Senior Care Live 05.19.18

Senior Care Live
Saturday, May 19th

Transcript - Not for consumer use. Robot overlords only. Will not be accurate.

Are you caring for an aging parents or are you searching for answers. Yeah senior care line of program dedicated. Providing information education and resource. Become the best caregiver you can beat. I'm your host Steve peca. Hello and welcome to senior care alive I'm Steve peca president of senior care consulting. Thanks so much for tuning in today I really appreciate you the mission here on the program mr. provide information education. And resources for seniors and their caregivers. We discuss important subjects such as how to remain independent in your own home. When do you consider moving from your home to senior care community. Then how to find the right senior care community for your exact needs. Also discuss how to pay for the cost of senior care we review legal issues involving elder law on estate planning. And that we discuss how to care for the caregiver. If you listen to us on the radio right now you be streaming this on line or listening to a podcast after the fact again. Thanks so much for being here today. If you need help with placement services for my firm's senior care consulting or if you wanna learn more about services provided by one of our very knowledgeable guests. He reaches hard toll free number at any time that's 1800. 3316445. Again. 180331644. Or five can also visit online at senior care lie in the LA ZE. Senior care lie in the dot com. All right so we have a really really good show today I'd been wanting. To define this level of care for a long time with experts in the area but before I introduce my special guest today. We give just a very very very quick overview. Of the the primary levels of care at that are available for for seniors right now in the Kansas City area so. On the entry in I've covered this a lot this is going to be very quick overview there we're gonna focus in on the one that bird and talked about today. So the entry level you downsize. Sell your home move into independent living primarily apartments. And then on the unknown very far side of this of this scale if you will. Is long term care when people refer to them as nursing home skilled nursing skilled nursing and rehab. Health center that sort of thing and that would be the highest level of care debts. That you can that you would receive. Although there's an asterisk to that we're gonna touch on that animate that there is that why do center lane. Generally referred to as assisted living that's the social model can help you with your activities of daily living to should be your medications. And a lot of other good support Soria. On the lighter side of assisted living we have residential care facility are CF one. Or CF two a Missouri Kansas is our CF one so that's similar to assisted living but really definitely on the lighter side of it. And then you have what we're gonna talk about today on the heavier side. Of assisted living in really going into that long term care category. You have and on some level of care it's called home. Plus and I talked about it for it just as many times but I voice just kind of touched on it and I thank you know I. Bring in some experts into the radio station in just share their expertise and their knowledge with senior care like listeners. So with that would like to introduce. Some actually just wonderful people mr. Jerry Poland's he's the owner operator senior care homes. In mr. Neil Barnett the owner operator of care haven homes. And Jerry Neal thanks for being here today. Thank you Steve great to be here exe. All right and so if you wanted to reach out so TU militant or one of them for the staff and Kerry even homes. In the gimme some contact information online in its spelled exactly like this health care haven homes. Dot com. Here haven homes dot com and also called 913. 64301119136430111. And if you wanted to reach out to Jerry or one of his great staff its senior care homes online senior care dash homes. Dot com senior care dash homes. Dot com and also call 913236. 0036. Since 9132360036. All right so I have. Briefly described home plus. But now that we have a real experts. And real owner operators here in in the studio today. I would just like to throughout the question what is. Home plus. Home pluses and there's a small group setting. Bed ski stay Kansas mandates only up to twelve individuals are cared for. They're actually the best part is there hidden in neighborhoods or recreated in. More commercial settings to actually be a small home where. Looks like a home feels like a home and it acts like a home for everyone who lives there and that's really the best part. So it's it's literally. I think one of the best bets best parts amity and it's it's literally a house I mean it's not. It's not an institutional looking structure it is a whole house it's a home. You know these are definitely counts if you drove by one of these counties you wouldn't necessarily. Know if there was anything different going. No signs out front. And and the idea is that they've blend into the neighborhood dislike in the other room on the block. So the home plus term is primarily used in Kansas. Other states OK so the so it is their home plus