Marty Stevens-Heebner : (00:02)
Moving your mom, or your dad, or yourself isn't just about moving things from one place to another. It is much more complicated than that as are so many things having to do with later life. How to Move Your Mom and still be on speaking terms afterward provides in-depth conversations with professionals, older adults, and their family members who share their stories with warmth, understanding, and humor. I'm your host, Marty Stevens-Heebner and here you'll find answers to many of your questions as well as different perspectives that I hope will inform and inspire you. Meet my colleague and dear friend, Susan Pomerantz, the founder and CEO of Concepts for Living.
Susan Pomerantz: (00:49)
My mom who use to say to me, and this was way before I fell into this profession I'm in, she used to say to me, please promise me you'll never put me in the home. The home was a nursing home because back then there were no assisted livings or retirement communities.
Marty Stevens-Heebner : (01:09)
For the last 22 years, she's worked with her clients to find them their ideal later life living community. My dad likes Susan's mom, also dreaded the idea only instead of the home, he called it the warehouse. But now...
Susan Pomerantz: (01:26)
That couldn't be further from what we work with, with our clients. And we know how quality of life in an assisted living or retirement community can exponentially, make them feel better about themselves and have a much more fulfilled life. But back then, there weren't those options for my parents.
Marty Stevens-Heebner : (01:45)
But now there are lots of options from independent living communities that feel like resorts to others with only five or six beds in them. And those are for people requiring professional 24 hour care. We're lucky to have Susan Pomerantz here to color in the full landscape of later life living. I'm Marty Stevens-Heebner, CEO of Clear Home Solutions, and this is How to Move Your Mom and still be on speaking terms afterward. So, Susan, what are some of your favorite memories of your grandparents?
Susan Pomerantz: (02:21)
My Nana was my best friend and she moved in with us when my grandfather passed away. We shared a room for many years. And when I was old enough to be dating, my mom always felt very secure in going to bed because she knew that Nana would wait up for me and that she did and I would come home and we would settle down, maybe have some see's candy between us. And she would grill me about my dates. What was he like? Where did you go? What did you do? Was it fun? And just on and on. And so I just, it was growing up with a senior, but a phenomenal senior right in my fingertips. I do believe unbeknownst to me back at that age at 16 or 17, that it was very much a part of who I am today. She was my buddy. She really was.
Marty Stevens-Heebner : (03:12)
But Susan's Nana wasn't without her frailties. And she faced those with a courage that made a big impression on her granddaughter.
Susan Pomerantz: (03:19)
She had a heart condition and she had a heart attack at 78. Came through it and ultimately knew when she was going to have an attack because it was congestive heart failure. So she would have trouble breathing and she would come and she would say, okay, it's time to go to the hospital now. And before we could go to the hospital, she would pull up her girdle. She had to have her girdle, oh, and dusting powder. And she had long white hair. And she would say, Susan, please come and fix my hair for me. And we'd put it up in a French twist. And then she would go to the hospital.
Marty Stevens-Heebner : (03:53)
I've been entertained many, a time by Susan's delightful sense of humor. And I'm sure that gentle humor is what puts her clients at ease. Removing people from the homes they've lived in for 15, 30, and even 50 years. Think of all those memories. They're literally dealing with the treasures of a lifetime and some other things. We once moved someone who was 89 years old from the home he'd been born in and lived in all his life, 89 years. It's a huge and unsettling shift. And not just for the older parents, it's tough on all generations of your family. It's really difficult. And that means if you work with older adults, you've got to be jam packed with compassion and empathy. It has to be second nature built-in especially because a lot of us have come to our current professions from others that were completely unrelated. Before Clear Home Solutions, I owned a handbag line. As for Susan...
Susan Pomerantz: (04:57)
My falling into senior care was strictly by accident. And I think by fate, I was meant to be here. But initially I was in a completely 180 career. I own children's stores, children's boutiques. You didn't know that?
Marty Stevens-Heebner : (05:15)
No.
Susan Pomerantz: (05:17)
I owned children's boutiques. I had them for 10 years and I sold it. And then I was at this crossroads of what am I going to do now? So my mother-in-law lived at the Jewish Home for the aging. And I thought, I'll go volunteer. That will make her happy.
