A Patient Advocate's View

How Caregivers Can Save Time and Reduce Stress

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January 5, 2016 Posted by | Uncategorized | Leave a comment

WHCOA: 5 months later, Experts report in

Carol Marak Headshot

Experts know that older adults rely on good health to remain independent and productive but by the measure of medical diagnoses, baby boomers are sicker than their predecessors. The NCOA confirms 92 percent of older adults over 65 live with one chronic condition, more than two-thirds (77 percent) have at least two, and about 15 percent have at least six long-term ailments. The sickest account for more than $324 billion spent on traditional Medicare.

Knowing the massive numbers of sick people, financing long-term care might be unsustainable. But why didn’t the conference tackle the problem of paying for long-term care since it’s the most unstable factor eating into our retirement security? A new federal brief found that half of Americans who reach age 65 will experience severe functional needs and will pay $138,000 out of pocket for care.

The White House has access to such figures — so, why was it missed?

But that wasn’t the only one. There were a lot overlooked. Topics like the future of aging, transforming nursing homes, dementia support, and tapping the vast knowledge of older adults — all ignored. And since expert panels who could give meaningful answers to the critical issues were not included, asked prominent aging leaders to share their perspectives of what SHOULD have been discussed:

In your experience of reading about (or participating in live webinars during) the White House Conference on Aging, name one aging opportunity the conference missed?

More focus placed on retirement security, prevention of elder financial exploitation including abuse, and long-term services and supports. Evan Farr, Farr Law Firm — Strengthening Social Security and finding ways to protect pensions and Medicare not covered nearly enough. Also, the agenda overlooks our diversified older population (including ethnic, non-white, and LGBT elders).

WHCOA missed creating solutions not just revealing problems for caregivers trying to meet needs of aging carees. Kathy Birkett, Senior Care Corner — Can we give tax incentives for adult caregivers working while caregiving? How can spouses pay for items not covered by Medicare-homecare, training, co-pay, dental care, hearing aids? It would also have been helpful to have a real forum for caregivers to voice their concerns during WHCOA.

The main complaint I hear from patients is not getting to see a doctor. Caryn Isaacs, Get Health Help — The change from doctors to Physician assistants and nurses doing doctors work, the changing role of the physician to a paper pusher. I asked this question at a conference and was told that the plan was to phase out doctors.

Caregiver health and well-being isn’t covered sufficiently and that mirrors society in general. Anthony Cirillo, The Aging Experience — Family caregivers in the workforce is another important issue that needs to be discussed. A recent report looking at hospital chief experience officers and their role found a glaring lack of initiatives and priorities focused on caregiver burnout.

We need to combat Ageism. Michelle Jeong, Reminder Rosie — We need to combat Ageism directly to tap into the wisdom and experience of those over 65.

Respite for caregivers. Nancy Wurtzel, Dating Dementia — I’d like to have heard more concrete details about how to provide respite for caregivers. Respite care is discussed, but the reality is that there are not enough free or affordable programs for those of advanced age or those living with Alzheimer’s. This has to change as we are facing a rapidly aging population and it will take people and money to make this happen.

A look at senior living community regulations and how they hinder/help could be beneficial. Michelle Seitzer, — It seemed to be quite comprehensive in its scope. But perhaps a look at senior living community regulations and how they hinder/help could be beneficial, particularly as the new generation of senior living residents is already changing what these communities look like and what services they provide.

The opportunity to advance LGBT senior rights was one topic sorely overlooked. David Mordehi, Advise and Protect — Great strides were made this year in marriage equality laws; however, with Congress not funding the conference on aging in 2015, many believe the opportunity to advance LGBT senior rights was one topic sorely overlooked. Unless addressed, this populace of elders will continue to suffer discrimination when it comes to housing and healthcare.

The glaring need: to increase the frequency of the conference Nancy Ruffner, Navigate NC — It needs to rise in the frequency due to the swelling of our aging demographic and include more topics. Sure, we further engagement with watch parties and online access. We may even connect the consumer to visionary and to spur action. The rub for me and many is: one day, in 10 years time, and four topics?