in Missouri. There is no home plus a mystery. They would it as you mentioned in your intro. They might be licensed as a residential care facility okay and beat Kansas. As soon adopted the name home plus. And it is pretty unique to Kansas I haven't run across it in any other state okay. But that's how Kansas deals. Very very cool so so Jerry they're they're different models within home plus side if you wanna cover that. Sure there are a few different models and and within the home plus mocked the home plus setting. Neil and I specifically focus on dementia care nosair. The primarily the residents that we care Ford dementia parkinson's. Strokes other types of folks that might have neurological. Issues and a home setting the small setting. The continuity in sort of the familiarity that we can create really. Lends itself to being. Helpful to those types of of individuals. And going and was also gonna save both Kerry and I. Have multiple home pluses and we we own and operate. Dead isn't necessarily the way it is throughout so if you could go under. Typically some of the more rural settings in Kansas he might QC eight singled home plus owned and operated some. So you do have differences within home plus environment. This city Kansas has been gored in terms of adopting the home plus. He. Designation and giving us specific licenses. A specific license with regulations that help to guide our operations. Not all states have done that and it's really specific to the the individual home. A lot of rural areas like Neal said to have had one or two or. Multiple home pluses pop up or individuals. Nurses typically from the stories I've heard caring for a couple people on their house and the state finally said hey if we're gonna have people being cared for in their house let's regulate that let's give them some. Some some guidelines such operate I. CNN and makes sense. And OK so I'm not gonna throw it in media providers under the bus but I stumbled into a place in Missouri I was just I was just doing my normal research. For someone meeting. A home plus hyperbaric small may be residential care type of an environment. I for one of my clients and and she needed and injection. Of particular medication was an insulin is is another issue but. I sit Q can you accommodate deck as I was having some doubts despite this brief conversation over the phone it in and I am not kidding. She says all in my friend lives or works his right down the street at the dentist's office and she could probably go c'mon down once tomorrow I'll give that injection alike. OK. I'll have to give back with you on that thank you for playing so. But just like like that that just doesn't lack of a regulation. It and I usually generally fall into the camp of less regulation. I think that government can be overbearing sometimes regulation by sometimes it's it's needed in I'm I'm glad to hear that there's very specific regulation. Ford the home plus model. I would also add one thing just to give your listeners a better sense there are. More than a 140. Home classes license to cross state Kansas fire and in Johnson County we have a little more than twenty so just to give you a feel for the kind of numbers that we talked. The one of the most interesting. Experiences I had was a call I got from an individual that was an A a home. Plus is they indicated. And I went to the house and they said they needed to move and it was because of the owners were going to jail. And well why are they could just bypass all the regulation and operate on their own because it seemed like a great idea to just have a couple people living in your house oh my god collect rent and and essentially be a landlord and and when you're giving medications and caring for people in dealing with issues all the way through end of life it's it's a lot more complicated than. Yeah there there are standards there are regulations there are things that you can and cannot do. So if anyone says hey that's a good idea I think Carl brings some people and I don't do that. This is a very involved. Process and there are things that you have to do including getting a license etc. would get into a lot more of this right after the break fee you can talk eye contact. I care haven homes in 913. 6430111. And also context senior care homes at 913236. 0036. We're gonna have a lot more right after the break but let's not forget the senior care life question of the week. The home plus level of care is similar to. Hey independent living be assisted living seat long term care. Or dean. None of the above so take a minute we're going to be back in about three minutes what's your answer. Will be back. You're listening to senior care lives on the senior care broadcasting network. For more information call now toll free 1803316445. Operators are standing by 1803316445. I'll be right back. Welcome back. You listen to senior care lions. On the senior care broadcasting network. For more information about the services offered on this program and how we can help you and your family cholera toll free number at any time that's 1800. 3316445. Again 180331. 