Acknowledgement from Our Clients and Their Family Members

I have the pleasure of meeting with local senior concierge professionals on a regular basis.  We meet regularly to get to know one another and to share ideas for success in this business.  This group is a great place for me to get a sense of the normal issues that can emerge with our very different clients and their family members.

In the last meeting, it was very clear that there is an issue about our roles in the family system.

Often times, out clients family members are busy people with their own lives just trying to stay afloat in this nutty world, raising children, making the mortgage payments, keeping careers going.  We are very needed as senior concierge professionals because we can take care of the things that our clients sons or daughters may not have the time to do or the bandwidth to stretch and deal with.  This is what keeps us employed.  

Many of my concierge professional colleagues have become VERY involved in our clients life and some of us have felt a real closeness with our clients.  As they age, and become sick, it's really hard on each of us to face those changes with them.  When more serious matters face our clients their family members come on the scene to make sure that all plans are in place and things are going along in a way that works for the family. 

During this period of time in the client engagement, is a point at which you really get to know the clients children and you get a sense of where you as the senior concierge fit into the picture of the team or family unit.

This is the point at which work with the clients can be very upsetting for the senior concierge professional.  The concierge professionals in the meeting said things like... ("I'm just treated as the help", "All that I have been doing for their parent is just tossed aside", "I know their parent and their needs better than they do", "they didn't even acknowledge me or allow me to speak at the funeral")  These are very real feelings and it can be terribly hurtful to have put in so much work for a family and to be treated like you don't matter.

I have experienced this too and I have had to resolve it in the following ways.

I know that I like to be acknowledged for all of the hard work that I do.  But sometimes, the client and their family members are not going to be the type of people that are big on acknowledgement.  As concierge professionals, we have to acknowledge ourselves for the hard work that we do. We have to give ourselves that pat on the back and say good job. This acknowledgement is something that you can't expect from your clients and their family members.  It's really nice but it may not happen.  You have to know this before getting into this work.  

Another strategy to this work that I use may seem cold but I think it helps.  I make sure that I keep my boundaries with my clients.  I keep our relationship very professional.  I don't give hugs and kisses when I come and go. Additionally, I don't spend much time letting them know about my life. I'm very empathetic to their concerns and issues because that's my role to help them through life challenges but I make every attempt to not get emotionally involved. It's difficult but I try.  

I feel that if you keep the professional boundaries of this work clear then all you're doing is providing a service and making a positive difference (hopefully) in their lives.

Establishing Your Role as a Senior Concierge

Your clients will need direction about what your role can be in their life.  It's up to us to assess their situation and present options that work for you and for them.  Below you will find my process for engaging with clients and their family members.  It's an iterative process.

Inquiry:

The initial conversation over the phone or in person should include a lot of questions about the clients needs.  

• What are your struggles?
• How are you getting help now?
• Who helps you now or in the past and how has that worked?
• What would you like to have happen?

I believe it is the role of the senior concierge to spend a lot of time understanding the initial needs of their clients.  Write all of this down. I call this their "data dump" about all that is on their mind, their fears, their wonderments, their concerns.  It's important to capture all of this on paper in bullet points (just for yourself).

This process can be wonderful for the client.  It's therapeutic to have someone take down all that's on your mind.  If serious depressive or anxious thoughts arise make sure you refer them to the appropriate help.  But in general, it's cathartic to get it all down on paper.

Processing the Information:

Present back what you have heard the client and their family members have communicated.  You might list:

• The client is having surgery and will need assistance when she comes home.
• The house needs to be prepared for this surgery because there is clutter everywhere and there are items in the home that present a fall risk.
• Bills are going unpaid because of the illness
• The house is a mess and needs to be cleaned
• Medications management and reminders are needed

Establish Your Role:

The Senior Concierge needs to quickly establish themselves as knowledgeable about the senior industry.  How do you do this? 

Here is a suggested practice:

Once you have said back to the client all that you heard them say make sure you make it clear which of the items on their list you feel are jobs that you as the concierge are able to take on.  

From the list above helping to de-clutter the house, and helping to get on top of the bills would be something that you will do.  

If they need deep cleaning you should refer them to your favorite cleaning person that you have vetted and seen their work.  You have established that they are insured and bonded and you feel they are trustworthy.  You can help to arrange this relationship. Possibly you help the cleaning person and your client figure out a rate, the way the client would like to have the house cleaned and the frequency of visits.

