Geriatric Care Manager Sonja Kobrin was in her twenties when she began caring for the grandparents who raised her.  She had no help and was traumatized by the experience, but it informed her approach years later, when she cared for the biological father who had been absent in her childhood.  This school of hard knocks training has influenced Sonja’s holistic and comprehensive approach to helping her clients at VIP Care Management, the Palm Beach County, Florida company she co-founded with her husband in 1993.  Tune in for real talk from a compassionate care manager who shares her insights and advice, and stories of families in crisis that may sound familiar.

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INTERVIEW TRANSCRIPT:

[INTRO CLIP/MUSIC]

JANA – It’s a terrible thing to watch an aging parent or any family member or friend lose their independence because of declining health. Whether it happens slowly or all at once, often when you want to help you feel helpless – or guilty for not being able to do enough. Add to that the logistical and financial challenges, and even the most battle- hardened caregiver can be reduced to a puddle of tears. I learned the hard way after my father died that I couldn’t care for my elderly mother all on my own. But it was one thing to admit I needed help, and another to figure out where to get it. If only I’d known about the work of today’s guest, Sonja Kobrin is the co-founder of 27-year old VIP Care Management, a one-stop-shop for families in need. Sonja’s approach to care management is holistic and comprehensive, which means whatever you need help with Sonja can make it happen. She’s here to share her expertise on effectively managing the challenges of aging and disability, and she joins us from Lake Worth, Florida. Sonja Kobrin, welcome to The Agewyz Podcast.

SONJA – Well, thank you. Thanks for having me today.

JANA – Sonja, you and your family have lived in South Florida for decades, but you’re not from here. So I wonder if you could tell us a bit about your background and your upbringing.

SONJA – I grew up in the Washington DC area. My mom worked for the government. And my mother, my natural born mother, actually died at age 21. And my father was 22. So I was basically adopted by my grandparents, who I called Mom and Dad, and they took me in when I was eight months old. And I think that that gave me a really different perspective on working with older folks later in my life. I mean, during my childhood, I didn’t really even realize that they were my grandparents. People would say to me, they look older. But I was always shocked to hear that. To me, they just look like mom and dad.

JANA – So your early experiences with caregiving revolved around who? What was your first experience of caregiving, I guess I should ask.

SONJA – Well, unfortunately, when I was a newlywed and pregnant and 25 years old, both of my actual grandparents who raised me became sick. And I spent two years going back and forth to hospitals with both of them. One was heart disease, one was cancer. And unfortunately, they passed away while I was pregnant, one when I was four months pregnant, the other one, I was seven months pregnant, leaving me basically orphaned at 25 years old. And now in retrospect, I really understand how underserved they were by the medical community.

SONJA – My grandmother wanted hospice so desperately, and her doctor said that she didn’t believe in hospice. So neither my mother, which is my grandmother, nor I, as a child, got any sort of supportive care through hospice during this terrible time. And now it’s very common to use hospice, but back then a lot of doctors were resistant to it. So that was my first brush with caregiving, and I absolutely was traumatized by it as a young person, losing both their parents in four month’s time while pregnant and a newlywed,

JANA – And your dad was in the picture or not?

SONJA – Yes, my biological father – he never live with us. But he often lived by us, but sometimes would take off for a number of years and then come back.  To me he was just a family member I was happy to see.  When he was in town, it was great to see him. When he was gone, I didn’t feel like oh, my daddy’s gone, because I had my quote unquote, parents. They were my grandparents. So my father, biologically, was really not somebody who contributed in any way to my care.

SONJA – But later in his life when he was 57 years old, after many years of denying his diabetes, he became physically challenged, and I had to become his caregiver when he had never cared for me. He had no income, I had to put him on disability and put him in an assisted living. And he remained in facility care until he died at age 70 a few years ago. So that was a very challenging caregiving experience. But by then I was already a professional. When I lost my grandparents, I was not in the field of anything, really.  I was a young mom staying at home and I didn’t have a career.  But when I was taking care of my biological father, I was very lucky to have the resources that I have in this community and also employees to help me manage his care.

JANA – Uh huh. So when your parents-slash-grandparents who raised you were ill, and as their health declined, what did you feel was the most frustrating thing for you as someone who wanted to help?

