Healthcare Equity, Caregiver Burden & the Long-Term Care Crisis with Henry Mason Jr. === Caregiving Crisis Overview --- Candace Dellacona: Hey, survivors. As most of you know, the caregiving crisis is not just one problem, it is three. And today we are connecting the dots between healthcare equity, caregiver burden, and long-term care. Join us. Candace Dellacona: Hey, survivors. Welcome to another episode of the Sandwich Generation Survival Guide. I am your host, Candace Dellacona. Today's conversation is one that I believe every caregiver, healthcare professional, policy maker, and family should hear. We often talk about the challenges facing those of us in the sandwich generation. We're balancing our careers, we're raising our children, we're caring for our aging parents, but you know, the caregiving experience is not the same for every family. Long-standing inequities in healthcare access, socioeconomic disparities, and systemic barriers often mean that minority families shoulder an often even greater burden. And at the same time, our healthcare system is facing an unprecedented shortage of long-term care beds. These issues do not exist in isolation. They intersect in ways that really create enormous challenges for families. Meet Healthcare Henry --- Candace Dellacona: So we're gonna explore these issues today: healthcare inequality, unique caregiving burdens for minority families in the sandwich generation, and our country's long-term care bed crisis. To help us unpack these complicated issues, I am so thrilled and honored to welcome Henry Mason Jr. Henry is an author, he's an educator, he's the founder and CEO of Precious Hospice in Atlanta, and he is widely known to many as Healthcare Henry, which is how I found him. Henry has become a respected voice in healthcare advocacy by educating the public on how our healthcare system actually works. He highlights disparities in care, he advocates for transparency in the end of life, and for solutions that put his patients and his families first. Henry, thank you so much for joining me today. Henry Mason, Jr.: Thank you for having me. I'm super excited, and that was by far the greatest introduction I've ever heard. I actually want you to send me that transcript 'cause I feel like more people should use it just like that. I loved that. I loved that Candace Dellacona: Listen, it's all true. And we already started talking before we recorded, Henry. We have so much to get to and talk about today, and I couldn't be happier to have somebody like you, who truly is a thought leader in this space, joining me. So for listeners who don't know you, tell us a little bit about your journey. What inspired you to become Healthcare Henry, and the passion that you have for the incredible work and advocacy that you do? Henry’s Origin Story --- Henry Mason, Jr.: This is so interesting because I, and I'm gonna tell you just a part of it and then I'll bring it back full circle. There is a gentleman named Dr. Michael Ford. Have you heard of him before? Candace Dellacona: I have Henry Mason, Jr.: he's all over. And so I was sitting in my house one day and I think my girlfriend at the time or what, I don't know who it was, it was years ago. She sent me a video of this guy in a chair talking about healthcare and it was Dr. Ford and I was like, "Oh my God, he knows what he's talking about." And she said, she followed up by saying, "You could do this. Like you could start talking about healthcare and get people involved in." And I said, "Oh no, I can't do that 'cause I'm camera shy and I don't like to talk, right?" And so just it's like, "You gotta try, you gotta try it." So fast-forward, I try it about maybe about a couple years later, maybe a year and a half later. I go on and I say, "Hey, we're struggling getting patients out of the hospitals. The hospitals are not working with me in Atlanta and it's been too much of a hassle. My last call basically is to just go on social media and see if people will resonate with me." So I go back and I tell her and she responds, "I sent you this guy a couple years ago. Do what he's doing." I kid you not, within a year we started talking about hospice, educating the community on hospice, long-term care beds with nursing home, home health, home care and what it looks like. Next thing you know it just has taken over and become a like a larger than life thing. But it started with him and coincidentally enough I was able to even talk to him one-on-one about a couple months ago. I was like, and I told him, I was like, "I'm so excited to meet you. I'm like a kid in a candy store." And I tell him, say, "This is why." He's like, "Really?" I said, "Dude, you are the one who started my journey and I've just been so grateful for the outpouring love and support and to be able to come on podcasts like yours. It's really just so amazing how much has happened to me in a year. It's really been amazing." Candace Dellacona: Listen, Henry, you have a way of communicating really difficult topics for families and providing us with the solutions that we're looking for. So how did you get started in healthcare in general? Starting a Hospice --- Henry Mason, Jr.: 2014. So my mother used to work for another hospice out in Atlanta or so, and when 2014 