6445. The net. That until you write that number is literally answered 24. Hours a day you can call at any time I'm not kidding about that. So given a try it don't forget you can also stream the program. Hit any electronic device super simple lots of people do that go to senior care lie and a dot com. You can click on the listen live button or the giant microphone right there on the home page. Given a few seconds to connect and then it will connect to your phone your tablet your laptop your PC whatever you have it really is. That simple right back to the senior care life question of the week. The home plus level of care is similar to eight independent living. Be assisted living. Seat long term care or. GE. Non all of the above and Neil and Jerry I'm I think we've touched on some of that by. I thought why is the home plus level of care not similar to the other levels of care. Well really Steve it's it. It has little bits of similarity with all those items. We have people that come to us from their own homes of people that come to us from assisted living. If people that come to us from long term care. It really is a unique model. Your point it's not exactly like any one of those other things that's why the state of Kansas treats us differently in issues separate. Licensed care picked. Everything about the home class is tailored and specific to the neighbor at home to the small home model. Perfect perfect end. By the way it's an house. So if you've got that home their home like setting recovered. The end and I know everyone has plans of care and everything but I'll tell you what that that's going to be a lot. A lot more doable allowed. Easier to deliver. When your dealing with you know eight to twelve residents and home. And in and you have great staffing ratios I know we're gonna get in staffing ratios here in a minute. But the bottom line is home plus. Is is absolutely. A unique. Model its license differently I love that the state kids is recognized that so. All right well so let's are right so this perfect segue. Do I just wanted to ask the question you know why is. Home plus a better model. May we give some specific examples. What their number of reasons but probably the one of the most important reasons is it's the staffing. Ratios accuse you mentioned who. I know both carry it and a and I typically would have a ratio for residence or caregiver and a home. And that's a fantastic ratio. Very very hard to find it anywhere in the community of any fear. Have a private duty situations which would be 11. And if you did have a private duty coming in seeing you know staying with your loved 1247. You know you're looking at its cost prohibitive I mean if you can do it that's great I mean you can stay home. Frankly most people that's just not affordable at all or for very long but that's. Twelve to fifteen to 60000 dollars a month and the depth points that's. Just so expensive that most people are not Camilla. To handle that. One of the things that our families that senior care comes are always talking about is that and it sounds really simple but. We actually have bedrooms and not apartments and and I say that because if you go into a larger sort of big box facility. You find everybody in their apartment with the door closed on trying to bide their time or figure out what to do work. Navigate 80000 and get into the bathroom and things on their own without any supervision. Had a home plus you walk in and and I can't remember the last time I saw our resident in their room except sleep so everybody's out. Everybody's about with eyes. Caregivers nurses. Visiting doctors and other folks you know able to to see them interact with Sam. And and basically. Be out in the sunshine and be out participating in the house. Just like you would do in your own home. Exactly it and that's that's the point. From the that that's the point this this is just a no brainer to me. Is just such a great great level of care if you want to reach out two mile distaff secure haven homes. I even check out their website care haven homes dot com. Or call 9136430111. And then if you want to reach out to Jerry Poland's and a great staff that senior care home it's. The one line at senior care dash homes dot com we could call 913. 23600. 36. All right so we're talking about the ratio so if we have a listener and the like one before I know that that doesn't sound. I don't know if that's good or bad. Let's. What without throwing anyone under the bus. Provide some staffing ratios that you would see the typical assisted living and then a typical long term care community. Typically they're going to be higher than that one to 81 to ten. Are things that we hear but I think that kicker is overnight and overnight is worth 24 hours I mean folks are up in about. They're doing needing care throughout the night and ratios can go 1212125. They can get even higher than that so. Our ratios are consistent and ended the folks are able to get that attention around the clock. And I I've seen it and if anyone thinks that that's an exaggeration. That is not. It is not so if you have twenty to 25 residents. In a neighborhood Horry Hillary wing or whatever you wanna refer to it this. We have one staff. And that staff is helping someone who might be having never a bad time 2 in the morning. In the other you know 192024. Residents someone else needs some help to the restroom. Not gonna get it in any even any sort of a timely manner to just