The post surgery help, you may recommend to them a caregiving agency that again you have vetted.  Also, it's important to talk to them about all of their options about caregiving (private or agency) etc.  

Maybe the client needs a household information booklet for the caregivers that will be coming into the home.  This is where you can list emergency contacts, doctors information, household rules, information about the client that will help the caregiver get oriented to them and their home.  

Discussing the role of a Nurse Care Manager for their medication management is another topic that you should discuss from the list above. Hopefully, you have some resources that you can draw on for this referral.  

If they need your help going to medical appointments to take notes you could be available for this. 

If the client and family members would like you to keep them informed about all that is going on at the household offer this service too.

Help them to prioritize what's important first, second, third. Sometimes it just feels like so much and they need you to help them with an action plan.  One of my clients actually only hires me to hear all that is on their mind and I present a spreadsheet of their action items, due dates, and status columns so that we can track on their progress.

So, there are a lot of things that you can do for this client even though most of what they're initially needing does not involve you-they are really needing a caregiver.  You will establish yourself as a knowledgeable in the industry and a great resource to people in need.  You have also found business for other great people in the industry too.  You have also separated yourself from the crowd and not pigeonholed yourself into a care giving role by taking on the post surgery help or cleaning lady work.

Resource List:

Remember to keep a database or filing system of resources that you can access.  It's nice to have this information at your fingertips.

On-Going Support of Your Client:

To continue to establish yourself as a concierge it's important to continue to define your role for your clients.  

When I arrive at my clients home the first thing I do is pull out a notebook.  I write the clients name and date and start the process all over again. What's on your mind?  What is needing to be accomplished? Check in about how things went last week with activities you helped with last week (you remember this because you took notes and they are kept in the client file).  How did the cleaning lady work out?  Did you like that caregiver?  The new list you review and figure out which of the items you're able to assist with and then communicate your suggested plan for the rest of the items.  

If your client has difficulty establishing what they need to have happen make sure you are having these conversations with their family members.  Family members will have a long list of items they would like to have completed.  You may look around their home and find things that you think should be handled.  I noticed your mailbox has fallen or the refrigerator seems to be leaking. Would you like me to help solve these problems for you?

Are Some Tasks Beneath Me?

No!  Someone asked me if I do laundry for a client or take out the trash.  If during the course of my other work some laundry needs to be put into a washer and items need to be brought out to the trash I will do it.  But, if you're only hiring me to do those jobs it's better that I find you an individual that can do this at a lower cost.  I feel better about the work that I do and the client feels better in their pocket book. Everyone feels a lot better and you have established yourself as a great resource to them.

Again, it's important to define your role as a senior concierge upfront and at every visit because it's very easy to get utilized incorrectly and for there to a be a misunderstanding about the work that you do.  I believe it takes a consistent effort to continually establish yourself as a concierge by listening to your clients need and then presenting back your suggested plan of action making sure that you're taking on the appropriate tasks.  

  

The Senior Concierge and Driving our Clients

I hear this so often from my Senior concierge trainees. Senior Concierge professionals ask me how to justify our rates to their clients when all they need are rides.  

We are not a driving service!   Driving may be a part of our task but this is not something we should do on a regular basis at our rates.  If my clients need rides I immediately find them a lower cost option.  There are better things we can do with our time and their money.

Getting rides to shopping, restaurants, theater events, and errands can be a huge issue for seniors and there are options but it's up to us to provide those options (for a fee).

First of all you need to match their ride needs to their physical mobility.  If someone asks you for help with finding a driver and they are a serious fall risk you will not want to connect them with a local taxi company.  A trained caregiver with insurance would be more appropriate.

Senior Concierge professionals definitely drive but it's for more important things like visiting the doctor to take notes, helping your clients in tax or legal meetings remember their questions and take notes of the answers.  These are appropriate times to drive your client where your fee is understood.

There are many driving options.  First, please consider that sometimes errands can be handled faster if the client does not come along.  Picking up cleaning, going shopping, or going to the hardware store can be very tiring for some older people and they prefer that you go for them. 

But if they definitely want a ride, finding a local caregiver through a care giving agency (that you have vetted) is a good option.  Make sure to provide the agency with all of the requirements of this employee. They need to be able to drive their own car or the clients car and have insurance to do so.

There are on-line services where you can find drivers that live in the zip code of your client that have been background checked. www.care.com is a great listing of local private caregivers.  Make sure you verify their insurance and registration as well as making sure their have the skills needed to help your client and the personality type to match.