Marty Stevens-Heebner : (05:34)
A bit of background about the nonprofit Los Angeles Jewish Home. It serves thousands of older adults regardless of faith. And all religions are welcome. The organization's name stems from its very quiet beginnings over 100 years ago. A very thoughtful group of neighbors invited five homeless Jewish men into their homes at Passover. That was 1912. It's now become one of the leading senior healthcare systems in the whole country. In addition to that healthcare, the Jewish Home provides in-home care. They also have beautiful later life living communities here in Southern California. So for the Jewish Home to elevate Sue from volunteer to staff member was a big deal. And Sue had discovered her life's vocation, work that required empathy as much as skill and knowledge as much as compassion.
Susan Pomerantz: (06:30)
I fell in love with the clientele. I mean just fell in love with them. And two months into it, they came to me and they said, we'd like you to interview as director of the program. I didn't know what the heck I was doing.
Marty Stevens-Heebner : (06:44)
Despite what Sue says, her work ethic and warmth, wowed residents and colleagues alike. They were not the only ones she impressed as it turns out because pretty soon a company with more than 30 skilled nursing facilities hired her to develop their volunteer program. So what is a skilled nursing facility, you ask? A skilled nursing facility or SNIF because of its acronym. And just because you can just say SNIF a whole lot faster. A SNIF is not to be confused with the nursing home. At a SNIF, you get high level medical care from licensed professionals like registered nurses and physical therapists. And stays there are temporary. With a nursing home, you move in to live there. Also, while there are usually certified nurses present at a nursing home, you don't get the high level medical care you see it as SNIF. Skilled nursing facilities are for people who need IVs injections, catheter care. Yikes. Usually because they're recuperating from major surgery.
Marty Stevens-Heebner : (07:51)
After Sue set up the volunteer program for all 32 SNIFs, hospice came knocking, asking Sue to cultivate their volunteer program. A lot of people get anxious and even panicky when they hear the word hospice, my dad certainly did. But during his last days on earth, when the hospice workers came and were so supportive, dad was fine with it. Especially when they told him their services and the medication they provide were free. Like my father, a lot of you probably think hospice is only for the end of life, but that's not always the case. It's also for those diagnosed with a terminal illness. And sometimes those people go into remission or even recover. They don't need hospice anymore at that point, at least for the time being. Hospice cares true purpose is to provide palliative care. That means pain management, support, and comfort. Sue took comfort very seriously.
Susan Pomerantz: (08:52)
It wasn't about just making life more cheerful. It was really about getting in deep with our patients to make them feel that one-on-one and doing some spectacular things with them. We had one person that loved the sunrises at the beach. We took her to the beach to watch the sunrises.
Marty Stevens-Heebner : (09:11)
Sue took the time to make sure they found out about the inner lives of their hospice clients and what supported their serenity. By knowing that, she and her colleagues endeavored to make their lives as peaceful as possible. Especially as they approach the end. Sue started surveying the later life landscape because she was on the lookout for living options that were more serene than a skilled nursing facility and they're equivalence.
Susan Pomerantz: (09:39)
I looked around and I said, okay, so here were the choices in hospice. Someone either died at home or they went to a nursing home. And I said to myself, there had to be something between. Many times families can't take care of them at home. It's just not possible. You've got working families. In a nursing home, it loses its personality, it loses its humanity a little bit. So I said, okay, there's got to be more out there. And that's where board and cares come in.
Marty Stevens-Heebner : (10:05)
Here in California board and cares have five or six rooms for residents who need 24 hour care and attention like people with late stage dementia or those in hospice. Board and cares are often redesigned family homes in residential neighborhoods and are hard to pick out from the rest of the neighborhood. We have lots of them in LA County now, but in the mid 1990s, Sue says you could fit all the senior living communities on the head of a pin. The number was that minuscule. But board and care communities have proliferated since then, along with lots of other later life living options. Why? Demographics. That's why. 10,000 baby boomers turn 65 each day, every day in the US, 10,000 per day.