came, this was her second bout with cancer. And during this bout, she's going through chemotherapy and radiation for a total of about eight months. At the time, I finished college about four years before that, but I'm working out of, in and out of DC. So I'm going back and forth, and I go visit her, and one time I say, "Mom, you tell me you had this job. I've never met these people, right? Not really, right? And I don't know, do you really have a job? Like you work in healthcare, and your healthcare company has not been here one time. Who owns this company? What is going on over here?" And she said, "You're right, I haven't met no one come to check on me or anything." And she took that company and grew them 4X in two years, just to show you how impactful she was there. And so we were sitting there and she says, "Henry, I have an idea." Now my mom for people to have a point of reference, she had a lot of ideas, tons of ideas all the time. So it's just like, "Sure, Mom, let me hear it." She says, "I think we should start a hospice." I said, "Absolutely not." Now, to be fair, I was one of those people that we're trying to educate now. Hospice is morbid. People are dying. P- I don't wanna meet people on Tuesday and they die on Wednesday. She says, "Oh my gosh, you are just like everybody else." I said, "Yes I am, and I don't wanna do that." So the truth is, she calls her father, who's my grandfather, and she tells him that she wants to open this hospice and that he needs to call me. And so about maybe a couple hours later, I guess, he calls me and he says, "Son?" I say, "Yes, sir. How are you?" He doesn't respond to that. He says, "You know, you're gonna open up this hospice with your mom," and then he hangs up the phone. That is the true story. And from there we just got to going and we wrote policies and procedures while she went through chemotherapy, and we just ran with it, and that is how I got into the business of hospice. That is the true story. Candace Dellacona: So that is so amazing, especially because all of our listeners are sandwich generation members, or for the most part, right? So an intergenerational idea that was executed and directed by grandpa. And your mom, what better resource, having been in healthcare and having somebody in the midst of needing that care, so looking for the deficits. Sadly looking for the deficits. So you spend all of this time now, Henry, educating the public. Long Term Care Beds Explained --- Candace Dellacona: What do you wish that every family understood about navigating our healthcare system now that you're on the other side of it? Henry Mason, Jr.: Where do we start? It's-- The biggest thing for me is we have that's in place, you guys have to understand that what- whoever's in office, whatever the administration is, you have to understand what they're doing and work within those parameters. And it's like I don't get into a lot of the bashing one side versus the other 'cause everyone's good and some are good, some are bad. It just depends on what side you're on. Ideally, though, for a lot of families, they have to understand this is what's happening, right? So like you mentioned before, long-term care beds. That's huge because the sandwich generation, to your podcast, a lot of the problem is that they ran out of long-term care beds. And when people ask me like, "Well, Henry, what does that mean?" Long-term care beds comes from nursing homes. Nursing homes are two parts, right? The first part is rehab, rehab beds. The second part is long-term care beds. So rehab beds are where you go when you broke your ankle, broke your, your foot, whatever, and you need to go there and get PT a few times a week. You do that in a facility. Long-term care beds were the people that we take care of when they're passing away or dementia patients that we're at home with now, they would go and stay on the long-term care side. When we used to call these places nursing homes, that's what we were referring to. But here's the kicker, and I like to give people the business 'cause if you know the business of healthcare, you know how to take care of your people. Candace Dellacona: So true Henry Mason, Jr.: The physical therapy or rehab side of nursing homes is paid at $15,000 a month. 15,000, that's how much the government's gonna pay them or insurance is gonna pay them, anywhere from 12 to 15,000. So your long-term care beds are only $4,400 a bed a month. They're the same beds. So if the administration's gonna let them put everybody in a $15,000 bed, we gotta figure out like who are we really upset with? Is it the nursing centers? 'Cause we don't call them nursing homes anymore. They're centers 'cause you don't live there anymore. You're in and out in 20 days. Or are we mad at the administration that put it together? So those are some of the things I like to talk about because they're not prepared because they don't know, and things are happening so fast, they're blindsided. So you and I have to do a job or as best as that we can getting that information out to them as fast as possible. Why Beds Disappeared --- Candace Dellacona: So let me ask you then, Henry, so we're gonna go right to the long-term care bed crisis then. You've summed it up really succinctly in saying that it's a financial decision from a lot of these administrators of the long-term care facilities. Which, okay, I understand that. You and I both, work for a living. I get that it's dollars to dollars. But why is it now so much more difficult than it was even a decade ago? What is the difference now, Henry, than it was, just a couple of years ago? Henry Mason, Jr.: Because they used to have this this idea that people or companies would do things in good faith, right? And so a good faith is, "Hey, we would like you to keep 20% of your beds for long-term care beds." Is that a law or is that good faith? 