SONJA – I think just watching the physical deterioration and the mental deterioration. I didn’t know what to do, I felt so helpless. I was young, so I was ego-absorbed, too, you know, always thinking about me, me, me and what this was going to mean for my life. And, you know, I knew they weren’t going to see my newborn baby, and that was very emotional for me. So, you know, I went into that place of being all about how this is affecting me. Looking back on it, I realize that I could have been a lot more supportive to my grandparents had I had somebody to teach me more about what I could do and empower me and help me.  But I had no help at all. Not at all. So I had to learn the hard way.

SONJA – And I think what one of the things that frustrated me the most, and it still frustrates me as a professional geriatric care manager now, is the lack of communication with physicians – the lack of caring.  Watching my mother, who was in so much pain from cancer, sit in a waiting room for an hour waiting for the doctor to finish her lunch, but she booked an appointment for my family during her lunch time – this type of thing goes on all the time. Doctors booking their appointments four people deep. You sit in there, wait for an hour and they have no regard for the people in the waiting room at all.

JANA – Yeah, that’s a tough one.

SONJA – This has never changed. Also, the lack of communication. Physicians don’t want to talk to the family. And if they do, they certainly don’t want to spend more than a minute or two. And it seems to be a Florida thing.  Many of my clients from New York and New Jersey are so shocked that they can’t get a doctor here to call them back, and I just tell them, this is South Florida.  Doctors don’t return phone calls. They don’t communicate.

SONJA – Oftentimes you don’t even know who they are. They pop their head in the door, you’re just a chart in the hospital. So this is a very bad situation and the way I’ve personally solved it in my own life and for my clients, I believe heavily in concierge medicine. I pay my doctor $1,600 a year to be in his practice.  I have his cell phone, I don’t wait in a waiting room. I’m in and out of his office in 30 minutes. And my time is very valuable. And I want communication. So I pay for it.

JANA – That’s something that I think a lot of people don’t know about as an option. How did you find out about that? And maybe you can elaborate on that offering.

SONJA – Yes.  Often, it’s a very experienced physician who is sick and tired of seeing 100 patients in a day and wants to have, you know, maybe 600 patients instead of 6000 patients, and financially, if everyone pays them, you know, $1,600, that allows them not to have to take so many patients into their practice

JANA – Mm-hmm.  It cuts out the middleman, too.

SONJA – Exactly.  This is called concierge medicine. And you have direct admit to the hospital, you don’t wait in a waiting room in a hospital. There are many advantages.  And I met a doctor he explained what he did, and I’m like, That’s for me. And I signed all my family members up for this service, and I’ve become very close friends with my physician. And there’s other doctors out there who do this type of medicine. But usually because they want to deliver quality care, not quantity.

JANA – Right. So Sonja, can you explain exactly what care management is, for people who don’t know? It’s kind of, you know, one of those terms that people hear, but maybe they don’t know what it is.

SONJA – Right.  Well, it’s also a term that’s been – and I love to use this word for this – it’s been perverted. The word care manager started out meaning someone who would manage the care of another. Unfortunately, insurance companies call their gatekeepers care managers, and hospitals call the people who are trying to discharge plan and kick you out of the hospital, a care manager. And this has become a very generic word and nobody knows what a care manager does.

SONJA – In our work at VIP Care Management, a care manager listens to the family and explores many different areas of the senior’s life, whether it be financial, legal, medical, psychological, insurance, government benefits, psychosocial, community, religion – whatever is in their life, we are touching on that. And if there are ever any issues in one area, then we strategize with the client and the family if there is family, how to address that issue, and then find resources and also look at what those resources will cost, to help address a bigger problem, and hopefully improve the quality of life of the senior and their family.

JANA – So what’s a typical day like for you? And do you take calls at all hours?

SONJA – Unfortunately, yes. Clients that have our service know that they can call us after hours for emergencies, and most of them are very good at discerning what is an emergency. But yes, we are always available. And our role with every client is uniquely defined by the needs of that client and by what they want, and even what they want to pay.

SONJA – So a typical day for me might be, for instance, this morning. I have a client who has two terrible wounds that happened to her while in a nursing home. I just got the medical records. I’m reading them, and I’m trying to find out where shall we move this woman so that she can have her wounds addressed? She’s 101 years old.