Society’s stigma against aging and caregiving. Connie Chow, DailyCaring — Caregivers are isolated and feel alone in their struggles. How can they get support unless they can speak openly about their experiences and needs? Today, one in eight Americans are caregivers, so why isn’t caring for seniors discussed and supported like caring for children is?

Endorsing penalty-free and tax-free withdrawals from qualified accounts to pay for long-term care or LTC insurance. Stephen Forman, Long Term Care Associates, Inc. — This year’s WHCOA generated nearly 20 large-scale initiatives on topics ranging from aging-in-place to fall prevention. And while the White House took steps to encourage better retirement planning (via the 401(k), myRA and TSP programs), it stopped just short of that missed opportunity.

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December 16, 2015 Posted by | Uncategorized | Leave a comment

Please help me to continue to offer mentorship.


Mentors Martha & Matt

I met Martha Stevens when I was just starting out in my career, as a healthcare practice management consultant. Martha was surprised when I told her recently that I always told people that she was a role model and mentor to me. She has always been there for me with advice, referrals and friendship. After 30 years, I was finally able to pay her back by being there for her when her husband began demonstrating the signs of Alzheimer’s disease.  Matty passed peacefully this summer after returning from a Florida vacation. With the help of Laura Giunta of Senior Helper’s Martha had wonderful home health attendants to make sure that Matty was able to stay comfortable at home.

For the past year, I have been listed on the Alliance for Professional Health Advocates as a mentor.   Take a look at some of the other mentors and the reviews they have received.

It has been my pleasure to take calls from people who are interested in becoming Professional Patient Advocates. I’ve followed up with advice, references and referrals. The only thing I’ve asked is that if I’ve helped you to advance your plans in becoming a Patient Advocate that you write a review for me either on my LinkedIn profile or on the APHA mentor page.

Now, I am in jeopardy of having my listing removed from APHA because I am not getting the feedback that is required to keep this program going. All I ask is that you post a sentence of two to this easy to fill out form. Your contact information will not be shared with anyone unless you give permission.

Please take a moment to help me to keep this service active. The review should be of my coaching/mentoring service if I have helped you to increase your business, not for my Patient Advocate services.

Here is the link where you can post a review.

Thank you, Caryn Isaacs

August 25, 2015 Posted by | Uncategorized | Leave a comment

Maintaining a healthy weight.

Dean  Witherspoon  Dean Witherspoon just posted a new white paper — Small Steps or Giant Leaps: What Works Best for Health Behavior Change?
In it he talks about the difference between lasting weight loss experienced by people who lose weight quickly, but put it all back on and those who are able to lose it quickly and then keep it off. He mentions the “Biggest Losers” diet as one in which the people are not able to maintain the weight loss because the program is too strenuous. In comparison, he shows that people who try to make just small changes, like taking the stairs instead of the elevator, will not be able to maintain their weight loss program because the rewards are just too small for the person to feel incentivized. That last one describes me.
I came to realize that most of my clients who suffer from diabetes, heart disease, COPD and cancer have all been overweight. Knowing what to do and how to do it were not enough to help these people to lose weight. Several of my clients in nursing homes have finally lost weight only because their meals are prepared for them by a dietician and there is no way for them to get other foods.
Rather than wait to take that drastic step, I am starting the Nuvo Ultimate Fat Loss Diet TODAY! This is a four stage program in which you lose weight rapidly while learning to maintain the weight at the same time. It is doctor and nutritionist supervised. It has many of the successful aspects of the programs that Dean talks about, including eating real food, not the shakes and bars that have been my (unsuccessful) go to plan for over twenty years.

Another part of the plan is using EFT, Emotional Freedom Technique to help you through the stressful times, and reduce the chance of emotional binging. I found a great EFT video that you can tap along with, from the Mercola people.
Wish me well. I plan to post my weight loss and other experiences here, so look for the before and after pictures by the end of summer. Yes, this is one of the things a successful diet starts with, letting people support you.

July 21, 2015 Posted by | Uncategorized | Leave a comment

Misconceptions on Aging Report: America Has a Major Misconception on Aging

Forty-four senior care industry experts discuss the financial and emotional toll on an unrealistic aging population and offer pro-active solutions.

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Misconception on Aging

Misconception on Aging

We are facing a catastrophic shift downward in the standard of living for the majority of people in the United States. Social security won’t save us. Our kids won’t house us. And, our savings won’t cover us.