not. And that's just a fact in so that one to 2125. Overnight at some not at all places some places. That is that's a real number. And I think it's important it is to go beyond the numbers as well. I mean just because. We're time matter ratio one to war but it really allows us to provide a more personal or more customized. Level of care so when you have somebody that gets up in the morning and likes to have a cup of black coffee and read the paper. When you are staffed adequately. You can provide that experience to go to the recipe and if you're one to twenty. There's no way that that can happen in at least and timely manner so it's more than just the numbers it's what does that number mean. And right right to piggyback on that Neil. That individual could also sleep until 930 or ten get up and have the same cup of coffee in the same breakfast there's no push or rush. To get them to a big dining room or at specific time for breakfast we can be flexible. Up. Absolutely and of course stats part of person a person senator change in culture change or person Senator Kerry culture change that. And the entire. Senior care industry is trying to achieved by U. Meet dad inch image she didn't we've done that from day one again one of the many many benefits of home plus. We're visiting with Neil Barnett owner operator of care even homes and Jerry Poland's. Owner operator of senior care homes can reach out to carry even homes in 913643. 0111. You can also reach out to that senior care homes and 913. 2360036. And we're gonna go into a lot more detail about the license sure. Staffing ratios and have some success stories we do not wanna miss the second half of the programs so hang on don't go away we'll be right back. You're listening to senior care life on the senior care broadcasting network. For more information call now toll free 1803316445. Operators are standing by 1800. 3316445. I'll be right back. I'm back he'll listen to seniors here live on the senior you're broadcasting network. For more information services offered on this. Program and how we can help you and your family color toll free number and any time that's 1803316445. Again 180331. 6445. Don't forget if you ever miss an episode of the program if you wanna share of the program with a friend or family another person might be interest in the subject matter of that state. Maybe just wanted to review it into security again no worries and all of the senior care live dot com. Click on the podcast tab and that's where you'll find all of the previously aired episodes. I just find the one that your interest and then click play and boom you are end. All right it is feel free to do that and again you can do that 24 hours a day exits on the website and lots and lots of people. Actually I had a lot of people say no Steve I work on Saturdays but I love your show I never miss one I just wait for the podcasts I listen to and on Monday accusing itself. I so feel free to do that. All right so today a senior Carolina were really focusing on the home plus level of care something that's very unique frankly to the state of key insists. In and we can talk about I mean what would you. As you probably have be it residents and families coming in from. Missouri and in all all other states but it's really kind of and this Kansas specialty it's such a cool assists and on some level of care. It is on the high side of assisted living and I would say definitely even moves into that long term care level of care we're gonna talk about. Even going up and through end of life care in a minute or visiting with mr. Neil Barnett owner operator of care haven homes. In mr. Jerry Poland sees owner operator of senior care home so let me let you know. I tell you how like reach these guys here since Jerry and or his staff that senior care homes online senior care dash. Homes dot com. Can also call 913236. 0036. The also reach out to Neil Barnett and one of his awesome staff I care haven homes. And so it's up online just like it sounds it's spelled like it be like you hearing care. Haven homes dot com. Well call 9136430111. All right so. Senior care homes and Kerry even homes. Use specialize in memory care. So first of all thank you god bless you for that because that's not easy care. I mean the did the residents coming to you they may have few mild cognitive impairment. They may be you know severely impaired with you late stages of alzheimer's or one of the different forms of dementia. So thank you that that's tough work right there. That you have to be specially trained you have to really. Know what you're doing so let's talk about memory care and what does that mean and and and how is that different. It delivering memory care and home plus verses you won the other options out there. I think we range when you say memory care I think it ranges on one end of the spectrum from forgetfulness is someone that's just forgetting. Things may be there unsafe in their house maybe they're leaving the stove on maybe they just need some reminders. I'm all the way through to a would be more formal dementia alzheimer's. More advanced where. I'm speech is impaired physical abilities are impaired things like that and we run the spectrum. Does small home setting really does. Sit for individuals as we have