JANA – Oh, my goodness.

SONJA – She’s in pain. Yes. And her family is desperate to give her the best quality of life for the last possible year of her life. And part of that is healing these wounds. So that’s one situation. Today we had our meeting where we talked about everyone in our caseload, and we have clients that are moving into assisted living and they need a dementia unit because they wander.  And we’re constantly listening to our families tell us what their issues are.

SONJA – And then I tell them, we have a crystal ball in a way. We know from our vast years of experience, what is coming down the road for them, and we help them plan and try to visualize what the next months and years will be like so that they don’t feel blindsided every time there’s a change in status with their loved one.  Because aging happens very quickly. You know, a year in the life of a 90-year-old is a very, very long time.

JANA – Oh, yeah.  And we’re not here to bash government-funded aging and disability resource centers, but in your talking just then it occurred to me that your relationship with your clients is very different than, say, a resource center that gives you information and then you might not hear from them again. It seems like you really develop long-term relationships with your clients.

SONJA – It is a long-term relationship, usually from the time we meet them until the time they pass away.  And then even after, helping their families through estate matters and things like that. But any disability center, any information and referral government entity has parameters.  They have a job, it’s a very narrow scope, and they’re not going to go outside of that scope. So most families experience the same things that we do: they get on the phone, and they are told by some recording that their average wait time is going to be an hour. And we’re used to it.  We know to plan our day around, Okay, if I have to call Social Security, let me make sure I have two hours there was nothing better to do.

SONJA – A family member gets very frustrated, and they often hang up and don’t accomplish what they need. And they also don’t even know what paperwork to have in front of them when that clerk gets on the phone with them. Then they end up being told, Oh, we can’t go any further in this process of helping you, because you don’t have XYZ information in front of you. So we can cut through a lot of red tape because we know how all of these systems work.

JANA – And you’ve been doing it for a long time. I was really interested in the full-service idea of what you guys do, because your husband and you also have a real estate business, right?  So you can pack up people and, you know, address those family members who have hoarding issues and all that.

SONJA – Exactly, exactly. The real estate business that we have, which is South Florida Real Estate Connection, does both commercial and residential.  But it’s very important to our clients, because when they do have to move into an assisted living or a nursing home, sometimes they resist doing that because they’re so afraid of losing their home or leaving their home and they can’t imagine the task of packing it up, maybe all by themselves. So if we can take that off of the plate, and we can do the packing, and also just disseminating all their belongings – getting rid of them, selling them, etc., – then that’s a big burden that we take.

SONJA – And then of course, we give them a reduced commission when we sell, so that they can benefit also from using our service when selling the home.  Then that money, the money that we get, can be preserved in a Medicaid trust if they want, to be able to be used for that person’s care even though they’re on government benefits. So the whole thing is a big picture. You can’t solve one problem without finding a million other problems. So our practice is built around many different categories of problems and having solutions ready for every problem.

JANA – Right. The connecting the dots ability, which is really rare. So what are some of the misconceptions that family members have, for instance, or expectations that they have for how their loved ones will be cared for, say, in an assisted living facility or a nursing home, versus the reality?

SONJA  – Well, I think that the word assisted living is the biggest misnomer, because what we think of when we think of assisted living is aides and nurses are around to help, and that our loved one will be fully monitored and get all kinds of care. And the reality is, in my opinion, the assisted livings in Palm Beach County are really divided into three parts.

SONJA – There is assisted living that I consider to be delivering a very low level of care. They’re really just an independent living with maybe a bath being given to someone that they need it and a meal. They don’t want someone who is going to have incontinence issues or walk on a walker or use a wheelchair. They want some of their residents to wear nice clothes when they come into the dining room. They have to dress for dinner. That is one type of assisted living that exists in our area.

SONJA – Then you have the kind that deliver a high level of care. In fact, some of these people could also qualify to live in a nursing home, they’re so debilitated. But the facility is more willing to take on clients like that and deliver some care. But it’s still not a nursing home.  You still can’t consider that every medical issue is going to be monitored and managed in an assisted living, because it will not be.  And then what happens is the assisted livings will tell the family, Oh in addition to our fee you need to hire a private caregiver, because you need more care than we’re going to give you.  And now you’ve got a $10,000 a month bill.