In some cities there are volunteer organizations where people will drive for free or a donation.  Make sure you have learned about all of these services.

There is a lot in the news about Uber.  Learn how to get them a ride through this service if they are very able to get around themselves.

There are often city run services.  Here in the Bay Area of California we call this Paratransit.

It's important to educate your clients about all their options and not fear that you will lose them as a client if you find them a less expensive and safe option.  If they find that you have done a great job solving this issue you will probably be invited back to do other types of things or to sort out other issues that may come up for them. This is how we add value.

We are problem solvers..and in a way educators about all the services in the local area.  We have to do our research to be able to offer solutions to our clients.

Just a reminder.  Check with your insurance company to make sure you are covered to drive your clients.  Most business liability insurance companies will not cover you for this. Check with your vehicle insurance company if they can provide additional insurance to you for this service of driving.

Helping our Clients Find Their Way with Long Term Care Insurance

Many of our Senior Concierge clients have purchased a Long Term Care Insurance Policy.  Long Term Care Insurance (LTC) provides a portion of the funds for the costs of long term care for a designated period of time like home care or care at an assisted living facility that is not covered by Medicare.

As a Senior Concierge I have identified the policies when filing paperwork or paying their bills for my clients.  Sometimes, my clients will forget that they have paid for this policy or that their employer purchased one on their behalf earlier in their careers.  It's important to help them to determine if they have a policy or not because it can be very helpful for them as they begin to pay for assistance.  

Unfortunately, our senior concierge fees are not covered by any LTC policy because we are not home care providers and we don't have that specific licensing and certifications.

Once you have identified that the policy exists that's the first of many steps.  Make sure that your clients family members are aware of the policy too (with permission of your client).  It's important for them to know because if your client was unable to communicate this information now someone else knows beside yourself.

If you client's health begins to decline or declines suddenly and some of the Activities of Daily Living (ADL) are becoming difficult like (eating, bathing, dressing, toileting, transferring, memory, grooming, walking) it's probably time to start a claim. Most LTC Insurance companies require at least three ADL's to be problems before your claim will be accepted.  Often memory issues are in their own category and don't require additional ADL.  

Before you help your client begin a claim, the entire care team needs to be on the same page.  Your clients, the financial adviser, your Geriatric Care Manager, the doctor, and pertinent family members need to know that you're helping your client begin this claim.  It might not be a good time financially to start the claim o.  

Most LTC policies require a 90 day deductible.  This means that your clients must be living in an approved facility or be receiving care with an approved home care agency (normally a licensed organization).  This 90 day period of time can be a huge expense for your clients.  

During the claim period you will be required to fill out required forms, see the doctor to have him or her fill out a portion of the forms and often your are visited by an independent nurse to review your case.  Sometimes it can be very difficult to get your claim reviewed.  Just because you file a claim does not mean that you will pass the requirements.

I help my clients through this process because it's long and it can be very confusing.  Keep track of what has happened, who you have spoken with, and keep copies of all records you're sending to doctors etc.  

Hopefully your client will be approved and they can benefit from an added income to help pay for their care.

Our Client's Health Insurance

I'm a little late in talking about this subject since the Medicare Open Enrollment period has ended.  

I meet with a group of local Senior Concierge professionals locally on a monthly basis.  We get together to talk shop.  A few of us had just been through Medicare Open Enrollment with our clients. We all had different perspectives about how to help our clients in this area.


Medicare recipients have the right to change their health insurance coverage or supplemental insurance policies towards the end of the year to begin in 2015.  Luckily, most seniors stay with their existing plans because they have established themselves with a doctor or group that they feel good about.  Rarely do we get this request.

The women in this group are all very competent and we all felt as if we could look at plans side by side with our clients to help them to understand their options.  Some of us actually have assisted with this process.  

I think that if you understand the terminology and can convey this to your clients then more power to you; but I like to leave it to the professionals.  

I believe that if there are free options for your client and you don't have to charge them for the time to assist them, then I utilize these services.  

For Medicare choices my go to referral is HICAP  The Health Insurance Counseling and Advocacy Program (a California based organization) but there are equivalent organizations in your State. 


HICAP provides free and objective information and counseling about Medicare.  Volunteer counselors can help you understand your specific rights and health options.  

I have had several clients appreciate these counselors support and guidance through all of their questions.  However, one very competent client of mine, did not feel his counselor knew any more than he did about his options.  So, this may be hit or miss?  But, I would check it out first before charging your client time for your research.