Marty Stevens-Heebner : (10:55)
The so-called senior citizens number over 56 million now. That's up 40% since 1995. 40 years from now, try 95 million or almost one fourth of the entire US population. That's a lot of people. Sue is one of the first to see the silver tsunami coming. She knew how vital it would be to have a variety of later life living options available. Because of health and need of assistance vary with each older adult. And let's not forget that people want to live out their later lives in many, many different ways.
Susan Pomerantz: (11:35)
I was part of the trajectory that growth, that explosion as seniors live longer and what we could do for quality of life, for value of life, and fun of life, for energy.
Marty Stevens-Heebner : (11:49)
So 22 years ago, Susan Pomerantz launched her company Concepts for Living here in Los Angeles. She started working with older adults and their families to find places that offered professional caregiving and were more hospitable and neighborly than a SNIF or nursing home. Concept for Living or Concepts, as Sue often calls it, is a placement agency, finding the perfect match between person and place. And get this. Her services are free to her clients. Placement agencies in general earn commission when, and if the client decides to move into the community of their choosing. Nowadays, there are many more placement agencies. And over the years, my staff and I have managed moves alongside most of our local ones. A personal and customized approach with each client is as vital to someone doing placement as it is in my own work. And no one relates to people better than Sue, including me if I'm honest. It's her years of experience and dedication and just the natural warmth of her personality. She shaped an extraordinary practice that begins with a detailed and patient discovery process.
Susan Pomerantz: (13:10)
The initial conversation is lengthy. My goal always is to make them feel comfortable enough that they can really share with us. They can share all the pitfalls, all the angst, all the concerns, what it's like to have mom or dad living with them and they have a toddler. What it's like to go and leave mom and dad while they go off to work and then come home and find the burners on the stove on. They've been on all day. When they're comfortable enough, they feel permission to not only open up, they cry and that's okay too, because that's what we're here for. My goal usually is even if they've cried by the end of the conversation, I've made them or helped them to laugh. It's not cookie cutter. It's not generic.
Susan Pomerantz: (13:59)
So if I hear my dad was in the military, he was a Colonel. We were a military family that moved around. So he loved to travel and they want a place where maybe he can relate to the other people living there that they'd have similar backgrounds or similar experiences. And then we get of course to the physical needs, but it's more than the physical needs. It really is about that psychosocial. And sometimes it has to do with religion and ethnicity. Very often it has to do with cognition. It is so individualized. And I think that my hospice background has given me that ability to listen and advise. And I also have a former physician assistant slash registered nurse on my team. When they talked to us about a diagnosis or a condition, we've heard it. We know it. We're the only placement service in all of LA that has healthcare background.
Marty Stevens-Heebner : (15:01)
Those are the things you need to look and listen for when you're interviewing placement agencies. First, ask about their own professional history working with older clients. If it's not very substantial, they may not have sufficient experience and empathy to imagine the ideal living situation for each individual client's needs and enjoyment. Second, make sure they understand the specific kinds of support you or your loved one will need. That means you need to do a little homework and make sure you come prepared with specifics because they will ask you a whole lot of questions or at least they should. Finally, if they're hurrying you during your first interview or two, they're not taking the time to uncover the less than obvious details that help identify the best living situation, the right fit.
Susan Pomerantz: (15:54)
So we have that initial phone call and we feel like we get to know each other. And listen in that phone call, it's a whole interview because I need to know finances. I don't want them walking into a place that they go, oh my God, this is fabulous. This is amazing. This is like walking into a five star hotel only to find out they can't afford it. That's not fair. It's not fair to them. It's not fair to the community either because I've then wasted their time. So that's a very important part of it. It's also big places versus small places.
Marty Stevens-Heebner : (16:25)
So who's a good fit for a board and care versus an assisted living community?
Susan Pomerantz: (16:31)
Of course their diagnoses, if there are any is essential, because we're going to look at the places that excel in taking care of that kind of situation. Do you have someone in good health going into a board and care? It's going to be your fall risks, because that's really important. If they're habitual fallers, you want somebody who's going to hear them and know that they've gone down really quickly. Cognition is a big part of it. What's more important, the better ratio of caregivers and that immediate presence, if someone falls or is the social life, and the outings, and the discussion groups, and the arts more important? It's a give and take on both sides. So it really becomes a question of what are the primary needs versus secondary needs?