JANA – Yep. I’m familiar with that one.

SONJA – So I think it’s a misnomer. I think that people really expect a lot more from a word called assisted living than they’re actually going to get in the assisted living realm.

JANA – Uh-huh. Related to that, you have a very useful bit of information on your website called The Four C’s of Facility Selection. I wonder if you could talk a little bit about that, for people who are looking to place someone in a nursing home or assisted living facility?

SONJA – Well, I can tell you that the very first thing you don’t do is get a list of all the buildings and start touring.

JANA – Which is instinctive.

SONJA – Right.  That’s what most families do.  You know, there’s 120 of them around here.  And they all have a niche, they all have a culture. They all have a price point, and they all can be divided into this high-level and low-level care. I had said that there were three categories – the third one being Alzheimer’s memory care, which is basically secure so someone can’t wander, and there’s supposedly more staff in those departments.

SONJA – In terms of finding the right place, the Four C’s is what I call my method. The first two of those C’s are non- negotiable.  You cannot negotiate away how much care a person actually needs. So in choosing a facility, you have to make sure you understand the client’s needs, and if that particular building is set up already to meet those needs.  Then comes cost. Most people have a budget, and you can’t go beyond that budget. So that’s a non- negotiable item too.  You’d find out your price point, and you don’t look at facilities that are outside of the price point.  But how would you know that?  Because you’re not going to see that in any internet site. So that’s where our service is so valuable, because we do track that information. We know what the price points are.

SONJA – And some facilities have an all-inclusive fee, and some have, like, a menu of services, which ends up feeling like a little nickel-and-dime, but their philosophy is that you only pay for what you’re utilizing. So, you have to choose.  It depends on if you want that.

SONJA – The next part is the culture. And that is, where do you fit in? And not just language-wise or religion, or any of those very obvious areas, but also, where do you fit in socio-economically? Do you want to be wearing your finest dress when you go to the dining room? Or do you want to be able to go the dining room in sweatpants? You know, this is the culture of the building. Where do you fit in? Some of these facilities that deal with very elite and wealthy clients are cliquey, just like any country club. Cliquey, like high schools. So if you’ve never been part of the clique before, you’re probably not going to do well and in a cliquey environment. So that’s the culture that I’m talking about.

SONJA – And then there’s the community. Do you need to stay within a certain mile radius of family, friends, doctors, dialysis centers – whatever the factor is, it tells us where we need to play someone. So based on those four criteria, that’s how we narrow it down. And finally, a client will maybe have three or four buildings that meet their criteria, that are unique to that client. And we can help them tour and decide.

JANA – So care, cost, community and culture.

SONJA – That’s right.

JANA – The four C’s. You have a master’s in psychology. Let’s talk about family dynamics. Do you do a lot of counseling of family members?

SONJA – Well…

JANA – You don’t need to name names.

SONJA – You know, my grandmother said to me when I decided to major in psychology, she said, How are you ever going to find a job doing that? And I wish that she had lived to see me do this business, because I use my psychology degree every single day, mostly to calm myself down. The reality is that everyone that I meet is in crisis. And they’re also, if they’re caregiving or caring about a person who needs care, they are going to go on a rollercoaster ride. And it makes them feel better to know that they have a guide on that ride, and that we can calm them through certain things by educating them.

SONJA – And when they are starting to go into the same phase that I went into when my grandparents were sick, and I was young and I was all about me, and Oh, this is terrible for me – that’s natural. That’s a natural reaction.  And helping them emerge from that into Okay, now, how are we going to be solutions-based? How can we feel in control of a kind of uncontrollable situation? What steps can we do to gain control and at least have peace of mind?

SONJA – If there’s anything that I sell here at VIP Care Management, it is peace of mind.  The peace of mind that comes from knowing what’s going to happen and when it’s going to happen, to the best of our ability, and what will it cost if it happens?

SONJA – So I think fear is the number one stressor, and change is something that is very hard for people to go through.  And dealing with denial.  I mean, I was on the phone with a daughter today who really is in denial about her mother’s level of dementia.

JANA – And what do you say?

