Tara Ballman – National Aging In Place Council
In this episode of The Caregiver’s Toolbox Podcast, we sit down with Tara Ballman of the National Aging In Place Council.
0:00 – Tara Ballman – National Aging In Place Council
Hey everybody and welcome to another episode of caregiver toolbox tools for everyday caregiving. Likely the greatest podcast of all time with the greatest guest of all time. We have Tara Ballman Tara, how are you.
0:17 – Tara Ballman – National Aging In Place Council
I’m good Ryan, thank you how are you
0:20 – Tara Ballman – National Aging In Place Council
doing very well and Tara is the president of Homeworks Physical Therapy located in Orange County and we know each other through a little something called the NAIPC the national Aging in Place council. So we are on opposite ends of the country chatting via zoom, how about that, if, if only our grandparents knew. But before we get into this Tara, we have a sponsor. Yes, we have a sponsor, so I get to do a sponsor me today’s podcast is brought to you by Well Aware Care. The smart eldercare solution for today’s caregivers sleep sound. The company’s premier solution is a remote nighttime fall detection and notification system. Sleep sound is there where you can’t be, and provides real time fall notification to caregivers so help can be provided quickly. The system uses no wearables buttons or cameras. It provides caregivers with peace of mind their loved one is safe. Learn more about the smart fault detection solution at wellawarecare.com, wellawarecare.com How was that was that an okay read, let’s say,
1:30 – Tara Ballman – National Aging In Place Council
That was very professional,
1:32 – Tara Ballman – National Aging In Place Council
very professional. It was the most professional read I’ve ever done, it was easily the, considering it’s the only one I’ve done but let’s get back to you you’re over in Orange County, you’re part of the National Aging in Place Council and I’m gonna keep saying that so people, maybe look that up and find out more about your community that you’re really spearheading, but we’re going to talk a little bit about your business so how about you explain who you are and how you got into your business and what your business does.
2:06 – Tara Ballman – National Aging In Place Council
Okay so our company is Homeworks Physical Therapy, it’s actually my husband’s company and it’s been serving seniors in Orange County for about 15 years now, so I came on board with him. We’ve been married seven years so I came on board with him, eight years ago, and I handle all of the non medical side of things and we have about, probably 10 or 11 therapists on our books, and they go into a patient’s home so patients don’t have to be home bound or under all of those restrictions with part A, you know benefits were Part B outpatient so it’s really great for seniors who don’t have transportation to get to therapy or just by the time they get to therapy and getting in and out of the car, they’re just exhausted sitting in the waiting room and so they just don’t want to do it so we find really creative ways of, say, My husband is visiting somebody at five o’clock and the senior wants to cook dinner so he’ll help her cook dinner, and as they reach for plates, they’ll reach five times reach and stretch and grab and, you know do kitchen sink exercises and things like that so we’re able to get seniors moving a little bit more than, say, therapists in a facility would
3:21 – Tara Ballman – National Aging In Place Council
yeah I mean I know, I know, I know when I’ve done those types of exercises. I definitely not me but my caregivers have we try to help out, but there’s definitely a big difference between somebody that’s a trained and professional PT, OT versus, you know, a caregiver that’s there to help out with ADLs. On most days.
3:43 – Tara Ballman – National Aging In Place Council
Sure, if they are Medicare patients you know there’s a certain amount of benefits that they receive every year through Medicare and that respect at the end of the year so this is things that seniors should take advantage of and goes to their doctor, even if it’s just basic strengthening exercises or if something has changed a little bit in their lives and they need help getting proper access in and out of a car there’s definitely ways you can do that where it will hurt you in ways that it will be helpful to you. So there are a lot of little things that just seeing a physical therapist once or twice a year for to visit, since it’s already paid for, you know, you might as well take advantage of it if you’re seeing.
4:22 – Tara Ballman – National Aging In Place Council
Absolutely it’s it’s those benefits that, that somebody has now, getting back to you joining the company your husband started the company and then you joined in eight years ago.
4:36 – Tara Ballman – National Aging In Place Council
4:36 – Tara Ballman – National Aging In Place Council
so how did he start the company, what was the kind of process that that caused caused it to become what it is.
