you more about the Center, but first we’re going to hear his story of caring for his parents. It’s truly inspiring. In fact, Jaime is inspiring. He’s 72 years young and he joins us from West Palm Beach, Florida. Jaime Estremera-Fitzgerald, welcome to the Agewyz Podcast.

JAIME:  Well, thank you Jana. This is a real treat for me to be able to be on your podcast, be talking with you. And by the way, thank you for getting my name so fantastically correct.  It’s wonderful.

JANA:  Well, I’m a Greek so I’m sensitive to ethnic pronunciations. So let’s–

JAIME:  [laughs] — I love it. I love it.

JANA:  So let’s begin at the beginning. Tell us where you were born… and I understand you moved both of your parents to New Mexico, but take us through that process quickly.

JAIME:  Well, very quickly– yes, thank you. Very quickly, I was born in Puerto Rico and when I was one year old my parents migrated to California, actually Northern California for… through my second grade in school. And then they transferred to Southern California where I really grew up. So I grew up in Southern California and then through the years, got my college education, was in the United States Air Force and eventually, uh, through, uh, many life experiences, I ended up in New Mexico where in 1991 I moved my parents there also. Because I’m the only son of this marriage. My mom had been married before, had four sisters that are half sisters of mine, but my father and I and my mom, that was our family. So I moved them in ’91 and I helped my father take care of my mother for about 15 years, and she passed away at the age of 99 in 2003. And then because of caregiving of my wife, who had a father that she hadn’t seen for many years, we decided to come to Jupiter, Florida, where I brought my dad with me. And for the next seven and a half years he lived with me in the home. And this time my wife and I were the caregivers for him. And I have to confess to you, my wife was even a stronger caregiver than I was because I was out working to help other people.

JANA:  Right. And just to back up a minute, I understand from what you told me in a previous conversation, you had a heart attack. Can you tell us when that happened and what brought that on and, and who cared for you during that time?

JAIME:  Well, you know, that was 2002. I was a runner, a very avid runner, and had a very interesting thing happened. There was a blockage in one of my arteries in my heart, not because of clogging, but it just happened. And as a result I had a heart attack. Thank God I was very close to the hospital. My wife took me there. Because of how quick I got to the hospital, I got no heart damage, I had a stent put in and I have continued living life. And the caregiver for me at that point in time was my wife. She is the one that I owe, and in many ways my wife has been an incredible caregiver along with me. And then in 2003 is when mom passed. So it was a year later.

JANA: Yeah. Oh that’s tough. So what was it like having your dad live with you? And did you have any outside help?

JAIME:  Well, you know, it’s interesting. Once again. No, we, we moved my dad and my dad was doing good, but there was things I had to take care of it. And then my wife and I chose to complicate our life at an older age even further. Uh, we decided to adopt a child, you know, in the family adoption, and so we inherited a two-year-old boy. And so all of a sudden I found myself, and so did my wife, on the one side caring for my father who at that time was in his mid-eighties, and then my little boy who was two years old. So I truly was what we were calling at that time– and I don’t know if we still do– the sandwich generation. I felt like the bologna in the middle.

JANA:  With a little mayo and lettuce. Maybe some pico de gallo thrown in. [both laugh]

JAIME:  With a little mayo and lettuce! But you know, it was, it was really interesting Jana, because I realize not only because of the work that I do, that all of a sudden I was experiencing, as you said in your intro, how many people are as they’re aging, not only having to be caregivers for an older parent or loved one, but many times I find that there are many people doing what we did. They have a younger person, a younger child in their life that all of a sudden they’re dealing with both spectrums, sides of the spectrum.

JANA:  And what was your Dad’s health in those years, in his eighties when he was living with you?

JAIME:  Well, that’s where I’m really blessed. My mother, even though she lived to 99, had several chronic diseases to deal with: heart condition, you know, arthritis, many other things. My father, believe it or not, till he died at the age of 95, only took a baby aspirin his entire life.