'Cause if it's good faith, that depends on who's in office, right? And from what we're seeing now is like they were telling us this was policy, this was law, you had to do that. And we said, "We can't find that law," right? And so that's what they're saying. We can't find this law either, this regulation, so if it doesn't exist or we can go back and say, we as in the com- the, they really can go back and say, "Well, what if I don't have a bed available for them? Then what do I do?" And that's kinda how we've gotten here. And back in the day, I-- And I'm not just saying this to you. I don't want people to think... I've said this to politicians, I said this to people running for governor in many states. Medicaid expansion to me is very important, but the reality of it is, and I'm gonna say this, and I hope your listeners are okay with this, it's truly a facade, right? It's truly a facade. Because even if we gave everybody Medicaid right now, we still could not service all the people because the government has this thing called certificate of need in place, which keeps us from even opening up new hospice companies, new hospitals. So when you tell me a hospital closed down, you know you can't open another one five minutes down the street because certificate of need won't allow you. So even if we gave everybody their Medicaid right now, there still wouldn't be a way to help you, and I think that's what we gotta get across, too Candace Dellacona: I think you're right. Medicaid Medicare Basics --- Candace Dellacona: So let's, for our listeners who don't know Henry, let's talk about the difference between Medicaid and Medicare so that people are all on the same page. You referenced the expansion of the Medicare program. There's a movement, Medicare For All. There's an expansion request for Medicaid as well. So for our listeners, people should know that Medicare is a program that people are entitled to once they reach the age of 65 in the US, or if they're certified blind or disabled. And Medicaid is aid. It's means-tested, meaning you cannot have a certain amount of money or a certain amount of income and still get the aid. So making sure that everybody's on the same page and understanding that, let's go more into, the issue, is that, that we have to prove to the government that we need the actual care, Henry, right? Certificate of Need Barrier --- Candace Dellacona: So when it comes to that certificate, can you fill us in a bit on that? Henry Mason, Jr.: So it's basically impossible, right? That's the first thing I want people to understand. And I say that as someone who started an academy and thousands of people, I told them you can't, you cannot do this," right? And I don't want you to waste millions of dollars to do it. So if you wanna open up, let's say a hospital or a hospice in a place where they say, "We have a certificate of need in place for this state or this county," you have to, one, prove that that need is there. So the surveys that you have to go in and do, the actual understanding the community, talking to the community, getting people to sign off on things, you're looking at a couple million bucks easy. Easy. Before you even break ground on opening up your own business. So for most people, it's not something that's doable. So if you wanna go into that space, you have to buy one, but you still run into the same problem is that there's not enough of them that exist to actually help people. When you're talking about too, and I, I'm hopefully it's okay to say this, what we're doing now with Medicaid is actually going to make pr- things much worse in the future, even if we were to get this overturned. And so one of the things I say, because it's important for people to know, even if you don't have insurance at all, you can always go to the hospital. You can always go to the hospital, and they have to at least look at you. I'm not saying they gotta treat you, but they at least have to stabilize you because of a law called EMTALA. So that's important for people to know. And for people who have Medicare and say, "Well, I don't care. I'm a Republican. I don't care if these people get Medicaid or not." We need to explain to them what that means too, 'cause there, there's both sides of this. The other side is, let's say you go to the hospital and the person who has a cold, has the flu, who would normally go to the doctor or normally go to urgent care, is now going to do what? Go directly to the hospital and sit there just with you. And because we don't have name tags on our foreheads that says, "I have Medicaid. I have great Medicare insurance," we have to treat whoever comes in with the