SONJA – I give her examples of the things that her mother has done in the last month and a half, that show how dangerous her situation is. And, you know, I have to keep bringing this into reality. And we’re actually waiting for, in this case, is for the doctor to give us a definitive diagnosis so that I can then educate her about the diagnosis.  Because I’m not a doctor. And I’m not going to sit here and say, Your mother is this diagnosis or that. I will take a medical professional diagnosis, and then help educate them about the disease.

JANA – I know that it’s not uncommon in families for one sibling to do a lot of the heavy lifting, and to have suspicions about a family member who is maybe exploiting a parent. Do you see a lot of that?

SONJA – We see it almost in every case.

JANA – Oh, my gosh. Really?

SONJA – Many of our clients – yes.  Many of our clients have no family. But those that do, there is this dynamic… I always tell my clients, whether you had one child or 10 children, the situation is the same. Only one kid is generally going to step up. You’re very lucky if you have two siblings that will work together, cooperatively, without fighting. Those that are successful at working together, look at the division of labor and say, Okay, I’ll handle the money, you handle the doctors.  And they figure it out. And we can help with that process. Who is good at what, and who should be in charge of what.

SONJA – What is really horrible is when you have a child living, let’s say in another state, and you have a child local.  The child who’s local is doing all of it and stressing out and dealing with a lot, while the child who lives out-of-state calls at night and asks for a report, and is playing Monday morning quarterback, and criticizing and saying, Well, I would have, I would have, and then explaining why they’re so busy they’re not doing anything. This is the most common family dynamic that we deal with.

SONJA – And I’ll be very blunt about it: the one who’s sitting up north and doing nothing and not helping, not even contributing financially or anything – to me, their opinion does not matter at this point. We only need one chef in the kitchen, one person taking control and doing it well with support. But if the other one is going to be in the way somehow, or just causing stress, there needs to be a lack of communication. They need to be cut off for that period of time. Because that stress will drive a family member crazy.

SONJA – I have a daughter going through that right now. Her sister is threatening the father, telling the parents, If you don’t let me in your finances, you cannot see our grandchildren, your grandchildren. Meanwhile, the local daughter is not spending time with her own children because she’s having to spend time with her parents and dealing with a lot of the issues at home. So this is a normal day for us, to deal with that.

SONJA – I said to a daughter this morning, When’s the last time you saw your mother?  A year ago. Well, that’s why you don’t know her status anymore. She has changed a lot. So I don’t want to judge. I don’t actually even judge the daughters and the sons that are staying far away. There’s a reason, okay?  There’s always a reason. But for me, it’s black and white: either you’re in it or you’re not in it. If you’re not in it, don’t be an obstacle.

JANA – Amen.

SONJA – I’m not. Right. But I’m not going to judge and say you should be here because, you know, your mother needs you. There’s a reason why somebody doesn’t come down and see their mother for a year. It could be their own health. It doesn’t have to be a problem in their relationship. It could be something happening in their life. You know, I don’t ever judge on that one.

JANA – Yeah.  Sonja, I wanted to ask how, you know – as I mentioned in the open, VIP Care Management is 27 years old – what changes have you seen over the years in the way people, for instance, care for aging or disabled family members, or in the healthcare system in general?

SONJA – Wow, that’s a really great question. I’ve seen a lot of changes.  And changes come in cycles. It has to do with, number one – wow – there used to be more of a feeling of, I care more for the client than I do for the place I work for.  In other words, a person working in a hospital or an assisted living, they were very protective over the clients. Sometimes I’d have to say, Okay, I’m the new care manager for Mrs. So-and-So, and that person, let’s say, a home health care company or a nurse or someone, would be threatened by me coming in and working with their client that they feel so close to and so protective over.

SONJA – Now, it’s the opposite. There’s nobody who feels protective, and they don’t care as much anymore.  And I’m seeing that everywhere. I think don’t hear people talking about how much they love their job. I don’t hear people talking about these things. And I think it’s really because we’re kind of overwhelmed here in South Florida. There’s over 1,000 people a day moving here, and there’s so much need. And now the resources, which are huge and plentiful, are really being tapped out.

SONJA – This Christmas, oh my goodness, what I saw was every home health care company had more business than they could handle. This is probably the first time I’ve ever seen it. I actually called a home care company two days before Christmas, and the person answering the phone said, Can you call back tomorrow?  We’re too busy to talk on the phone. And I was giving them a round-the-clock homecare case worth $13,000 a month.  And they didn’t have time to talk to me.