4:44 – Tara Ballman – National Aging In Place Council
Well, he was a wrestler in high school, in college, he wrestled at West Virginia University,
4:49 – Tara Ballman – National Aging In Place Council
He had a couple accidents and had a few knee surgery so he got into physical therapy from that side as a patient and then just really enjoyed it and like seeing the progress and what you can do to a human body and the way that it can recover. So that’s how he got into it when he’s from New Jersey when he moved out here to California. He just saw a need, and certainly one here in Orange County. So that’s really how he started the business and he just did it, knocking on doctors doors one on one, ortho surgeons gerontologist pain management doctors people like that, leading baskets with the staff so we can get five minutes with the doctor you know you probably know how those things go,
5:32 – Tara Ballman – National Aging In Place Council
that’s how he got started and then we actually met I was working for the FDIC, not in senior care at all. And I was on a softball team, and we were short men one night, and he came out that’s actually how we met playing softball in Irvine, California, and we just kind of connected and one thing led to another and we started dating and when the FDIC shut the office down here he was really just himself and a part time Biller, and there was so much opportunity he was turning down business left and right and I said why don’t you just, let’s try this out, let’s give it a go and, and see what we can make of it so thankfully we are still together, married still married. We have a three year old daughter now and I think we’ve done pretty good with our decimals
6:22 – Tara Ballman – National Aging In Place Council
I think it’s great that that I asked because it’s good to have people’s backgrounds I mean, how they get into things is always is always interesting and there’s usually a personal story behind it, and you know who would have thought that softball would have brought you into. If it weren’t for softball, we probably would have never met because you start to get into senior care you know it’s just one of those things so
6:48 – Tara Ballman – National Aging In Place Council
going full circle I actually got into senior care. Years and years ago, I was a civilian employee at Fort Hood, Texas and the MW our department, and I got a phone call from my dad in Florida, he had cancer and so that phone call really changed my whole entire world my projection of life everything so I ended up moving back to Florida, and he had just retired and was getting into reverse mortgages. So I was working with him and the reverse mortgage industry back in the early 2000s I have actually two books that I wrote on the subject, one was published in 2005 called the reverse mortgage handbook. And then the second one was a few years later called reverse credibility, and it was all about how you should relate to seniors as a salesperson, it was only focused on sales people and we broke the process down. We call it our pie chart process intent and expertise. So we really broke down each stage of the reverse mortgage process and covered the process of it, the intent behind it, and then the expertise and the rules and the legislation that really governed it so that was my true entrance into the SR world and I was also involved with the National Aging in Place council back then so many years ago. So, and that was in Florida, so it’s really interesting how everything is connected and comes full circle.
8:13 – Tara Ballman – National Aging In Place Council
You know what the listeners don’t know is that before we started recording, he’s like, I don’t know, you know, 16 minutes worth of content, and now you’re dropping a bomb that you were in reverse mortgages and you wrote two full books on it which not only deals with senior care, it deals with the real estate industry and it deals with the sales industry, I mean, we should have blocked out three hours of time you’ve got plenty of things to talk about it, and it’s only been 10 minutes into this episode so I mean, it’s funny how people are like, get worried about how they’re going to make it through 30 minutes and I’m like, oh my gosh we just, we could cover three hours right now. That’s fascinating. So, you wrote two books on that and, and what was what caused you to want to write books like that’s kind of an interesting thing.