St. Louis, Missouri (PRWEB) April 28, 2015 has published the Misconception on Aging report that delves into the reality problem Americans have regarding aging and long-term care needs. While 70% of the population will need long-term care services as they age, 63% of Americans do NOT believe they will need such care.

In the report, Carol Marak of interviewed 44 senior industry experts, from organizations such as the American Health Care Association and The Scan Foundation. The experts discuss why there exists such an unrealistic perception of the care that will be needed and the consequences of a nation unprepared.

The report discusses the perception gap – between the care individuals will need versus the care individuals believe they will utilize. Dr. Bill Thomas, who the Wall Street Journal dubbed one of the Top 10 Americans shaping aging, suggested “human beings have a very limited ability to accurately predict or even really imagine the needs of their future self. It is especially true when that future contains scary possibilities and lies decades in the future.”

It also addresses the consequences that people face if not prepared for long-term care. Rhonda Harper, Founder and CEO of Penrose Senior Care Auditors, states “We are facing a catastrophic shift downward in the standard of living for the majority of people in the United States. Social security won’t save us. Our kids won’t house us. And, our savings won’t cover us. We risk state-institutionalization on a massive scale.”

The experts shared potential solutions to educate the growing aging population on closing the perception gap and to better prepare for their future care needs. When asked how he would improve the public’s perception, Dr. Bruce Chernof, CEO of The Scan Foundation, states “Working families need better tools to plan and pay for their future care needs, and this can only happen when there is a groundswell of public support and dialogue.”

Mr. Tom Burke, Senior Director of the American Health Care Association had this advice for consumers, “Start the conversation about the future with aging parents now so everyone can agree on a course of action before the unthinkable happens.“

The comprehensive Misconception on Aging report, with Key Findings and Full Text answers from all 44 experts, can be found online at

About is dedicated to informing consumers about the realities and options within the senior care industry. brings together established experts in the senior industry to discuss the pivotal issues the country faces as the demand increases for quality senior living and health care for the growing aging population.

Caryn is listed at here

July 6, 2015 Posted by | Uncategorized | Leave a comment

Celebrating 5th Annual Private Professional Patient Advocates Week

Patient Advocacy is getting their own Prime Time TV show on ABC!

The Advocate was inspired by the real story of former talent agent Byrdie Lifson-Pompan, who teamed with Valerie Ulene, a medical doctor and a health education specialist, to launch a healthcare consulting company, It centers on Francis “Frankie” Reese, a tough, resourceful, type-A businesswoman at the top of her game who has a medical scare and experiences firsthand the hazards of our healthcare system. Shocking her friends and family, she leaves her career behind, becoming instead a brilliant and relentless advocate for anyone caught in the chaotic and ever-changing maze that is modern medicine.

I am a member of the Association of Professional Health Advocates.

I am also listed as a mentor on their site.

Here is a press release from Trish Torrey, author and founder of APHA.

pppawheaderThe Fifth Annual Private Professional Patient Advocates Week – is this week – March 16 to 22 -and I’m here to share tales of the growth of our profession.

Can it be that patient advocacy as a profession is now so “old” ?  Granted, there were a handful of advocates practicing long before we began to quantify and qualify the profession.  The year 2009, with the launch of NAHAC and APHA / AdvoConnection, marked the beginning of the growth that would make us a recognized profession across North America.

Some background:

From the 30-ish people who joined AdvoConnection in 2009 – for free! – with a belief that this might be an interesting alliance full of possibilities… to the almost 550 members of APHA today, and dozens more who aren’t yet on our current radar…  yes, growing.

So, as I did last year, I thought I’d share a profile of our membership and achievements:

  • We hail from 38 states and 2 Canadian provinces, with more members from California than any other state or province.)
  • We are international, with members from Australia, Russia, South Africa, Spain and the UK.
  • We represent advocates who have been performing advocacy services for 30+ years, those who are just exploring the opportunity to perform advocacy services as a business, and everywhere in between.
  • Our APHA members provide at least 40 unique services to their clients.
  • About half our membership is signed up to use our APHA Forum where we discuss every topic imaginable (the other half could participate, too, but they’ve never signed up.)
  • We have held 50 teleconferences with experts to help members build their practices.
  • The Alliance and AdvoConnection have been mentioned in the likes of O Magazine, Health Magazine, Forbes, CBS TV, CNN and others.  Its members have benefited from dozens of local press mentions.