highest level of acuity. That's just the way it is. And I think people, until they s- are hit with that firsthand, I don't think they'll really come around and say, "I think we made a mistake. I think we made a mistake." So that's kinda where we are in this economy right now Defining Healthcare Equity --- Candace Dellacona: No, you're right, and that's a great segue, Henry, into talking about the equity of healthcare or the fact that maybe there isn't much equity in healthcare. So it's become a major topic of discussion over the last several years. When you hear the phrase "healthcare equity," what does it mean to you in practical terms for families and patients that your hospice agency, for example, is advising? Or when you go out in the community and talk about the issue of healthcare equity, what does that mean to you? Henry Mason, Jr.: For me, it means everything. I come from the South Side of Chicago, I come from public schools and, high school in Chicago, and I've witnessed both sides of the fence. And I'm, I haven't told this before, but I'll tell it to you first. I come from a very unique situation. My mother and my father were married until I was about three or four years old, roughly somewhere around there. And in Chicago, where my mother's family lived and her parents, we had everything. So anything I wanted, I could get. It was a real thing. Anything I wanted, I could get. Before people were driving expensive cars, my grandfather had them, so just trust me on that. Versus my dad's side of the family, he literally, we didn't have much. I, so it was very interesting when they divorced, I would spend summers with my dad, school days with my mother and that side of the family. So you can imagine what I've seen. So when you're talking about healthcare and health equity and what it looks like in terms of access, there are, where my mother was, where we lived in Chicago, whatever we needed, whether it's when she, oncology visits, OBGYN if she needed it, pediatrician on every corner when I needed it. Whatever I needed, not a problem, you go get it. Not to mention we had the best healthcare you could get, right? I could get it. When I come to Atlanta and visit my dad in the summer, to live off of Stonewall Tell Road, at the time it was very, impoverished area for that at that time. There was nothing. It was a healthcare desert, right? There was maybe one pediatrician in a 10, 20-mile radius. If you were to go the line would be out the door, right? So it'd be insane. So even having one in, in 20 miles, going there, a visit I could go do in Chicago with my mother and I'm in and out in 20, 30 minutes. Here you're talking about a seven, eight-hour visit. The other problem with that is that we don't talk about, my dad had to go back to work. My mother could afford to take 20 minutes off and take the whole day off if she wanted to. My dad couldn't do that. It's a very unique perspective, especially for an African American man in America to have both sides of it, and I think when I talk about hospice, to your point, it's the great equalizer, right? It's supposed to be. It's the one thing in America where everybody can get it, and we come to you. Candace Dellacona: Mm-hmm. Henry Mason, Jr.: It's the one thing, right? Like home health, you gotta have Medicare most times. It's really the one thing in America where everybody can get it, and Precious Hospice has to come to you. It's, to me, it is the great equalizer. Candace Dellacona: Absolutely, and actually it gives me so much hope to hear that. The flip side of it though, Henry, is that what I think is happening nationwide, particularly in communities that don't have a tremendous number of resources or are more rural, these issues exist and they're very real. Access to care is very real. So where are you seeing, as somebody who studies these issues every day and has seen both sides of the coin, where do you see the biggest disparities today? Rural Care Shortages --- Henry Mason, Jr.: When it comes to being in rural areas, to, to your, to that question, in rural areas, that is the lack of doctors, right? That's not even just a lack of actual centers or practices. That's a lack of doctors. And this is where Medicaid expansion becomes the most important thing that they can do. You tell a doctor they gotta go to undergrad, then they gotta go to medical school, then they gotta finish all this, then they gotta take the boards and all these things, residency, whatever. That person can come out owing, and I've, and I'm not joking half a million upwards to $800,000 back in, in just in school debt. Candace Dellacona: Yeah Henry Mason, Jr.: 'Cause it's not even just about going to school. There- you can't really work while you're in med school. You still gotta have an apartment. You still gotta eat. You might need a car to get back and forth to school. You have to put gas in that car. These are all the things that I don't know if we're really considering. When you tell someone, "Hey, you live in rural c-communities. We need doctors to go there." And we have to be realistic, and I love everybody, I'm gonna say that, but as a business owner, I do see the conflict. You want a doctor who just has debt of 800... They'll never be able to pay that back