folks in their early sixties all the way into their nineties then. It's it's personal. And it's set out to be familiar. I have residents' civil tell me when I come in and that my house isn't for sale that. They don't want the house to be sold out of and then guys is their house yeah May Day take ownership of it. And I think that comes from the fact that there's a real dining room table a real kitchen where we cut just like you and your house adapt. Bedrooms you know all the amenities of a regular house is there. Yeah I'd add onto that you know we have Barbeque grills that he two home and we're getting to the time of year when we can cook out in the alma. Exactly and that's something that you would do in your room. I. Absolutely an insult that the if you deliver memory care and we're not tired trying to throw anyone in the busted this is just. A stark fact is just reality. Memory care delivered. NA NA house sit in a ranch style type of a home. I caring for 678 maybe a maximum of ten to twelve residents this just different. And caring for maybe a much larger number and and another and another community. The folk. So we care for need supervision and they need oversight they need support and they need it from the time they get up to the time they go to bed need and through the night so. Just being able to do sort of I've heard it called purpose driven her real activities sleeping and desk clearing the table helping set the table helping cook. Going for a walk in the backyard those are things that are just. They create purpose for that individual Annette senior care we call moments of joy. We live in the moment of the resident and if we can create. A few moments a few times where. The caregiver or the family member. Are connecting with that resident they're really getting. Into the things that then. Make them happy they give them purpose. It makes all the difference. And add and add another point about the home class city news. If you just think about the sheer numbers of people talking about smaller number of residents. And a smaller number of staff although the ratios have been a smaller number of staff that's good for somebody with dementia if you're an F. In a large facility may be. Forty residents and all the staff that goes along to support those forty people. It can be very disorienting for somebody whose memories interior so there's some inherent. Benefits. To being in a smaller. More cohesive type you know I hope it's absolutely and if you just think about. Just one thing one simple thing. You're walking down. What fifteen foot hallway dumb down the hall and in when he homes. And how long are the hallways that you would be walking down in in a much larger place hundred feet long. Certainly did a hundred C and I've stuck CD even longer than iron twice and outerwear and we're all each. Door to each apartment looks exactly like the one next and so there's no differentiation. Very hard. Somebody with dementia didn't have to navigate that type it said. With dementia and may be a physical impairment. Maybe they need. A wheelchair because it's a hundred yards whereas in our house and they can just be walked whipped by the caregiver or have a little bit of assistance and they can stay and keep their independence and their mobility. And I am a lot. I have a lot of clients that they can walk around I'm with a walker and an independently. In the smaller you know structure of their own home. But if you get outs into one of the larger. Communities out there in debt that and in many to I was in a place the other day I swear that the hallway was at least 200 seat and I think it was. I'm in almost gave me a look like the vertigo look and I mean he really kind of freaked me out the ceiling was kind of low and I'm like oh my goodness. He had memory issues here this this hallway right here we would blow you away I mean it would it would. I'm tell you would cause some problems and it was in the memory area but. If they they for for these much larger areas that they have to depend on the wheelchair and all the sudden. The independence just went down. You know I was in a facility this morning actually end and the wife of the gentleman. Who had the impairment said that she takes him out sat out of the room. They go left all the way down to the end and they go right all the way down to the end and it's just under a mile. And I could only kidding that's their exercise in it and and that's a mile under one roof in a building unbelievable. That is debts breathtaking. We're visiting with Neil Barnett with care haven homes and Jerry Poland's with senior care homes. If your interest in this level of care if you have a loved one. Two it has real mild cognitive impairment to you know extremely high cognitive impairment. Alzheimer's one of the forms of dementia. And you're interested in May be checking out some options and if this is catching your attention. Reach out to kneel and Jerry's son Neil Barnett owner operator with Karrie even homes. You can go online at care haven homes dot com. Coal mine 136430111. Also reach out to Jerry Poland's owner operator of senior care homes or one of his. I great staff members there it's at check out online senior care dash. Homes dot com. Coal mine 13236. 