JANA:  Oh, wow.

JAIME:  So what happened to my father is that after about seven and a half, seven years, he was with us, one day he fell off his tricycle that he had, didn’t break anything, but at that moment did not want to get back on that bike. And from that moment on, we began to notice his mental decline. And that began to really concern us. And then that continued to grow to a point that my wife, who I really again give the kudos to, who would take care of him morning, noon and evening, then I would come home and help at night… we began to notice that we could not take care of him any longer at home safely and with our wellbeing as well as his wellbeing. And that’s when I had to transfer my dad to a small assisted living here in West Palm, which we were very happy to take and be able to– my father, all of his life was the only wage earner, so there was, you know, he had nothing except his Social Security, which was under a thousand dollars. We were able to get Medicaid for my father and some of the benefits and he contributed all of his Social Security. And my father, as I said, passed away at the age of 95, even still taking only a baby aspirin. And dementia is the only problem that he really had.

JANA:  Uh huh. And that’s really hard for families to say, okay, this is a point where we can no longer do it all. How did you guys cope with that? And was it hard for you emotionally to let go?

JAIME: It was very, it was very difficult. And you know, I thought being in, in the, in the organization that I run where we deal with, as you said, uh, services and supports to keep seniors in their home for as long as possible, for the first time, even more than my mother, way back years ago when she passed, I experienced and along with my wife, a feeling of kind of like, gosh, we’re failing. We are, you know, somehow we haven’t done it right, or somehow, you know… and we felt bad. And I remember, I will never forget the day I moved my dad into the assisted living and left, I really felt like a bad son for a few days. And then my wife and I began to help heal each other and we began to realize, you know what? Actually if we didn’t do what we were doing, I would have failed my dad for sure because he needed better care than my wife and I could give him at home. He needed much more care and, and, and, you know, we couldn’t physically or time-wise do it. Once that kind of sunk in– but it was always difficult. When I would go see him and leave, ’cause I visited my father at least four times a week. And you know, it just– being so close, as my father and I became, at the same time, I am ever grateful for the people that do work in assisted living and are there when there is no other choice for us except to have somebody else take care of them.

JANA:  And what year did he go into the facility?

JAIME:  Well, let’s see. Uh, he passed away six months ago. He was there the last three and a half years.

JANA:  Okay. How significant a role does culture play in your attitude toward older adults?

JAIME: Oh, it’s plays a huge role, and that’s why I am a huge advocate that in our home and community-based services as well as in our services and supports that are more long-term care, like assisted living, like nursing homes, we need to recognize that the cultures are so different, so we need to be able to provide a setting. Where I was very fortunate and blessed, which is what has really made me a stronger advocate than ever for small assisted living is, the place that I put my father was run by an organization that maintained very much the Cuban Puerto Rican culture that my dad grew up in. First of all, there was only 21 clients that were in the home. It was really a home atmosphere. My father in Puerto Rico had grown up in a big house with a lot of siblings. He was, himself, kind of brought into the family. He was, he was, his mother was the sister of the mother of that big family. They had about 10 kids. And so when I brought my father into this assisted living, in many ways, he related number one, like it was back home again. And secondly, the food, the people that would talk Spanish and English, it really made my dad so comfortable and it made me realize, as you just brought out, how important culture is for, as we age, to help us in the caregiving that’s given. It’s, it’s very, very critical, uh, from food to the conversation. It just is very critical.

JANA:  That sounds like a really unique ALF. Are there a lot of such facilities like that, so tailored to a culture? Did you guys go out looking for different kinds? Did you know this is the one right away? How did you find it?