SONJA – And what I’m seeing for the first time ever, is that there are more clients who need help than there are services to deliver the help. So I think with that comes a little bit more of a disconnect, from the protectiveness of the client. You know, the feeling of Oh, I want to do the very best. That’s our philosophy. That’s why I keep hiring people so that nobody’s burned out. But in assisted livings and in home care companies and in hospitals with nursing shortages, there’s this huge burnout that’s happening.

JANA – And what do we need at this point to happen, to improve the situation?

SONJA – Well, there is a shortage of doctors, nurses, psychiatrists.  Medical professionals are getting out.  And something has to be done about this.  And neither you nor I can solve that problem, because this is really about reimbursement. But there’s a few other things that have changed. There used to be nursing agencies. Now there’s more nursing registries. People don’t know the difference, but registry means that they don’t have a nurse supervising them. So you basically have people who registered with an agency in a senior’s house, unsupervised and unaccountable. Most agencies have converted over to registry.

JANA – Registries are basically a Rolodex of names that the company can –

SONJA  – it’s a matching service.

JANA – Right, it’s a matching service. It’s really tricky. And people don’t know the difference. And it’s really important to ask that question, if you are going to use an agency. Because there’s a big difference between a registry and an actual homecare agency.

SONJA – If you use a registry, the family should be involved or a care manager like us should be involved. If not, if it’s a person living alone, and there needs to be more supervision, an agency would be better. So other changes that are going on… there’s constant changes in Medicaid, and veteran benefits. And now with the new VA rules, it’s very difficult for veterans to get their benefits. It’s always been difficult, and I’ve written articles about it on my website, about how aide and attendance is the best kept secret for veterans. But now there’s more obstacles that the VA has put up. So that’s the very, very sad. And Medicaid is easy to get. It’s not too difficult.  But VA, not so good.

JANA – So are you heartened to at all by anything that you’ve seen?

SONJA – No. I mean, I’m in the problem-solving business. So to be honest, the more problems there are, the more business there is. I look at everything that’s going on and say to myself, how can I solve it? I don’t lament about how difficult things are. But I do see that the way it’s affecting clients and their families is that, a daughter used to be able to fly down from New York and kind of coordinate a few things and go home. Now, that’s not so easy. It’s very difficult for a lay person to get anything handled. And that is the one of the biggest problems.

SONJA – Even just hiring a home care company is not that easy. They want deposits – large deposits now. You know, all kinds of issues have come up causing these companies to put up walls, and they’re trying to protect themselves. And they make themselves less accessible to the client.

JANA – Sonja, what is the most satisfying thing about the work that you do?

SONJA – I love – and I should have it written in letters across my conference room – the most common thing I hear after we work with a family and consult with them that first time and tell them, you know, what we think about the solutions is, they tell me, You don’t know what a burden you’ve lifted off my shoulders.  You give me peace of mind. That’s my payment, right there. I love to hear somebody say that. And my clients, the senior clients are very grateful most of the time.

SONJA – Of course, you have some people that will never be grateful, because that’s not their lifestyle, but most of the time, they recognize what’s being done for them and they are so happy, and they love us.  And we love them back. And that gratitude is personally very fulfilling for me and for my staff. If I ever get a letter about the way we work, I share it with the staff, to help remind them about the what we accomplish for people. That is what keeps us going every day. And the problems, the obstacles in care and all that, you know, it’s not going to change.  The pendulum swings.  With every government administration and every healthcare approach and everything, our lives are always going to be changing.  But it’s how you deal with the problems that can make a difference for a client.

JANA – That is a great attitude. What is the hardest thing about what you do?

SONJA – Being the only one at a funeral. You know, I grew up Jewish. My mom used to tell me about a Jewish tradition called paid mourners, where you’d actually pay somebody to attend a funeral and cry for you. When I was a kid, I thought that was the funniest thing. You know, I just couldn’t believe it. But literally, that’s what happens with us. Our clients have nobody, and we are the only one standing there at the funeral.  And it is really sad to think that somebody can live a whole life and that’s the end. That some stranger that you just met three months ago is standing there, and they’re the only one there.