0036. We only have a couple of minutes left in this segment. But let's talk about the professionalism. At home plus so. Who. When I I've I brought some some people in. And they they they love ditch I but I had a couple of people say. Why don't just doesn't seem quite as and and they put the quotes a professional as in one of these other places and I tried to explain to them that. He did you meet all the same regulations you have nursing oversight but can you explain on some of their professionalism. You know aspects of home home plus. Sure I'd start with our caregivers and our own they are. Licensed certified nurse aides certified medication aides and their care and their performances over. Seen by a team of people but a number of nurses both our hands and elk eons. So there's there's a lot of oversight as to what they're doing. Out and in so that's in guess why that's exactly what happens. At all licensed communities and and you have Lorenzo PNC amaze CME's. In so there's no difference I think there were just thrown off by Howell casual relaxed. Hello that's a good thing. That that it was in home plus it still isn't highly professional placed highly regulated that right here. We take it really takes all the best practices of a facility because there are things you can learn from a big facility and things they do well. And it wraps and in the smaller package and I tell our. Families you know don't let the casual atmosphere fully you know the fact even running and open the French Democrats and a drink it's it's the same. Oversight as a big facility. Yeah up in so so don't let affiliate is a major major positive. Right after the break we're gonna have a lot more information about home plus so don't go away and I'll tell you why I'm I'm I'm loving love mean. This this conversation so I won't be right back justice. You're listening to senior care lives on the senior care broadcasting network. For more information call now toll free 1803316445. Operators are standing by 1803316445. I'll be right back. Welcome back. You're listening to senior care lines on the senior care broadcasting network. For more information about the services are. From on this program and how we can help you and your family color toll free number at any time. That's 1803316445. Again 180331. 6445. Today we're talking all about the home plus level of care the home plus model. It is an awesome fit for lots and lots of people in frankly I think there are a lot of people out there they don't. Either know about it or they don't understand it that's why were shining a bright light on the home plus. Model and level of care today in studio we have mr. Neil Barnett owner operator of caring for homes. Mr. jury Poland's owner operator of senior care homes. Can reach out to Jerry and his team. Senior care dash homes dot com. Were called 9132360036. Also reach out to Neil Barnett and his team that care haven homes dot com or call 913. 6430111. In and guys we had to cut off the that they're the professionalism. And in all the other clinical information etc. about home plus and get I've had a a few people. They want Diaz is just beautiful home and everyone's just kind of late kick back like you would see at anyone's home they're like. I don't know if this is professional enough let's let's kind of finish that thought. And talked about some of the other things that may go unnoticed but they're definitely there. Well I I think this tendency when people look at a home to just assume it's home like here Omar like my home. Greeley behind the scenes there's it is quite different. So our homes and in the same would be true of senior care homes. They have backup power backup generators they all have fire sprinkler systems fire alarm systems. They have secured doors so the people can't just wander away factor resident we had we moved to us many years ago stand. He did was living with his niece it was a middle winter and he just walked outside and left her home. Needless to say he moved into our homes that are. And was protected because he couldn't the door was locked and I didn't know the code to get out simple things a very very important. And the and the key part of providing. Dementia. A few the other amenities or things like in the bathroom roll in showers we have. At our homes we have years in the bathrooms we had speakers for music in the bathrooms we have. You know the grab bars and all the things. Didn't make it safe. In each of our veterans we have a motion sensor so. It goes off to someone tries to get out of bed and doesn't make a noise in the resident's room but it alerts the staff so within them. Short period of time they can come help that person but. Little things little safety. Things that are required or just implemented because we feel like it's right thing to do you know ounce. One thing the that dishonor of call light response time. And so I always ask about dad in I usually hear you three to five minutes maybe five to ten minutes I've also had people report to meet. We were moving from one place looking for different place they've waited twenty minutes. For someone to answer call light so how does that work and home plus environment. Well we don't have any call lights and home remember it's a home and if somebody wanted something they could just. You know