JAIME: No, obviously I used my own services through our helpline, and through the helpline they helped identify that there were at least two or three that might be worth me looking at it, like that. And so I went out, and this is what we do for other people, they did it for me, they gave me where to go. So I went, I personally visited and I found this one. But your point is actually the fact that no, there is not many and that is a huge need. And that’s why, uh, not too long ago, a couple of years ago I was able to speak at the US Chamber of Commerce where they brought together Hispanic business leaders from America, from all walks of life. And one of the things that I presented to the business leaders was the importance of, within our Hispanic culture, to grow the business of culturally correct, small assisted livings facilities. Because that’s the way our culture– and some other cultures the same– that’s the way people will feel the most comfortable. And it is a big vast need. And I believe personally that it is a, a good business need that we need to encourage more people to develop those kinds of facilities and develop that business. And I would really encourage it, because it makes a difference. And by the way, it makes a difference in costs also because your overhead is just so much less than, and they can find people that like that kind of environment to work. I also think, as you well know, the workforce in America for home and community-based services is very difficult. It’s dwindling and you know there’s not enough compensatio, and I think that smaller facilities are easier to actually recruit and have people working than some of the larger ones.

JANA:  Right. They feel less institutional, I’m sure.

JAIME:   Yes.

JANA:  How were you received by the Chamber members? The US Chamber?

JAIME:  Actually very well, because it’s amazing– you know, until it happens to all of us, we don’t realize it. Everybody’s going to be a caregiver. And all of a sudden I had CEOs– the CEO of Pepsi, who was there, who was Hispanic, came up to me afterwards and said, you know what? My parents are aging now and you really have made me think, ah, what am I going to do? I haven’t planned for this, for my parent. And so I, it was well received. Of course, what I’m hoping is, that there’ll be people that’d be willing to invest and develop a business line of smaller assisted living to meet not just the Hispanic culture, but you know, the African American culture, Asian cultures. So many of these cultures, family is the critical piece.

JANA: Yeah. And in this country– where you come from, elders are really revered. It’s a little different here, isn’t it?

JAIME: Well it is, but I’m hoping that through Area Agencies on Aging and frankly people like yourself that are willing to do programs like this, that we can educate folks of how important this is and change our own culture to recognize that our elders, our seniors, are vital not only to the economy, but they’re vital to our culture.

JANA:  So let’s talk about your work with the Aging and Disability Resource Center. How did you wind up there? And why did you choose to work there?

JAIME:  Well, you know, frankly, when I mentioned to you that we had to move to Florida because my wife, you know, we made a decision. I was, well positioned in Santa Fe, New Mexico. We had a wonderful life, but all of a sudden she came home after my mom died, she visited her own dad that year for Thanksgiving. Came back and realize, you know what? I’d like to be close to Dad because he’s aging. He needs some help. He’s got some chronic diseases. We decided to put family first and in less than 30 days we sold our house and moved to Florida. I did not have a job. I didn’t have a job. I always have to credit Governor Bill Richardson at the time in New Mexico. He called me and gave me a part time job in Florida for him. And then I saw an ad to some people that wanted to connect me to the Area Agency on Aging. I was able to get through the process and I became the Chief Operating Officer 12 years ago, and four years into it, uh, my boss, the CEO left, and through a long process of elimination I became the CEO and I’ve been now the CEO, this is my seventh year.

JANA: Wow, that’s fantastic. Now I know that your organization differs a little bit from other area Agencies on Aging in Florida, and in the US. Can you tell us a little bit about the work that you guys do, and the services you provide?

JAIME:  Well, the, the beautiful thing I can say, first of all on the large national scale is that the Agencies on Aging– there is an Area Agency on Aging in every county in America, and some of us represent more than one county. So I represent five, as you said, which is the Treasure Coast counties and Okeechobee and Palm Beach. And there’s another 10 Area Agencies on Aging in Florida. What’s unique about Florida is all the Area Agencies on Aging, all 11 of us, are nonprofit community-based organizations. And then a few years ago on top of the designation by the state and the federal government as an Area Agency on Aging, we were also designated, Your Aging and Disability Resource Center. And the reason for that designation is because everyone has recognized that seniors often have to go to so many different places to get help. They wanted to consolidate and make it a one door, like one gateway to all services and support.