March 18, 2015 Posted by | Uncategorized | Leave a comment

Plans for 2015

Beverly&Caryn   I haven’t posted here for the last few months, but if you follow us on Facebook or LinkedIn, then you know we’ve been busy with some very difficult situations for our clients. Many of you will know the clients I am talking about, so here are some updates.

Client A is a 66 year old man with chronic progressive health conditions including arthritis, gout, diabetes type II, depression and Obsessive Compulsive Disorder. We have been to all kinds of specialists, hospitals, rehab facilities and mental health providers without any improvement. Currently, we placed him in an assisted living facility with a full-time aide, while we attempt to find a residence that is more appropriate to someone of his age.

Client B is a 94 year old man suffering from Osteomyelitis caused by a non-healing heel wound. We were able to keep him in an independent living environment with private care for the past six months. At this time he is in a rehabilitation facility after which he will be transferred to Long Term Care in the same facility. He is happy to be alive and we will continue to help to keep him that way.

Client C is an 89 year old author, playwright and concert accordionist. We have tried to find her a cat to replace her long time pet. After fostering and returning over a dozen cats, she recently adopted a teacup yorkie. We are in the process of training the dog with the help of a behaviorist.

Client D is an 84 year old man whose family member helped herself to the man’s life savings. With the help of Iris Bikel, attorney the man is now home from the nursing home he waited in while Medicaid was approved. Unfortunately, the Long Term Managed Care plan we chose didn’t work out. No one was watching that he took his medications or ate properly. With the help of Ilene Griensky, Elder Care Consultant, we are looking forward to changing the MLTCP and have recently changed the home care agency.

Client E is someone we have known for a few years. A few months back his POA asked me to help to place him in a skilled nursing facility so that Medicaid would pay for his care. This didn’t sound right to me, as I didn’t see the need for skilled care. The POA somehow got the patient accepted by a nursing facility, but as private pay since his irrevocable trust was only set up a couple of years ago. Just before Christmas we had a call from the client asking why he had to stay in a nursing home. This is one story we will tell you about in more detail when we have everything settled, but happily we helped him to go back to the assisted living facility where he was living before.

We are thankful that all our regular clients are healthy and we continue to enjoy their company. We also have several new clients starting in 2015. We look forward to the challenges we will face together.

January 4, 2015 Posted by | Uncategorized | Leave a comment

4th Patient Advocate Conference: Take the lead in guaranteeing patient- and family-centered care

I wanted to let you know about the 4th Annual Patient Advocate Conference: Take the lead in guaranteeing patient- and family-centered care for your patients. This conference is produced by the Professional Patient Advocate Institute, a professional organization that I rely on for timely and informative information. Here’s a link if you’d like to learn more about the Patient Advocate Institute:

The conference will take place December 3-5, 2014 at the Wyndham Hotel in Orlando, FL. Join your peers to learn, network and share ideas on the emerging practice. As a friend and colleague of mine, I have secured a VIP rate for you where you can register at the early bird member rate of $395.00. If you’d like to come in a day early and attend one of the pre-conference workshops, you can register for the early bird rate and attend the conference and the preconference workshop for the rate of $890.00! Take a minute and review the agendaand the line-up of speakers. Register today at and enter VIP code PPAIPARTNER to take advantage of these great rates. The rates will be in effect November 30, 2014.

If you have questions, or would like to discuss the pre-conference workshops, please feel free to email Anne Llewellyn, the Conference Chair at

October 23, 2014 Posted by | Uncategorized | Leave a comment

Life Changing Events, June 8 in Kew Gardens

JUNE 8, 2014
2 PM- 4 PM
Join Us for an enjoyable afternoon of discussion about everything you need to know before making any decisions about a life changing event.

