Dr. Joseph Gaugler

And then the third resource I think is really helpful is, I believe it's University of Ottawa, or the Ottawa Health Research Institute. I forget the acronym, forgive me. But they actually have a whole compendium of different shared decision-making resources, many of them evidence-based, for a range of different healthcare decisions.

And then the third resource I think is really helpful is, I believe it's University of Ottawa, or the Ottawa Health Research Institute. I forget the acronym, forgive me. But they actually have a whole compendium of different shared decision-making resources, many of them evidence-based, for a range of different healthcare decisions.

And one of them includes making the decision to enter a nursing home or residential care setting. And it's very nice and it's very interactive. And again, it helps... families weigh the pros and cons, and it's tailored to each situation as to whether it's potentially the right decision or not. Again, these are all great resources. They've been developed and created.

And one of them includes making the decision to enter a nursing home or residential care setting. And it's very nice and it's very interactive. And again, it helps... families weigh the pros and cons, and it's tailored to each situation as to whether it's potentially the right decision or not. Again, these are all great resources. They've been developed and created.

The issue, as it is with so much of knowledge and innovation and science, Barry, is less about do these tools exist and more about disseminating and implementing them effectively. That whole latter piece to me is, again, something I'm really interested in, but In large, I think many of us, particularly those in academia, have not done a good job in attending to.

The issue, as it is with so much of knowledge and innovation and science, Barry, is less about do these tools exist and more about disseminating and implementing them effectively. That whole latter piece to me is, again, something I'm really interested in, but In large, I think many of us, particularly those in academia, have not done a good job in attending to.

social workers and i think it's usually just like we we started the program off with stanton i mean it it varies and it depends really on what are the financial resources of that particular family i mean uh in in most instances payment often will begin although i can't even say most instances i'd have to look into this more yeah but often for many families it'll begin with some

social workers and i think it's usually just like we we started the program off with stanton i mean it it varies and it depends really on what are the financial resources of that particular family i mean uh in in most instances payment often will begin although i can't even say most instances i'd have to look into this more yeah but often for many families it'll begin with some

private pay option yeah uh you know if one is lucky enough to have long-term care insurance and again very few do that can cover some aspects of services at least at the beginning but i think where it becomes challenging for many families is if someone and we know with people living with dementia it could be many years um someone who's living in residential long-term care at some point you know the resources that one has available are going to run out of 401k exactly

private pay option yeah uh you know if one is lucky enough to have long-term care insurance and again very few do that can cover some aspects of services at least at the beginning but i think where it becomes challenging for many families is if someone and we know with people living with dementia it could be many years um someone who's living in residential long-term care at some point you know the resources that one has available are going to run out of 401k exactly

All of those things. And so then, you know, the very challenging decision has to be made about, quote unquote, spending down where then public insurance covers it, which is Medicaid. That then also limits options, limits availability in terms of where people can go, where they can stay. And so, again, it becomes a very fragmented process.

All of those things. And so then, you know, the very challenging decision has to be made about, quote unquote, spending down where then public insurance covers it, which is Medicaid. That then also limits options, limits availability in terms of where people can go, where they can stay. And so, again, it becomes a very fragmented process.

series of financial decisions that often families are confronted with.

series of financial decisions that often families are confronted with.

Right. Medicaid, when it was originally designed and developed in the mid-60s, was never intended to pay for long-term care. It was health insurance, medical insurance for the poor. It's become, in many ways, de facto... financing, public financing for long-term care and maybe broader long-term services, but specifically residential long-term care.

Right. Medicaid, when it was originally designed and developed in the mid-60s, was never intended to pay for long-term care. It was health insurance, medical insurance for the poor. It's become, in many ways, de facto... financing, public financing for long-term care and maybe broader long-term services, but specifically residential long-term care.

There are many scholars who have explored how can we better refinance long-term services and supports. And when I use that term, long-term services and support, broadly thinking of not just residential long-term care, but community-based supports, how can we better come up with refinancing models that can allow people to stay at home longer, which again, most of us prefer.

There are many scholars who have explored how can we better refinance long-term services and supports. And when I use that term, long-term services and support, broadly thinking of not just residential long-term care, but community-based supports, how can we better come up with refinancing models that can allow people to stay at home longer, which again, most of us prefer.

But that may also provide some cost savings to us as a public as well.

But that may also provide some cost savings to us as a public as well.