JAIME: So that’s what Your Aging and Disability Resource Center is all about, as well as the Area Agency on Aging. And what’s great about the Area Agencies on Aging on a national scale, anywhere you are in America, if you told me, Jaime I got a sister and we’re trying to take care of mom in Seattle, Washington, my help line can connect you with someone there– specifically, someone that can help you and your family with resources and what’s available in that area. Now what’s different in Florida: we are the only state, I believe, that not only as Area Agencies on Aging but Your Aging and Disability Resource Center, we are really, actually in the state statutes, that were the ones to help with ALL services in Florida, including Medicaid Managed Care. And it’s very unique. And of course our Area Agency on Aging also is unique in that we have some additional wraparound services like elder rights. A lot of seniors, especially in south Florida, suffered in 2008 through now, with for closures of their homes. All these areas that need legal aid. And so we with, along with our partners, Legal Aid of Palm Beach, we work to help seniors with all kinds of legal issues. Victims of crime, last year alone we helped over 6,000 seniors with victims of crimes issues, from burglary to fraud, exploitation. And so there’s a lot of different things that seniors can call our help line and know that they will get help or they will be connected to the help.

JANA:  And where does your funding come from?

JAIME:  Well, most of our funding is either federal, state or local community funding from local governments. We’re starting now because of where we are in America at this point in time, we all are realizing that we have to develop additional revenue streams. So for the first time ever we have developed our own foundation called Your Aging and Disability Resource Center Foundation, and we are hoping that others within our communities that we serve will see the importance of making sure that an elder is not foreclosed on, that the needs of seniors– crisis needs, other types of needs– that there’s someone to help, and we are that entity along, I might add, with our wonderful community partners. Because we have community, other nonprofits, that are in each of the counties we serve, that we partner with, we contract with. They help us provide the services and supports needed to keep people to stay in their homes for as long as possible.

JANA:  And so how old is your typical consumer of services?

JAIME:  Our typical consumer is a female 82 years of age, and usually someone that does not have the ability to get around and is home bound. Now, you know, you asked me if that’s the typical– yes, but we also have every spectrum, from a young vet that just came back from Afghanistan with no legs and wants to stay at home and their family needs some additional help, to a senior who is taking care of her child for the last 45 years who’s disabled and now they’re 85 or 86 or 90 years of age, and they also need help along with their loved ones.

JANA:  And you also provide services for caregivers too. Is that correct?

JAIME:  Oh, definitely. You know, we are, we are learning more and more every day– and I know you believe this, that’s part of your mission and charge– is that caregivers, they really need help. Because if you think about it, if it wasn’t for caregivers, volunteer family members, friends that are doing caregiving in America, we would be in even worse trouble than we are today. And certainly my life has proven that the things that I was able to do and my wife for my parents, if we had not been able to do it… I hate to even think what would have happened.

JANA:  So can you connect caregivers to respite?

JAIME:  Yes, we do. And at the same time that I say that, I have to tell you that’s probably the number one biggest need that caregivers have because all of us, regardless of how much we love our loved ones, we need a break. You know, I have a good friend that helped write a book called, “Take Your Oxygen First,” and you know, when you get on the airplane they always tell you, put your oxygen mask on first before you try to help somebody. Well, I found out myself in my personal life, as much as I loved my dad, I needed some time to kind of replenish and recharge myself in order to be able to keep doing the good job I was doing for my dad. And so one of the things we are looking for even more is we have some programs to help caregivers with just practical tools. But you just mentioned probably what I think is the biggest need: is to have more respite available for caregivers.

JANA:  Can you tell us a little bit about the Circle of Care? I’ve seen that on your website.

