When Is It Time to Consider Home Care?

In Monaco, a western European country that borders the Mediterranean Sea, the average life expectancy is 89.4 years. In places such as Japan and Singapore, it’s just over 85. Meanwhile, those who reside in the U.S. regularly live to 77.3 years of age. What’s causing the drastic difference in longevity? Quality of life. People who live in regions with high life expectancies boast low-stress lifestyles, healthy diets, regular exercise, working past retirement years to stay active and early detection and prevention of chronic illnesses and diseases.

How can Americans apply these practices into our daily lives and extend our life expectancy? Amazingly, that is already happening thanks to a newly formed partnership between Upside and TheKey, a private-duty home care organization dedicated to improving the quality of life for older adults and those who love them.

With a shared vision to remove the stigma surrounding traditional senior living and provide people with ways to age in the right place, Upside and TheKey are working together to offer Upside+, a revolutionary way for older adults to enjoy an elevated, independent lifestyle. Older adults who choose Upside+ live in a luxury, multigenerational apartment complex in a unit that is retrofitted to fit their needs. Upside+ members enjoy the traditional benefits of an Upside membership, such as access to a Upside Manager, Papa Pal visits and maintenance-free living, as well as a variety of additional services tailored to their individual needs, including an on-site certified nursing assistant (CNA). This caregiver, provided by TheKey, visits a minimum of twice daily and can help with a variety of needs. 

Essentially, Upside runs and operates the real estate and services component of the Upside+ package. Meanwhile, TheKey manages the caregiving portion.

“What makes us unique is while other private-duty home care health companies focus on what’s called activities of daily living (ADLs), we take it a step further by focusing on advanced training for Alzheimer’s disease and dementia care, as well as Parkinson’s disease and other age-related conditions,” says Christopher Cascio, regional business development manager for TheKey. “Our caregivers are trained to look for warning signs before something gets worse. We’re a very proactive organization the way we look at home care. We fit so well with an organization like Upside because we can help see their members through that progression as they age. A lot of the clientele that they’re bringing in aren’t necessarily in a deep need for consistent or aggressive care from the beginning. It’s a more gradual aging process, and we can be a part of that journey with them.”

The goal is for members to grow older with Upside with easy access to resources and support that evolves with their needs. This, in turn, helps them age in the right place outside of a traditional institutionalized setting.

“Our effort to do that in partnership with TheKey specifically for this Upside+ product is incredibly synergistic and very well aligned,” says Jake Rothstein, founder and CEO of Upside. “From their approach to proactive care to their understanding of the needs of our members, the alignment there is really critical.”

Right Place, Right Time

The first step to executing a proactive approach to caring for older adults is getting Upside members to move into an Upside+ home before they have a substantial need for that level of care.

“We want to extend their quality of life for as long as possible,” says Rothstein. “Our theory about all things aging is that people should really take a proactive approach to it.”

That means moving into the right home for you before a trigger event (what Upside calls one of the five Ds) happens — death, downsizing, divorce, disaster or disability.

“Get ahead of it and get yourself into the right environment from a housing, care and support standpoint so that if one of those things happens, you’re not stressed and anxious and scrambling to figure out what to do next,” Rothstein says. “Typically, when someone’s scrambling, they can make bad decisions about where to live and who to trust. If you can make these decisions proactively in a state of mind that is calm and collected, you’ll make better decisions and age more gracefully and with more dignity and the support that you need for every step of your aging journey.”

Cascio adds that a lot of things could cause a trigger event to happen, but the unique partnership between the two organizations allows the caregivers to get ahead of potential issues and, as necessary, provide more advanced care for their members. This could include increasing daily visits from two to three or four times per day.

 “One of the beautiful things about what Upside+ and TheKey are doing here is that we get to have real-time updates on what is going on with the client,” he says. “Our caregivers provide feedback to the organization consistently about what’s going on.”

That means that gradual changes to one’s mental and physical wellness are caught in advance with plenty of time to make adjustments that can help prolong their current state and keep them outside of an institutionalized setting, which strips people of their independence and increases their rate of decline.