Marty Stevens-Heebner : (17:17)
Because of the increasing number of communities available, there are often dozens that could be considered, but Sue takes the time to narrow down the choices to make it easier on her clients. They're often overwhelmed by the sudden turns later life can take.
Susan Pomerantz: (17:35)
One thing that Concepts for Living does that we're very good at is designing a list of places that definitely meets their needs, but keeping it manageable. I do not believe in sending anyone, the daughter, the son, the grandchild who might be running this whole thing, God bless them or the niece who's doing it because she loves her aunt so much and their aunt didn't have kids so she steps up. I don't want them having to run all over the place and see places that are not appropriate. And I don't want them to be overwhelmed because it is overwhelming. We try to keep our initial list to six maybe. And we always say, you know what? If these don't work out, there's a whole lot more out there, but these are the ones that jump out at us that we think are the best options for your particular situation.
Susan Pomerantz: (18:24)
Be it because their rates are the best or location, location is so important. I always say to them, don't make it a field trip, because if it's so far that you have to make it a field trip, you're not going to go. You may go in the beginning, but then you're not going to keep going. And then you're going to feel bad that you're not going. Let's make this convenient for you too. So all those things that have to be taken into consideration, but we do try to keep it manageable if we have to go further and make it bigger, we will.
Marty Stevens-Heebner : (18:53)
Do you go with them when they visit the communities?
Susan Pomerantz: (18:55)
If they want us to go with them to see the place, we will do that. If it makes them feel comfortable to have that parent meet with me, it's my pleasure to do so.
Marty Stevens-Heebner : (19:06)
So families don't actually have to meet with you directly. You don't always have to do an in-person assessment.
Susan Pomerantz: (19:12)
The client is assessed by the places. When the family or the client narrows it down to what their, maybe two choices are, even one choice. That place sends out someone to see if they are really appropriate for their community. Their assessment is more important than my assessment. We send out with our listing to everyone this handy dandy little tool called our tip sheet. The tip sheet is fantastic. It's just like having us in your pocket. And it's all the questions to ask while you're touring and all of the things to look for. Obviously, you're going to look for cleanliness, but let me assure you the Concepts doesn't send you anywhere that isn't clean. So cleanliness, smell. Take into consideration, in fairness, things can happen in a moment in that environment. What they don't realize is that maybe when they walked in, it was a change of shift or it was going to become activities in the activity room.
Susan Pomerantz: (20:05)
And they've taken them out of their rooms and they're waiting to be wheeled into the dining room or whatever room was allocated for activities. 10 minutes later, everything could change. So that's very important to look at. The interaction between staff and residents, especially in a small places and between residents and residents. Going into the dining room, look and see how social it is. Is there a lot of chatter going on? Does it sound like they're having fun? Are they engaged? And then when you narrow it down, always go have lunch. They're happy to have you. You want to test the kitchen, because food is important. It's one of our last great pleasures. Sometimes you'll sit down at a table in a dining room and you'll be ignored, other than by staff serving you. Other places you'll sit down and people will stop at your table as they're walking by and say, welcome to such and such a community. We love it here. We hope you'll come and live with us. Those are the things you need to look for.
Marty Stevens-Heebner : (21:08)
You want to get a sense of what life is like there. Many communities offer respite stays where you can get things a test drive of sorts.
Susan Pomerantz: (21:18)
The larger ones, yes. The smaller ones, no. Because the small ones only have six people. The board and care homes, it's really hard for them to do a respite stay. They just don't have the capacity. Usually respite is a month. Some of them will do it for less, never less than two weeks. My focus is on getting them to where they're going to be happy. The feeling is it takes a month usually to get adjusted, to get the whole vibe going, to start to fit in, and also to find your circle of friends. They have model rooms set up. So you don't have to move anything with you, except your clothes and medications. Maybe you want to take a few pictures because a month is still a month, but you don't have to do any heavy lifting.
Susan Pomerantz: (22:00)
And when you do move in permanently, then you start bringing your furniture and things like that. And you go in and you're so compassionate and caring and patient and that you will help set up that room at the end. And then when they get to that community, they feel like they've definitely taken a piece of their home with them.
Marty Stevens-Heebner : (22:18)
So now is the time they relax, get comfortable and embrace their new life or do they?