JAIME:  Yes. Well, you know we decided that a good way to make clear to the community so that we could have people remember, is that Your Aging and Disability Resource Center, your local Area Agency on Aging, we help, along with our partners in the communities we serve, to make sure there is a Circle of Care that whatever the need might be of a senior, of a caregiver, of an adult with disabilities, that that is provided. And we call that the Circle of Care. And three years ago we started to do what we call a “friendraising” event, called the Circle of Care celebration luncheon to really call attention to the fact that while we receive federal help, state help, local government help, communities because of what you mentioned at the beginning of this podcast, how many millions of new people are turning 65 and are 70 every day, we have to develop more help. And the only way we’re going to do that is local communities have to be willing to step up. People, myself, others have to step up and say, I want to help. I need to contribute to make sure that help is there. Not just from my parents, but for others. My friend’s parents, my other family’s parents. And that’s why the Circle of Care to us has become a, like a flag, to say we need to develop a Circle of care that is strong for those that are aging in our community.

JANA:  And so let’s say somebody calls– a daughter or a son calls– the Center and says, I’m freaking out, my mom is running out of money. Can you give us an example of that sort of call you get, and what happens? How the Center deals with someone like that?

JAIME:  Yes. I will give you a good example. A daughter called from out of state, in fact, New York. And she had visited her mom here in West Palm Beach. And in this visit, she just had noticed that mom was kind of holding the walls whenever she was walking. And she knew that she’d fallen a few times but didn’t want to tell her daughter, and she knew that her mother had a very small $720 a month fixed income from Social Security– that’s it. No other, and there was no other income, no other revenue. Obviously the daughter was willing to help, but she had five kids of her own, and so she had tried to call around different places. She’d done that for about six months. Finally, somehow she saw and was able to connect with our organization. She even wrote me this. She said, the minute I called, first of all on the phone, they talked to me, they assessed on the phone, my mom’s situation, our situation, and they were able quickly to help connect my mom. They realized that my mother actually could qualify for Medicaid. They helped us with the application. They helped us put together the paperwork that was needed, and frankly she said, Jaime, two months later my mom was found eligible for Medicaid and another month went by. She’s on services and I wanted to call you and your staff to tell you, I was going crazy, the minute I called you, I was able to relax and your staff kept working. They would call me, they would follow up. I never had to call them again. They would follow up, and I can’t thank you enough knowing that my mom is receiving the help that she needs today.

JANA:  It’s so touching. And you have quite a high number of volunteers, right?

JAIME:  Yes, we have. We have many volunteers, in particular in our elder rights center, in our foster grandparent program, as well as in our SHINE program, which is a program specifically where we have very well-trained seniors themselves who help people with the myriad of Medicare issues that come up for people. And so we do have many people that help with all of those different programs. Yes.

JANA:  And those are seniors helping seniors. What does SHINE stand for?

JAIME:  SHINE stands for Serving Health Insurance NEeds of seniors. And the health insurance of course is all the Medicare problems. Helping them to make an informed choice. We don’t choose for them. We simply help explain. Which is a maze to get through the Medicare process, and I have people calling me every day saying thank you, because of your staff’s help, they saved me $1,000 a month on my prescriptions. And there are many stories like that.

JANA:  Yeah. How big is your staff?

JAIME: My staff, I have 60 staff, and with 60 staff, last year, just on the phone alone, we served over 170,000 people, caregivers and seniors. This year we’re on path to probably go over 200,000. And in elder rights issues we helped over 6,000 last year and in Medicare over 4,000.

JANA:  Oh, my gosh. Someone told me that you had a 94-year-old volunteer. What’s the advantage of having older volunteers?

JAIME:  Oh, well first of all, I love to see them be productive and purposeful in life. And it makes me so happy as I see them go around helping other people, but more importantly, they relate perfectly. When they call an 85 or an 88-year-old senior, or they call a caregiver that has a senior, they just relate. Right away, instantly, there’s a connection. And somebody feels like, this person understands. They know. And so to me it is such a benefit for the senior that’s helping us as a volunteer, as well as the seniors and caregivers we serve.