This personalized, proactive approach allows people to live with dignity and continue to perform whatever ADLs they are able to do in multigenerational communities, which is better for their overall health and longevity.

“If there’s a possibility to continue living the way you’ve always lived in an environment with people of all ages and with access to things in the community that you might want to participate in, why would you put yourself in a position where you are moving into a facility with people who are all the same age and getting these ADLs removed from them, which facilitates that decline,” Rothstein says. “We are a completely deconstructed approach. You can receive nearly all of the benefits of a traditional senior living facility environment with things like community, care and support. We provide all of that without the stigma, without the cost and with a lot more flexibility.”

Upside+ bridges the gap between senior living options by avoiding strict housing situations and a standardized approach to care for older adults. This type of individualized support is for the 90% of individuals who are not ready to move into a traditional senior living environment. It is the key to living completely independent with amenities not available in a traditional senior setting. 

“What we find is that we have many ideal members, but there’s a couple categories of people at different stages who are really good fits for Upside+. Couples who are aging at different rates find this very beneficial,” Rothstein explains. “The fact that we can care for one of the people in that relationship without having to move both of them to a traditional senior living facility is really valuable for them. We have many a variety of members like that today.”

Other indicators that a loved one may be ready to take advantage of the services Upside+ provides include:

  • Forgetting to pay bills on time or remembering doctor’s appointments
  • Unusual credit or debit transactions on billing statements
  • Experiencing confusion when it comes to taking medication or performing other ADLs
  • Getting lost while driving
  • Indicating a reluctance to driving
  • Not maintaining a healthy diet (significant weight loss or gain), eating regularly or staying hydrated
  • Needing help managing daily tasks, such as bathing, grooming, housekeeping or doing laundry
  • Increased incidents of falling or potential mobility concerns (unexplained bruises)
  • Prolonged feelings of depression, irritability or anger
  • Withdrawal from friends or previously enjoyed social activities
  • Lower energy levels or difficulty sleeping
  • Lack of proper hygiene

Ultimately, the best way to know when it’s time for more advanced care is when a person’s safety, health and quality of life is at risk.

“At the baseline level, our goal is to keep members safe, clean and comfortable,” Cascio says. “This can be as simple as a caregiver providing medication reminders, helping them with laundry, meal prep or running errands — that’s the most simplistic approach. It also could be as advanced as bathing, dressing and grooming support and regular transportation to doctor’s appointments or other activities.”

High-Quality Care

Allowing a company to send a stranger into you or a loved one’s home and trusting them to provide an adequate level of care is no easy feat. That’s why TheKey goes to great lengths to hire professional, passionate caregivers with a range of experience, skills, personalities and credentials.

“Caregivers have to be certified home care aides or licensed, certified nursing assistants to work in our organization,” Cascio says. “Once they join TheKey, they are trained on ancillary services as well. We do advanced training for dementia and Alzheimer’s care, as well as fall-risk prevention.”

Caregivers also are trained to be on the lookout for potential areas of decline and implement activities to combat them, including:

  • Encouraging stimulating activities, such as puzzles, art, games and more that boost engagement, strengthen the relationship between the member and caregiver and reduce the rate of cognitive decline and symptoms of anxiety or depression
  • Creating appropriate, age-related meal plans and encourage members to avoid indulging and eat mindfully
  • Customizing fun, safe physical activities to increase movement and reduce the risk of falls and other health problems
  • Helping members find joy and meaning in life through relaxing activities such as yoga, bird-watching or listening to music
  • Encouraging members to socially engage with others by making new friends, discovering a new hobby or staying connected to the community, all of which provide emotional support, limit stress and reduce loneliness
  • Ensuring members are getting consistent, high-quality sleep to help regulate their mood and increase cognitive function

In addition to the high standards TheKey sets for its caregivers, the organization also understands the importance of supporting those who work the closest with its members. Unlike many other home care agencies, TheKey caregivers are W2 employees, which means they are licensed, bonded and insured through the company. So if anything happens to a caregiver in someone’s home, the member has peace of mind knowing that TheKey is going to take care of the caregiver because they’re protected by the organization’s insurance.