speak up and say can you give me a hand and somebody damn haul wood which here in this. Images we sometimes rely on things like baby monitors which are very low tech but where we would have a receiver in the in the main part of the house and we could. Here what was going on in somebody's room throughout the throughout the night was very effective. We've got to resident that just wants to be in the family room and if they need something maybe they don't have the strongest voice they can just. Have a little bell next on and they just grabbed the bell and ring the bell and someone I mean you hear it you can hear anything across yeah. So so again it's not a giant giant place it's a very nice home. And so you don't have call lights you're not waiting. Three to five to ten to tornado who knows how many minutes. One of the many benefits of the home plus model. Also on the professionalism part be given doctors and other medical professionals that can see the residents in the home. We do we have doctors that can come visit the house podiatrist. Someone to get an X ray get blood drawn all those types of things. Can happen in the house and and that way when Stanley come and take their loved one out there taking them out to do something fun rather than ghosts and couple hours waiting in a doctor's waiting room we're going to get blood drawn the lamp and all that stuff happens in the home. And it makes you different if you take care of that. Yeah with our nurses and with the doctors and all those are two things I mean Mike Neal said I mean our goal is set. Allowed daughters to be daughters sons to be signs spouse is to be spouse is so when you're going out when you're coming over. You're actually visiting and enjoying the time not sort of overseeing the care and trying to track and her staff. And then the state of Kansas comes in and there's an annual healthcare surprise health her health care inspection or survey. Jest just like in any other health here. Institution would horror provider. And so there is there is some serious oversight. And they might even scrutinize home plus or leave it even little more thoroughly may be a larger community so. So if anyone. Wonders. Well how professionalism is very professional and you have professional staff he has doctors and other medical professionals coming in. You have state oversight and supervision you have fire sprinklers. It backup generators. Do we can just go on and on and on. Organized meal planners organized activities in meaningful activities. Not just an activity to fill a slot on the calendar so it's it's it's a great place. And then I don't want to forget no I want to cover the very very big question. How long can someone stay at your home is there can they stay through end of life or do you have to go somewhere else for that. Most of us most everybody stays through the end of life and we would typically. Meet with the family did at at the appropriate point in time and maybe get hospice involved and they would come into the home. I can only think coast may be one or two instances. Where very few instances. Since we've been in business where somebody actually. Went somewhere else to. It at the end of life it is rarely rarely happens. I think the end of life is actually one of the big strengths of the home plus and I come from a hospice in and actually funeral backgrounds that's what I. No and seeing it happen for our families and the support that you get at the end like this is huge I think I think we do really well and it is very rare for someone Neftali. All right in that would be the exception not the rule the national statistic is. From assisted living 59%. Of residents. Have to discharge from assisted living and move to the long term care level now frankly I think that number's probably heavy for the Kansas City community. But I don't think it's probably that far off because there are just limitations and their life and a lot of sister living. Communities are just really light on the care so that really forces at in home plus. You don't have to move you can do to person transfers. Bring in some specialized equipment if that's going to be needed. But they're gonna do all they can't for your loved one to live comfortably. In the home. Death theorized that there are comfortable with in this surrounded by the other residents and familiar staff would like to think. Neil Barnett and Jerry Poland's for being on the program today. I just phenomenal information. Again I just wanted to touch this one took Thomas former time reach out to carry even homes. And it care. Haven homes dot com we can also reach them on the on the phone 9136430111. Also reached jury Poland since senior care homes and senior care dash homes dot com. We're called 913236. 0036. In gentlemen thanks so much for being here today I really appreciate it. Thank you Steve thanks Steve thanks for evidence all right those just grade tend and may we do begin sometime. Absolutely. All right take every man that was passed. They're always catches me off guard every week so anyway. Your listeners thanks so much for tuning in today I'm your host Steve keep her and I wish you grace and peace. May god bless you and your family on this date and always. We'll see you next week right here on senior care lie.