9:03 – Tara Ballman – National Aging In Place Council
It was actually by force because my dad kept telling me you need to do this you need to do it and finally I was like Okay dad, I’ll do what you’re telling me to do. But when we first got into it I guess it was like 2003 2004, and there really wasn’t one single source for seniors to go to to find reverse mortgage information so when I started working with him I kind of liked to know all the rules of the game before I start playing it so I found everything I could find on reverse mortgages HUD handbooks, Anything you could find and I put it in chronological order and I, and I read it. And so after I had all that knowledge, he was like what are you going to do with all of that now. So, I put it into a book because it is really, really complicated so I took all of these had and mortgage legal leave terms you know and really broke it down into what seniors wanted to know, do I lose my house, I heard this back in the day is this still the case, tell me how the breakdown is and just general. I wasn’t trying to sell them a reverse mortgage, I just wanted to educate them, and that’s kind of like the National Aging in Place Council is all about to is education not just sales so yeah it was really interesting, I actually, that led to a little am radio talk show that I used to have as well. It was a weekly calling radio show and it was all seniors mostly reverse mortgage questions and my co host was a senior who was also selling reverse mortgages Hi David if you’re still out there. And so they would call in and we’d have a good old time a half hour show every Friday,
10:43 – Tara Ballman – National Aging In Place Council
that is. That’s hilarious. I could just watch I want it. Now we need to hear your radio voice What’s your radio voice, like, Hello everybody and welcome to WR Kayo and my name is Tara and here’s what we want to know that on the radio voice,
10:58 – Tara Ballman – National Aging In Place Council
you know what, let me read the next promotional thing for you and then you’ll hear it
11:04 – Tara Ballman – National Aging In Place Council
So, so I had so many questions the ATD is going just crazy right now so you you wrote your books and I was gonna say that reminds me of my aunt and uncle, what your kind of story is that my guess is and I don’t know your husband and I’m sure he’s the nicest guy in the world behind me. He probably sounds like he was the hunter. He was going out and getting the sales and, and, you know I’m the hunter too and there’s pros and cons to the hunter. You just want to go out, you want to get the sale and then once you catch that fish and the fish has been taken off the hook, you kind of don’t care about the fish anymore, you just want to find another fish right. And, and so my uncle joined a company where my aunt was kind of the hunter, and he put in the processes in place where it allowed the business to grow exponentially beyond her wildest dreams and it was like this perfect one two punch if you will, and it sounds like with your business you know he was succeeding at what he was doing, but it takes a lot of time to be a hunter, it takes a lot of energy to be Hunter, and you need somebody in the in it back at the office to be processing everything and packaging the fish and getting it out to the supermarket so you can sell it. Would that be a good analogy of how your business kind of grew that way or am I completely off base.
12:29 – Tara Ballman – National Aging In Place Council
You are 100% completely right on. He is not an office guy. He loves being out with people he loves putting his hands on people and working with them and something different all the time. I am a people person to that point and then I’m done. So to me, you know COVID Being at home I was like okay, well, welcome to my Monday, this is what I usually do I sit here in my office and work so we’re really good with that sometimes he doesn’t do the paperwork he’s supposed to so he does get locked out of the house until his notes get turned in which is a perk that I have. That’s okay for him but you know you got to do your notes.
13:09 – Tara Ballman – National Aging In Place Council
I agree because I, when I was speaking with my aunt she when I when I started this, taking over this company, I considered getting into insurance and Medicare, Medicaid, and she was like, I don’t know Ryan, you don’t have the personality for this this is a lot of dotting I’s and crossing T’s and, you know, the insurance paperwork is a real pain. And then they can come back a year later and say you didn’t do it right and just retroactively take money away from you, and you’re just going to go on list again you’re just going to, you know, and she goes I was you, but then my husband came in and he could handle that, the minutiae of all of that stuff, and it was, it was key and that’s that’s, you know, an outstanding trait to have because it’s the yin and the yang of taking your, you know, as a, as a business owner and I’m sure you’ve, you felt this way you don’t hire people that can do what you do well because you do that well, you hire people that can do all the things you don’t do well so that you have a team of people that that work well together, and you know that can that’s it sounds like that was a perfect match for you and him.
14:20 – Tara Ballman – National Aging In Place Council
Yeah, it’s a great match.
14:23 – Tara Ballman – National Aging In Place Council
That’s, That’s funny how it’s similar that way so you you have 15 You have basically a dozen or 15 PTs and OTs, on, on staff on how has COVID affected the business and being able to go out and see people in their homes and, and how is, How are you going through all of that.