Caryn Isaacs, Private Professional Patient Advocate has 35 years of experience helping people to navigate the health care system. She will help you to determine if you are the right person to take on the role of guardian,health care proxy or power of attorney. 347-965-9222

George Fehling, Daily Money Manager “King of Queens” The Queens Courier honored George for his commitment to the people of Queens. He will talk to you about organizing life’s details upon deciding to downsize or the death of a spouse. OrganizingLife’ 718-605-2626

Iris Bikel, Esq, Elder Law Attorney will help you to work through the maze to protect you’re the assets you have taken a lifetime to make. Besides the wills, trusts and health care forms, Iris looks at business succession plans, special needs planning, tax reduction techniques. 917-640-6292

Marc Miller, Ph.D. is a professional coach and mediator who specializes in helping family members to communicate more productively with each other. Marc will discuss the conflicts and misunderstandings that may arise when facing decisions regarding health care and changes in living arrangements. 516-935-7711

Annette Fisher is a Certified Senior Advisor NMLS 67607, Reverse Mortgage Specialist and Real Estate Salesperson. She is passionate about keeping seniors in their homes & other options.
Fort Funding Corp. Licensed by New Jersey Department of Banking and Insurance. Registered Mortgage Broker New York State Department of Financial Services. Loans arranged through Third Party Lenders. Connecticut Mortgage Broker Only. Not a lender or Mortgage Correspondent Lender. Equal Housing Opportunities. Fort Funding MLS 39463 718-968-5242

The New Homestead Senior Citizens Retirement Home
82-45 Grenfell Street
Kew Gardens, New York 11415
For more information Call 347-965-9222

June 6, 2014 Posted by | Uncategorized | Leave a comment

Gumming it the tasty way!

Many of my clients, who are in their 80’s and 90’s have been eating real food without any teeth. Some say they’ve lost their dentures, usually in the hospital, and some say they just don’t like them.


My own mother lost her teeth in her 30’s. In those days, the dentists believed that removing the teeth would help her chronic swollen glands. It didn’t do anything for that or the sinus problems she continued to have the rest of her life, but it did change the way she ate. In fact, I can hardly remember her eating anything with us at the table, except Chow Mein. When Burger King opened in the neighborhood, that became her favorite place to eat out. I think that may have been because the grilled burger broke up easily. She also liked spaghetti, eggs and French toast. When she became very weak with Myelodysplastic Anemia, I tried to get her to eat more vegetables. I made them in a stir fry, the way I love them. She pushed them away and said, I don’t eat that kind of stuff.  Now, I realize that she may not have been able or comfortable chewing it.

I firmly believe that fresh whole food will improve our health and increase our vitality. I recently saw a Facebook post from a company that has taken real food to a new level for people who need some help chewing.  Image

After I commented on their Facebook page that I loved their idea, they contacted me to talk more about their service, which is for assisted living facilities and nursing homes. I suggested that I would like to share the information with my contacts and they said that I could borrow anything I wanted off their website, So, here’s a little something to chew on:

Grind Dining™ is an innovative food services process designed to restore the dignity and enjoyment of mealtime for individuals with cognitive, neuromuscular and chewing disorders.

Consider an special entree of turkey with gravy, herbed stuffing, cranberry sauce, mashed potatoes and green beans – exactly the kind of sumptuous mealtime offering marketing studies have shown greatly increases resident satisfaction and drives higher occupancy in senior living communities.

But what about those with cognitive, coordination, muscular and other disorders that make using the utensils for this kind of menu item difficult or impossible? To serve these residents the same meal, they’ll need personal assistance. Or they’ll have to settle for unsatisfying, prepackaged finger food.

Grind Dining™ changes that. We start by using our “patent-pending” process of grinding the cooked foods on that day’s menu in a way that retains their taste, texture and flavor. And we train your staff to present the same meal in an alternative way, so that impaired residents are able to feed themselves without assistance.

The Grind Dining™ Method presents these transformed menu items in a visually pleasing manner and is as fully nutritious and as easy to digest as the same offerings on the regular menu, but without the need for utensils. In short, we make finger foods that actually taste good and that you would proudly serve to all your residents.

More importantly, Grind Dining™ creates a sense of inclusion for mentally- and physically-challenged residents – as well as the families who come to visit them – by allowing these important residents of your facility to enjoy the same delicious food your staff is serving to the rest of the community.