in rural communities. One, it's not enough people. It's just being honest. It's not enough people. And when you change the way that these doctor's offices are paid, going from, "Hey, you can spend X amount of time with them. We'll pay you whatever," to, "Now we're only gonna pay you so much," now it becomes a numbers game. So when you go to the doctor, you say, "Well, why'd the doctor come in and touch my knee and leave?" The doctor's only getting paid for 10 minutes. So in 10 minutes, all they can do is touch your knee and leave. That's a real thing. So they've gotta extend this Medicaid, they've gotta extend insurance to everybody, and they've got a way to change the way doctors and practitioners are being paid. Or, and I'm gonna say this, they're gonna get the backlash of doctors being upset because nurse practitioners then are going to be forced to have to be the new clinicians in the rural areas, and that's not gonna be by accident. It almost seems to me to be by design. Candace Dellacona: In many ways, I think you're right. I think that there is a deficit in care, and so the medical profession is looking to other skilled medical providers to fill that gap. So as it relates to those in terms of, families who maybe don't have the same means or who are otherwise marginalized, what are examples have you seen that patients have absorbed examples of inequities aside from shortages that are showing up every day in healthcare? What have you heard? What have you seen? Cost of Living Meets Care --- Henry Mason, Jr.: Healthcare is one part of the equation, right? And I think when we talk about, when we look at today, right? And I wanna give people the full picture so they understand. When we talk about things that are the cost of things, the cost of living, the cost of groceries, the cost of gas, the cost to get a car, and God knows the cost to buy a house or living somewhere, right through the roof. And so when you look at all of those costs, now someone has to make the decision. We did a story on a gentleman, I never met him, I think he was out of Wisconsin or Nebraska, and he literally had to decide between paying his rent or paying for his medication for his inhaler. I believe it was Albuterol, which is actually is not that expensive, by the way. It's called your inhaler, just a little puff. He chose to pay his rent and he died. I have a nurse right now, right? She works for Precious Hospice right now, and it's public so I can say this, and her grandmother, who was not on hospice, was taking a blood thinner medication. She said the name of it, but the cost of the medication has gone up three X. Her grandmother died because she could no longer afford to take the suggested dose of said medication. So then you have another cases of people just look at healthcare, but healthcare is a part of the bigger picture. So if you got groceries that you used to pay $100 a week for, now you're paying $250 a week for, can you s- also afford the increase in medication costs, right? If you don't have insurance, can you afford that $400 visit to the doctor or the co-pay that went through the roof or the high deductible at the hospital? These are all the problems that we're seeing, and for me, and I'm gonna, I'm gonna say this because you asked me, I'm starting to have an issue with healthcare CEOs, hospital CEOs, hospice CEOs who also are not vouching for the expansion of Medicaid because we're not helping the very people that we are saying that we went into this business to help. And it is starting to bother me tremendously to some points I do have a hard time sleeping at night over why am I the only one who has a problem with this. Candace Dellacona: You've really pointed out, Henry, the systemic issues related to the inequity of healthcare, and it's not just any one thing. It's not just the cost of the medication. It's the fact that somebody doesn't have a good job and therefore they don't have good insurance to pay for the cost of medication or the advocate at home to make sure that grandma can get to the doctor to get the blood levels tested because that person has to get, show up at work every day. Obviously I'm not a person of color, but I like to think of myself as an ally, and I know a lot of our listeners feel similarly. How Allies Can Help --- Candace Dellacona: So what are the things that you think people like me can do, not just professionally, but personally to help create a more equitable healthcare experience? Henry Mason, Jr.: It's, this is interesting because sure I get when you say you're not a minority, but c- I have to be honest here, right? When I look at things about women, women in general, regardless of race, right? And whether it be we telling women what they're gonna do with their bodies, we telling women how they're gonna function in dire need or in times in the hospital. We have women right now, who are going to pass away because they cannot have an abortion because of laws put in place that says it's not the kid's fault and essentially both of you have to die because of this, right? So the reality of it is, and I had a... She wasn't my hospice patient, but I love Kate to death. She's fantastic. She's 26 and she was on hospice. And she told me, she's also a Caucasian woman, and