14:44 – Tara Ballman – National Aging In Place Council
Yeah, that’s really interesting, it’s been an interesting year for us. Despite all of the struggles, it’s actually been really quite good for us, from a business point I don’t know if it’s because our business model was already set up so we had zero adjustments to make. We didn’t have to worry about the telehealth and everything else that people were doing our biggest hurdle when everything initially shut down here in California. In March, it was stay at home, you know, no one goes out except essential which physical therapists are considered essential but it was the senior living communities where we couldn’t get into and things like that that were really our initial hurdles but there were also people who had just had knee surgeries and other operations where their corner place was shut down and they’re like, I need surgery, how am I going to get this so that’s a lot of the people that we picked up that way they weren’t necessarily Medicare. So it was a little out of our wheelhouse, but we were still pretty busy and you know we just have to be extra careful the first few weeks I made my husband strip in the garage and throw his clothes right in my washing machine because we didn’t know right what was coming in or how it was transferred or anything like that so we’re just extra careful with our patients and we do the temperatures and the protection equipment and none of our therapists have been sick and we’ve had a couple of COVID patients that we’ve treated so something that we’re doing is working, which is good and you know it’s so important for seniors just to keep moving just a little inactivity can cause so many problems down the road. So, I mean we’ve been doing therapy through front doors and through windows the same way people are visiting their family. So it’s been interesting having to make the adjustments but as a company we’ve done, we’ve done pretty good I imagine you and home health have the same issues where people still need your services, non medical care but you know there are other hurdles you have to jump over.
16:43 – Tara Ballman – National Aging In Place Council
Yeah, there were some there were some really roller coaster quarters where like, when March April May came it was like a pretty, pretty good drop and then it just right up and because I think, I think a lot of people and myself included, we were in maybe wishful thinking that this was going to be a four to eight week thing, and you know people hey I’ll care for mom for 4 or 5 weeks just to make sure that they’re safe, which is, which is understandable but then, you know, the sixth, seventh and eighth week when the, you know two weeks to slow the slow the spread turned into two months turned into indefinitely, because clearly we didn’t have a control over this virus. It made it very clear that people were going to have to, something was going to give whether it was work whether it was caring for loved ones because life had to keep moving on and people wanted to keep their jobs and so hey let’s go back to using minute women or private homecare for our services and that’s kind of where we, we certainly feel super fortunate.
17:47 – Tara Ballman – National Aging In Place Council
Yeah, and as stressful as it is just working at home and I know there are a lot of people with children and also taking care of their parents probably after that eight weeks they were like, something has to give. You know that’s one of the great things about the national Aging in Place council that I love that this pandemic as horrible as it’s been it’s made people think, okay, I actually do need to think about aging in place, and how am I going to take care of my parents, I can’t even take care of myself in my home, how are they going to age in their home so it tells people to kind of get our concept a little bit more as well. Yeah, absolutely. Living in place.
18:24 – Tara Ballman – National Aging In Place Council
Absolutely, it’s, it’s one of those things and you know I was just reading an article yesterday in the Wall Street Journal that that conservatively, they think that air travel will drop by 20%, and possibly up to 50% permanently because of COVID. Because so many businesses have realized that the cost involved in traveling around the world versus just doing zoom. It’s it’s a no brainer. And of course, there’s articles talking about like consumer consumers just traveling for leisure, are going to be the ones that pay the price because it’s those business class seats that offset a lot of the, you know, consumer seats or the economy seats or whatever they’re called. And even Bill Gates was saying that he thinks it will be a full 50 for 50% drop and it just made me think like, well if that industry is going to be permanently impacted in some way right it’s going to happen in some way. What’s going to happen with all these in home, not in home but like, assisted living in nursing homes that are so used to having people move in where people are now realizing well, we can make it work at home through home care through, you know, PT at home, I just had a call with a company that does in home doctor’s visits for your primary so that mom and dad don’t even have to leave anymore and that they’ll go into assisted livings to but there is, there seems to be a bit of a momentum push of like hey we can really make this work with staying and in place in a residential home and, you know, I’ll bring that back to reverse mortgages Well, a lot of people say hey we got to sell the house to get the equity out of it to pay for the assisted living, where you can stay in the house and do a reverse mortgage and get the equity out of it, to pay for in home care as well and it’s, it’s, you know, there’s, there’s other options there so it’s going to be interesting to see how that, you know, kind of impacts things with senior living communities in the future.