“Our caregivers are incentivized to stay with us and work with us for long periods of time,” Cascio says, noting many other benefits, as well as staffing and scheduling oversight and additional support that includes a direct client manager and caregiver ambassador team. “The ambassadors make sure our caregivers are supported and being treated the way they should be because without them, we don’t have a business. They are the most important part of our organization.”

Because the model for Upside+ groups members together within a specific vicinity, it’s not only beneficial to the members, but also the caregivers because it prevents them from getting burnt out and adds variety to their day.

“Being able to provide that type of environment for the caregiver benefits the older adult themselves, but also helps with costs,” Rothstein says. “We’re able to split the cost of a caregiver across 10 members versus a traditional home care setting where someone has to pay for that caregiver for the entire day in order to give the caregiver sufficient business to make a living. So we think there’s a lot of benefits on both sides for this model.”

Cascio echoes that sentiment, adding that TheKey looks for caregivers who are not only highly qualified, but who also possess traits such as compassion, kindness and patience and have a true passion for caring for others.

“The type of caregivers we choose to be a part of this Upside+ model are people who have the skill set for advanced ADL care, as well as the type of personality where companionship and that type of social interaction is always front of mind,” he says, adding that in order to take a proactive approach to care, TheKey also ensures caregivers are the right fit for members’ specific needs. “We are a large enough organization with a deep enough caregiver pool that we can match a caregiver with a member based on their individual care plans and needs. That allows us to learn about the members from the beginning and build real trust with them. If we can do our due diligence on the front end and get the right fit and the right person, that’s going to lead to quality care and longevity in the home. That’s what families are looking for beyond anything else.”

TheKey Care Provider with Upside+ Member

Changing the Future

With the recent launch of Upside+ in Boca Raton, Florida, the partnership between Upside and TheKey is off to a successful start. Already, members are boasting a way of life that they never thought possible and don’t know how they ever lived without the services these organizations are providing.

“This is something that has become not just a luxury, but a necessity for their quality of life,” Rothstein says. “There’s so many things that as people age, they lose the ability to do themselves, which inherently causes them to lose their independence. We enable them to maintain that independence with a little bit of support, but not overbearing care.”

From the caregivers’ perspectives, they report that Upside+ members feel valued and treasured. “Hearing such positive feedback from both sides really cements what we’re doing here,” Cascio says.

As far as what the future of Upside+ holds, the goal is to grow and provide these services to communities throughout the U.S. and beyond.

 “Having an organization like TheKey stand behind this from the caregiver, quality and national coverage standpoints is really important for us because we plan to move out of the pilot phase and take this to the rest of Florida, the rest of the country and the rest of the world with the backing and support of a credible caregiver network and people who have a lot of experience doing this and are already operating in all of these markets,” Rothstein says. “Scale and speed are vital to our plan so we can maximize our positive impact on older adults everywhere.”

For Upside and TheKey, the partnership between the two organizations not only aligns from a business standpoint, but also their missions are personal for every person who works to ensure their success.

“It feels good to see that when we get the proper care in place how much that changes the way these people age, and that’s very personally gratifying,” says Cascio, who started his career as an EMT before advancing to management and business development. Regardless of where his path led him, he always knew he wanted to be in the health care field because he wanted to help people and bring value to his career. “TheKey’s goal for how they look at health care fits the values I have. I didn’t want a career where I felt like I was talking about something that I didn’t truly believe in or care about.”

For Rothstein, thoughts of grandmother give him the inspiration and drive to pursue his dream of providing better lives for older adults everywhere.

“When we’re delivering care to people and getting them in the right home environment and supporting them in the right way, I think of the things I used to do for my grandmother,” he says. “The fact that, through this partnership, we can scale that impact and have that ability to support older adults across the aging journey and across the country is hugely impactful and hugely personal. I truly believe that we can help people, and it feels really good to be able to come to work every day and do that.”

Just Ask

Are you ready to take the next step to living an affordable, yet luxurious, independent and maintenance-free lifestyle tailored to support your unique aging journey? Contact an Upside Advisor today to learn more about Upside+.

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