Image Thanksgiving Before  Image After Grinding


Chef Sarah Gorham

Chef Gorham holds a M.S. in Hospitality Management and Tourism and B.S. in Hotel and Restaurant Management from the University of Wisconsin-Stout

She has 23 years of experience in hotels, restaurants, catering, and hospital food service with 15 years of management experience in this field. Positions held include executive chef, sous chef, food production manager, co-founder/chef, and culinary consultant. Former employers include Marriott Hotels and Resorts and Two Chefs, Inc. She opened 4 hotels for Marriott including the Marriott Marquis, Atlanta, Georgia.

She also has 19 years in higher education as Associate Dean of Academic Affairs, Culinary Arts Department Chair and Chef Instructor.

Chef Stone Morris

Chef Morris has over 24 years of food service experience in restaurants, catering, country clubs, and five-star luxury hotels. The positions held include hot and cold food banquet supervisor at the Marriott Marquis, co-owner of an award-winning vegetarian restaurant Two Chefs, garde manger chef for The Ritz-Carlton, and line chef at The Buckhead Diner. Stone became a Certified Working Chef by the American Culinary Federation in 1981. She continues to work as an accomplished food-stylist for print and film. Clients include Coca-Cola, Home Depot, Southern Living Magazine, and Williams-Sonoma.


Here are some more eye pleasing food choices:



Here’s an excerpt from their blog. It’s the perfect example of what I always tell people who ask me how to get started in the Patient Advocacy business. Follow your passion!

How we got started…

“When you passionately believe in an idea that does not yet exist, then you CREATE it!”

Sarah and I had this idea that memory impaired and cognitively challenged residents in long-term care facilities deserve better choices when it comes to what they eat. Both of us had seen too many dining rooms where residents who had trouble eating were relegated to being served fried nuggets, spoon-fed pureed food, PB&J sandwiches that were torn apart by caregivers and other forms of finger food. All this while the residents at other tables had a choice of delicious-looking meals that they could eat on their own.

It just isn’t fair, we thought. And it doesn’t have to be that way.

The task of finding real dining alternatives for these residents was more daunting than we anticipated. The challenge, we discovered, wasn’t just in finding finger food – pigs-in-a-blanket, peanut butter-stuffed celery sticks, meatballs, those choices were always available. But creating something that was both nutritious, visually appealing and similar to what residents were getting on the traditional menu meant we had to rewrite the finger-food cookbook.

That’s when I remembered my Grandmother Bubbie’s tradition of using a food grinder to make gefilte fish, grinding and poaching fish into balls. If it worked on this time-honored Jewish culinary tradition, might it work on other, everyday meals?

So we employed Sarah’s grandmother’s old food grinder in our kitchen, added some attachments, and were off to the races. While experimenting with different meals, we heavily researched how cooked and ground meat was not only nutritious, but for many – especially the elderly – it was easier to chew and digest.

Plus, this was personal. Sarah’s mother had been living with dementia for four years. She passed away last summer at the age of 91, just as we completed our second pilot project at a Cobb County assisted living facility.

Having worked in restaurants, commercial kitchens, cafeterias and institutional settings, we knew the finished product would need to taste great AND but be served with a sense of flair. Memory care and cognitively impaired residents deserve the same presentation as other residents. We transformed selections from the main menu and created a palette for these meals that looked every bit as good – if not better – than what everybody else gets.

So began the Grind Dining experience. Much has been learned since we created those first few meals. We’ve put our technique to work in several locations and have put together a training program, toolkit and other professional services that can be used just about anywhere with any patient population.

We’ll be updating this blog as frequently as we can to let you know how that’s going and to present some interesting stories, research and other news that you might find useful. We invite you to share your experiences too. If you have a family member, friend or loved one who lives in a residential facility that might need our help, please let us know. And drop us a line on how you think all of us can do better at ensuring these folks can joyfully anticipate eating again.

One last note: We’re calling this eating with Ida because we both had close relatives with that name. So we borrowed it from them to stress Grind Dining’s strong belief that everyone should be able to dine with Independence, Dignity and Accessibility.


I look forward to sharing some of these meals at the residences I visit soon.  Maybe a buffet at a SUN or PESID meeting might be on the menu too.




April 27, 2014 Posted by | Uncategorized | , , , , , , | Leave a comment