20:24 – Tara Ballman – National Aging In Place Council
Yeah, that will be interesting, I think one of the little use parts of a reverse mortgage is using a reverse mortgage to purchase a home so in my mind I see a lot of people in the future selling their large homes downsizing to something more appropriate for aging in place using the reverse mortgage funds to purchase the home, and then still having everything that they need in their world, it, it’ll be interesting to see how it all unfolds and now like with WellCare with their, their, the stuff that they’re tracking with people and all of the new technological advances that are coming out, it’s gonna be so much easier just to like have peace of mind with, with your seniors did my dad fall, do I know if he’s on the ground, you know, things like that where those sensors can certainly help and I’m excited to see where everything is going in our industry actually,
21:15 – Tara Ballman – National Aging In Place Council
it’s it’s it’s they’re they’re definitely interesting. And obviously they’re sponsoring this podcast but I mean, they’re, they’re interesting the fact that some I told this to the guys, somebody is going to have the breakthrough with technology and seeing somebody who’s going to do it there’s a ton of money being put into it, and, and somebody because, yeah, you can pay me for one on one care, but that’s an old way, old school way of thinking, and it costs a lot of money right you know, that, that their services can’t do what I do in the sense of preventing a fall, like I can prevent a fall, but at least if mom is an A major fall risk regularly, you can have a little bit of peace of mind and hedge your bets a little bit rather than you know there’s some people that can’t afford, you know $3,000 a week for somebody to be there every single night or whatever it costs. And so yeah, there’s, there’s going to be some interesting things that happen with senior care, especially as the baby boomers, you know, age out. And then the next thing is you have the Generation X right isn’t that the next generation that comes through, but the Generation X has had not that they’re they’re not that they’re there yet but they’re having less kids, you know, there’s less of that family infrastructure as it was even with the baby boomers, so who’s going to be taking care of these individuals who are going to be for the most part on their own, it’s going to be fascinating the next, you know 1020 years. Yeah, why’d you. Why’d you laugh when I said Gen X is.
I just, I get lost with all of the Gen X Gen Y this millennials, you know, it all just merges together for me, like, are you my age are you older or younger,
23:03 – Tara Ballman – National Aging In Place Council
I’m 36 I’m 36
23:05 – Tara Ballman – National Aging In Place Council
Okay, we’re about the same, I wasn’t specifically, you know, that’s how I gauge people older younger than my age but we’re about.
23:14 – Tara Ballman – National Aging In Place Council
Gotcha. All right, well then that’s, that’s, that’s good. Now, granted, you’re you’re doing a podcast with a guy that’s over in Massachusetts, you’re in Orange County. What is Orange County just your service area do you go further out, I don’t know California as well but this is obviously going to be part of the NTI PC. This is going to be on your personal page and to use it any way you want. How should people get in contact with you, where do you service and what are the types of people that are going to be, should be calling your phone is many times in a row until they get ahold of you to get services.
23:50 – Tara Ballman – National Aging In Place Council
While we have an answering service though someone will answer the phone 24/7 all the time Homeworks Physical Therapy we’re technically in Costa Mesa, California, but our therapists do cover all of our county. We cover a little bit into LA County, pretty much long beach south. We are interested and expanding into more LA and San Diego the there’s kind of Camp Pendleton between Orange County and San Diego that is a huge chunk that really prevents a lot of traveling. But we do have, we’ve had seen some people down there before but we’re really our biggest need is finding quality therapists, we don’t just hire anyone, so we’re always looking for people who have a special touch with seniors who aren’t in it for like the sexy side of things, the Sports Therapy they want to do this and get people up and going, because, you know exercise for some people is really just getting up and walking down the hallway and that’s a great, you know, their main exercise for the day is just movement with their body so we’re always looking for quality, physical therapists and occupational therapists, even speech therapist, all of that kind of falls under our license with Medicare that we have so yeah if you need care for your seniors that is our specialty and 95% of our patients are Medicare patients. And we also have a lot of people along the coast who just prefer to the care to so we also go into homes we help set up home gyms, and we’ve seen judges and their chambers before we’ll go to the courthouse instead of tables and offices downtown Long Beach and high rise building, you know, wherever we can help people will do it if we can help them. So that, that’s really our goal is to just help people feel better and live a better life.