she told me, she said, "Henry, this, I'm gonna say this and I hope people are okay with this." She said, "A lot of what we do is we try to separate minority from this or from that, and the reality of it is a lot of us are in the same boat," right? Now it is progressively getting worse for some than others, but for me as someone who sees everybody, it's getting bad for everyone, literally everyone. And if we, with standing together, calling senators calling politicians in your area, mayors, one of the biggest things for me is patient choice. Whatever you decide for yourself or your family decides for you is super important. What companies you choose to go with what procedures you choose to do, right? And even something as small as small to me I'm in hospice, right? It was a fight. I've been in hospice since - 2014, and I remember fighting with them over cannabis laws. And I said, "Why do you care what a person who's dying, what they do? Do you think this person who can't get out of bed is also driving a Mack truck through the city and gonna run people over," right? And so they're telling me, "Well, they can't do, we can't give them that." I said, "Why do you care? What is it that we're doing?" It's a control thing. So for me, to your point is we gotta talk to our senators, our mayors, our politicians, and when we talk to them, they've gotta listen. And if they're not gonna listen, we gotta get new ones. That's the reality. And I tell them this. This isn't something, they're not gonna be surprised to hear this. If you're not gonna do what we ask you to do and we voted you in office, then we gotta find a replacement. Whether it's been one t- one term or two, I don't care if it's been 10, we've gotta find some replacements Candace Dellacona: You're so right, Henry, and I think, the little people of the world, myself included, sometimes we see it as hopeless in many ways that we cannot make any kind of systemic change, but we can. And being reminded that our local politicians is where to start, and they work for us. So I love that you're saying that. I also love and I appreciate the fact that you're pointing out that women are also victims of an unequal healthcare system, as evidenced by the new laws that are being passed across our country. So I'm grateful for you for highlighting that. Minority Caregiver Burdens --- Candace Dellacona: But, one of the things that I do wanna ask you, especially as, the founder of this hospice and a caregiver every day, right? You're in the trenches, Henry. So what are you seeing for those Sandwich Generation Survival Guide listeners who are part of minority families that they're facing in their caregiving journeys that other people may not be facing? What are you wanting to surface to the top that others aren't recognizing that minority families are having to bear a greater burden by virtue of the fact that they are minorities? Henry Mason, Jr.: I think a big part of that is, is threefold, and I'll give you all three. One is capital, right? And I think a lot of people try to look at us and say, "Well, you guys have had time to make money." I said, "Mm-mm. No, no, no." You have to understand how money works. You have to understand we are talking about real estate being passed down, life insurance policies being passed down. So even if I make a quarter million dollars and someone else makes a quarter million dollars, if I'm starting from me, the first one in my family making it, and that person's coming from three generations of three houses and $5 million in the bank, that's not the same quarter million dollars. So if I spend it, right? So let's just say for instance, let's use me. I took care of my grandfather, and I have a four-year-old. He's four now. At the time, he was maybe two. I think he died last year, right? Yeah. So he was two or three years old, taking care of both of them in a sense, and helping to navigate his care. And if he didn't have any capital, I would've spent all of what I was making to take care of him. So now I'm wiped out again, having to start over. Now, he only lived in that state for two years, but let's imagine he had lived for 15 or 20, and my decision was to continue to take care of him. So we are faced with one of two options: take care of them or, and people aren't gonna wanna hear this, we make a decision. We stop buying certain medications, we stop doing certain things so that we can leave something to the generation behind them, which is something that a lot of families are faced with right now. That's number one. Number two We don't have, we don't trust, if you will, the healthcare system. So a lot of we have women who are diagnosed later for something like breast cancer. Yeah, we do, right? Because they're not getting their mammograms. But we don't trust the system. And how can we trust a system that has used us as guinea pigs for the majority of our lives, my parents' lives, my grandparents' lives, and even today, even today, no one wants to talk about it. We are still being used as guinea pigs in this system. And so what it comes down to is we do not trust this system, so we need great doctors who are... 