Susan Pomerantz: (22:26)
After they move in, after they're settled in and everybody's doing well, sometimes things happen. It might be little things that can be dealt with so easily. It might be bigger things and the family is afraid to say something because it might be taken out on their senior. Or in small homes sometimes it's a weight increase and they're afraid to complain to the owner. We let them know through the whole process that we don't fade away when they move in. If they have an issue, they can come back to us and we will mediate for them. We will talk to whoever it is we need to talk to and say, hey, we referred you. We trusted you. This is what we expect in return. So it's not just like great, you've moved in, it's been nice knowing you. It's not like that. You stay a part of the family.
Marty Stevens-Heebner : (23:19)
I have so much respect for Sue's thoroughness and attention to detail. She's always thinking ahead. And she sees a missing link in the chain of later life offerings.
Susan Pomerantz: (23:29)
I tell you what we're lacking in the industry, which I tell my board and care owners all the time, we're lacking homes that don't cater to dementia. I want homes that will take a frail client who is cognitively fine because they need other people to mix with it that are on their same level. And we get several of those people. And I don't want to put them into a small home where they're not going to have conversation and it's not enough for the owner to say to me, oh, but our caregivers will talk to them. They need peer group. And they need to be able to talk about the old days.
Marty Stevens-Heebner : (24:05)
That connection with contemporaries, peer group as Sue calls it, can be so refreshing and reassuring because residents get to talk with people who remember the 60s as an adult. They remember when the Berlin wall was built, the power of Martin Luther King's words, and even the first walk on the moon, which was really amazing. I just have to say. I was wondering what Sue attributes her success and professional longevity to.
Susan Pomerantz: (24:31)
Marty, that's so hard to answer. You know me, I only have people working with me, who I feel have that same connection to people starting with Julie, who's my Jewel of an assistant. And then my team that's out there. They have to have that connection, that ability to connect and they do. And that's part of my responsibility is hiring those people. Maybe you become more seasoned with time and exposure and experience like in any other profession.
Marty Stevens-Heebner : (24:59)
No one knows as a kid, what course their life will fly along. Sue had her Nana as a child, the grandma she gossiped and giggled with late into the night. What a gift. The understanding that stemmed from that bond has been to all the clients she's found a new home for, and also to their adult children who has been relieved of the burden of having to research all those communities.
Susan Pomerantz: (25:23)
It's been a ride. It really has. I would never in a million years have guessed this was going to be my career. It's the only one I've stuck with.
Marty Stevens-Heebner : (25:33)
Sue connects because she's such a great listener and there's a story behind that.
Susan Pomerantz: (25:38)
I raised three kids and that means three adolescents. My last one was challenging. They all were in their own way, but she was much younger. So the other two were gone, off to college by the time I was raising her. She was fabulous, but very dramatic. And we bumped heads. I went by her room one day and I heard her crying. Knocked on her door and I walked in and I said, what can I do? Let me try to fix this for you. And she said to me, mommy, you can't always fix things. I know you want to, I know you're a fixer by nature, but you can't. And she said, but the one thing you can do is just listen. I have never forgotten it. I still get goosebumps when I say it. It was the single wisest thing that has ever been said to me and the single most important thing that I learned.
Marty Stevens-Heebner : (26:43)
And you carry that into your work.
Susan Pomerantz: (26:45)
Absolutely. Every single day. It's not something you learn from books or from higher education. It's just now I listen.
Marty Stevens-Heebner : (26:54)
And it's not just about hearing the words. It's really about absorbing them and taking some time to reflect on it.
Susan Pomerantz: (27:02)
And maybe not even answering. But I will tell you that on my outgoing message on one of the phone lines for Concepts, I didn't even think about it when I first said it. I say, you talk and we'll listen. And together we will make the perfect match. I've had so many people mentioned it to me over the years, that now I know it by heart, but at the time it just kind of came out and that says it all.
Marty Stevens-Heebner : (27:26)
Thank you so much for listening to, How to Move Your Mom and still be on speaking terms afterward. Please visit howtomoveyourmom.com for more information about this episode and for additional podcast episodes featuring other extraordinary guests and conversations. Until next time, this is your very grateful host Marty Stevens-Heebner.