25:36 – Tara Ballman – National Aging In Place Council
All right, so now, now you’ve opened up another can of worms, which is so you’re looking, I’m looking for caregivers you’re looking for therapists we’re on opposite sides of the country, dealing with the same exact problem. A little bit of a difference between what you do and what I do is that I can increase my rates as high as I want and I can pay people as much as I want because I have no hard ceiling I certainly have a ceiling that people if if I raise my rates too high then the just won’t hire me, but your reimbursement is capped per Medicare and Medicaid and insurance. So how, what, what are you thinking in terms of how do you find the right employees and attract them to work with you. When the difficulty is, is that the reimbursements are for what most people generally say lower and they’re not really, then they don’t raise, they don’t got the ceiling doesn’t go up in the same way that the cost of living goes up in these places as well so it can be very difficult to find people who are interested in doing that type of work, what do you what are you seeing out there on the left coast. Well, it’s
26:50 – Tara Ballman – National Aging In Place Council
interesting. You know we’re the way that we’re set up, we don’t have a lot of competition because we’re sending a therapist, into a person’s home so the way that the general therapy rules work, a therapist can be responsible for an assistant or an aide who can also see people so one person in a facility can fill from more than one person at a time where and our situation can’t so we’re very, very limited. And what we can pay, but our people are so important to us, and the senior care is so important we actually do get the majority of our reimbursement to the therapist since they are doing most of the work and we just, you know, kind of do things based on volume, given our business model which also helps keep competition away from a business standpoint, that they can just make so much more money as a part, a company or in other areas, you know, actually.
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The Caregiver’s Toolbox – Orphaned Seniors with Heather Hersee
An Epidemic of Forgotten Seniors
Orphaned seniors are a rarely discussed problem in the U.S.
There are two types of seniors in this risk group:
Firstly, some face neglect from their families.
Secondly, some do not have a family nearby.
In the healthcare industry, you quickly realize that many family dynamics play a role in determining the outcome and quality of care a senior receives.
It can be rather shocking to experience the callousness with which some adult children ignore their parents. There are several case studies of how much strain this behavior places on local healthcare systems.
In Denver, local hospitals ask family members to drop off seniors who have dementia. A few years ago, an article details how a male senior citizen appeared at an airport after a one-way flight from Florida to Denver. When he arrived, with no company, he had to fend for himself.
After the senior wandered the airport for many hours, airline front desk personnel realized he was alone and called the police. Police finally reached the adult daughter, who refused to accept any responsibility for her father’s care whatsoever.
The Consequences of Abandoning Seniors
Although police could send the demented senior to the hospital, he would become a permanent resident of that facility. When there is nowhere else for seniors to go, many end up in hospitals indefinitely. A study of 19 Metro-Area Denver hospitals revealed 113 at-risk adults in their system beyond medical necessity on a single day in September. The longest day among them was 577 days – all at taxpayer cost.
The final twist in the story is that local TV news tracked down the adult daughter to Florida and found out she worked for a home healthcare company that provides senior care. It’s safe to assume that if you’re abandoning your father at an airport 2000 miles away, some dysfunctional family dynamics are at play. Likewise, the demented senior was not likely winning ‘father of the year’ awards for raising his daughter.
When adult children who resent or outright disdain their parents become guardians, too often they refuse responsibility for their parents. As the baby boomer generation ages, this situation is going to become increasingly common.
The Challenges of Relocating Orphaned Seniors
The other type of orphaned senior does not have a nearby family to provide care. Again, baby boomers are the first generation in serious jeopardy of relocation challenges. This issue is often the result of their adult children moving away.
Firstly, this trend provides difficulties when someone needs one-on-one assistance. For example, transportation and chores require a social circle willing to respond.
Secondly, these seniors rely on paid services to bridge the gap between what they can do and what they need. Many seniors fall into this dilemma. They make too much money to qualify for state services but not enough to afford out-of-pocket care.
Lastly, Facebook groups exist to help orphaned seniors. Some suggestions endorse the idea of adopting a family of their own. Providing mentorship with other younger individuals in return and developing bonds are critical to sustainable care. Granted, something like this doesn’t happen overnight and requires planning for many years, and sometimes it happens spontaneously.
The Facebook group is more of a way for orphaned seniors to communicate with other seniors in their situations. It is in the community in which younger adults are reaching out to find older deaths to help. Above all, they exist to make isolated seniors feel more connected.
Heather Hersee, a life aging care manager, spoke to us about orphaned seniors in our latest podcast. You can watch it on YouTube or listen on all major podcast platforms.
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