JANA:  So do you see a spike in demand during the holidays?

JAIME:  Oh yes. One of the biggest things that happens over the holiday, especially the homebound seniors, this becomes a very dark time in our country for many of those seniors who frankly, some of them, many of them in fact, will not see their families this holiday season. And that pains me to know that, but also the anxiety– we get a spike in suicide calls that we turn over to [the] 2-1-1 crisis suicide line. It’s just really sad to think, you and I spend our life thinking about seniors and caregivers, and to think that there are seniors, many, many thousands of seniors in our country, that are alone and feel neglected, to me that’s so painful. And at the same time, it’s what inspires me to be so committed and passionate about my work.

JANA:  Oh, that’s great. Well, what should people know or watch out for during the holidays with the older adults in their lives? I mean, I think you talked about that a little bit, but what should people be on the lookout for?

JAIME:  I think if they see someone that looks dejected, first of all, step up and say happy holidays and, and engage in talking with them. Uh, you might see a senior that’s walking that you can tell cannot walk very well, and you might live close to them. I love to do that. I stop and I’ll put my, I’ll get out of my car and I’ll come over and say, you know, I noticed you’re walking. Uh, if you need some help, I’d love to help you to your place. And you know, it’s amazing, cause I want them to walk, but at the same time, not carrying bags of groceries like I see often a senior do. But more importantly, we try to watch out for and tell people, if you think your neighbor is by themselves, go and just find out how they’re doing and see if they need a little extra holiday cheer. I think, uh, you know, as I mentioned earlier, communities, if we could get back, uh, to recognizing that neighbor caring for neighbor– you know, we do that during hurricanes. That’s one of the things we teach people: hey, think about your neighbor. I think all year long, if you live in a neighborhood where you see an older American, don’t hesitate. Step up and say hello, introduce yourself. See if there’s any way you can help them with anything.

JANA:  That’s so sweet. And what do you, personally, you Jaime, look forward to each day when you wake up?

JAIME:  Oh, that’s easy. I mean, uh, my staff– I don’t drink coffee, but my staff thinks I’ve had five cups by the time I get to the office. Because I just get excited every day knowing that I know I’m going to find somebody that’s going to need help, and I know my staff is going to be helping today, hundreds of people. And what I want to do, Jana, I received a lot of help, not only from my wife but from other people, my own staff. And I want to make sure that any senior that I can reach out to that we can give the same help I got, I want to make sure they get it, too.

JANA:  So where can people learn more about Your Aging and Disability Resource Center? And if they don’t live in Florida, how can they access services?

JAIME:  Well, and the good news is, two things I’ll give you. Number one, our 800 line, which, it doesn’t matter where you are, you can call, it’s a free call. Our helpline and the number is (866) 684-5885. I’ll repeat it one more time. (866) 684-5885. And our website is www.yourADRC.org. And you can learn all about us, or you can call our helpline and we’ll connect you wherever you are in the country.

JANA:  That’s awesome. I want to give you the opportunity to offer any last thoughts for our listeners before we close.

JAIME:  I would just say that if you’re a caregiver, I just thank you for what you’re doing, and if you need help, we’re here and we’ll connect you with whatever you need. If you’re a senior, I just want you to know that we care about you, and you have contributed to our nation, and the Area Agencies on Aging are here for you and your family. Please call us.

JANA:  Jaime Estremera-Fitzgerald. He’s the CEO of South Florida’s Area Agency on Aging, known locally as Your Aging and Disability Resource Center. We’ll have a link to the Center on the agewyz.com website, so be sure to check that out, to learn more about this wonderful organization with its huge number of services and resources for caregivers and their aging friends and relatives. Jaime, thanks so much for joining us and thank you for all you do to help older adults live with dignity as they continue to age.

JAIME:  Thank you Jana, and thank you to Agewyz.