JANA – Yeah, it’s tough. Wow.

SONJA – Mm-hmm.

JANA – That’s tough. Well, for people who are listening to this who don’t live in South Florida, how does one go about finding a company as reputable as yours? And I’m saying that sincerely, that yours is extremely reputable. How do folks go about finding comprehensive care management?

SONJA – I have always recommended that they go to caremanager.org. And they will see an organization that comes up that will let you – it’ll say search for a care manager. And then you put in your zip code or your city, and you can pull up different care managers. What is difficult about that kind of search, even an internet search generically, is that a lot of home health care companies have advertised that they do care management, but really what they’re doing is trying to find business for their home care company. So when you find a care manager, like I said before, the term is perverted. So you need to really figure out what it is they are going to offer you, and they call that care management.

SONJA – So a real care manager should be talking about doing an assessment, a strategy or a care plan, and implementing the care plan. Those are the three steps of care management: assessment to determine the needs, developing a care plan or a strategy to approach the problems, and then the implementation of that care plan, which is to do the work or find someone who’s going to do the work. If they’re not talking about that, they’re not really a care manager.

JANA – And how can people learn more about your services?

SONJA – Our website is www dot-vip, like very important people, care management dot-com.  VIP Care Management, and we have a very nice website, and I have some articles that I’ve written on the blog that will let a lot of your listeners know that what they’re dealing with, they’re not alone. You know, financial exploitation of the elderly is something I get very strongly involved in. And I write articles about that, and about the obstacles to care. I wrote an article on there about concierge doctors too, because I really do believe that that’s one solution to poor care.

JANA – Mm-hmm.  Well, we’ve covered a lot of ground, but I want to give you the opportunity to offer any last thoughts if you have any.

SONJA – Well, my last thoughts are for people not to give up.  You know, you may make a lot of phone calls and get nowhere, but if you are pretty clear on what you’re looking for, at least can articulate that you have a need, reach out, spread the word out to your friends that you need help, find a care manager if you can, and at least have a consultation.

SONJA – You know, maybe you’re afraid that you can’t afford a care manager.  That’s one of the biggest obstacles, is that people are afraid that they can’t afford it. I’ll tell you what my fees are. I’m not ashamed – I haven’t changed my fees in 15 years. We charge $125 per hour, and we bill on the 15-minute increment. Many things that I do only take 15 minutes. I’m on the phone, I’m on a fax, I’m on an email, I get things done that way. So a lot of times people are shocked to realize how much can be done with very little time invested. So don’t be afraid when you hear prices. Investigate.  Maybe you have to hire somebody and spend a little money to get something started, and then you can finish it and follow through.

JANA – Mm-hmm.  And on that same note, I think it’s important for people to ask how long a company’s been in business, for one thing, just, you know, to get that information, but also, people are paying for your experience. And what you can figure out in 15 minutes might take another company who hasn’t been around that long, an hour to figure out.

SONJA – Right.

JANA – So it might be a scary sounding rate, but you’re paying for experience,

SONJA – Right. Exactly. Because we’re not doing research every single time. In other words, the research that someone who came before you, that’s the information we use for everyone. So yes, I mean, in five minutes, I can answer many, many questions, and I have resources at the tip of my finger. And we spend a lot of time and energy in our community networking with all of these businesses, so that we know who we are referring, and what their scope of services are going to be and their price point. We don’t want to just give out names. That’s the difference between getting any kind of referral from the aging and resource center, or even a hospital case manager who’s not allowed out of the building to meet with anybody. They don’t know who they are referring to. They’ve never been to their office, they’ve never met that person. They are just going down a list. You can do that yourself on the internet.

JANA – We’ve been speaking with Sonja Kobrin, co-founder of VIP Care Management, which has provided quality of life solutions at home, in assisted living and in nursing homes since 1993. We’ll have a link on our website to the website for VIP Care Management, but as Sonja mentioned, if you want to learn more about her company and how you can help a very important person in your life right now, go to VIP Care Management dot-com, and explore their wide array of services. Sonja, thank you so much for being on the show, and for all that you do to bring peace of mind to family members and people in need.

SONJA – Thank you. Thank you so much for having me today.