'Cause we can't all go to a Black doctor. We need great doctors who are also white doctors who can come in that we can trust and do great work and provide the best care, and not look at us as just another $500 visit, but a life and a loved one that you can sit with and talk to and ask questions about our culture and what things that matter. And you say, "Well, just eat better." Well, yeah we would love to eat better, right? I would love for my cousins to eat organic bananas every day. But if an organic banana is a dollar and the one that they're getting is 10 cents, you want them to buy one or you want them to buy 10 for 10 cents? And that's some of the cultural differences that they have to understand. So for me, it's like that's what I look at and what I see, and as it, we're talking about that sandwich generation with these long-term care. Nursing homes in rural communities, whether it be farmland, that's super important, too. We're losing a lot of this farmland to data centers. No one's talking about it. It's not an accident that these hospitals are shutting down in rural communities. It's not an accident. You go back two, three years later, they got the biggest data center you've seen in a long time. You got billionaires buying up so much land for these water rights, you've never seen it before. Why is that, right? What's really going on? And you say, "Henry how do you know this stuff?" Because they did not realize who they were talking to when they gave me some of this information. Or that I would get... I'm just being honest. That's what happened. And so they talked to me about it. I said, "And now I can give you guys the truth," right? And so that's what we're looking at. And how do we become a part of a system that generally feels like we're hated, we're mistreated and then every time we turn around, even when, like to your point, public officials are supposed to work for us, right? When we look at politicians and what they could do, I'm not seeing a lot of changes across the country right now. I'm just gonna be honest. I'm not seeing it. From m- majority of them, I'm just gonna say it, Democrat or Republican, I'm not seeing it. So how do they come in and say And I'm gonna be fair, 'cause I have to be fair. Most of them have never lived in my shoes, yet alone most of them have never been poor. Most of them have never even been middle class. So I can only expect them to do so much unless we figure out a system where someone from a certain space has to be represented in that space. So we have to be fair with them as well in that manner, but those are some of the things that I'm seeing. I don't know how we fix them overnight, but those are some of the problems that I see that are continuing to be exacerbated over time, especially in this administration. Candace Dellacona: Yeah, you could not have said it in a more eloquent way in that, when you have generations upon generations of people who are not only marginalized financially but from a healthcare perspective to then be expected to trust a system that has betrayed them for so long, there's going to be a bit of a runway to get everybody on the same page. Programs That Pay Caregivers --- Candace Dellacona: And so what are the community resources that you know about, Henry, that you wish more families knew about? Henry Mason, Jr.: So it, there, there are resources, right? There are Medicaid programs, there are structured family care, where if you're in a home and you're a caregiver and your family member has Medicaid, you can apply for this program through Medicaid called Structured Family Care, and they can pay you to take care of your loved ones. Candace Dellacona: Yes Henry Mason, Jr.: I'ma be honest, I don't like the program either. I do not like it. And the reason why, these are not secrets. I've already told politicians, they know this. I don't like it. Because they make the person who's taking care of you not have another job. So you're gonna... Again, we go back to this works for someone who's on Medicaid, again, I'm gonna say this, because they got $3 million of assets locked up in a trust. Yeah, that, that's a whole... And no one wants to talk about that, right? We're just gonna act like that doesn't exist Candace Dellacona: Well, let's break that down, Henry, though. So what you're talking about, we call that in the north consumer-directed care. And so what that is, is your family members, for the listeners who don't know, can become what we call certified as personal care attendants, so that they can provide the care that would otherwise be provided by licensed home care attendants, and they're getting paid. And what Henry is so wisely pointing out, everyone, is that it's not a livable wage, and the only way that a family member can take that on is if they don't have another job. So it's not sustainable. Yes, it's great to say, "My daughter-in-law can be the one to provide the care. I love my daughter-in-law. She knows how I like my eggs cooked." That's fantastic. But unless your daughter-in-law has access to other resources that will help her pay her rent, it's not sustainable. So thank you for pointing that out, Henry. Henry Mason, Jr.: I'm ex- I'm excited that you knew what it was. That's the biggest thing for me. You knew exactly, and it's like I don't understand... Again, I have to give them some grace. They've never lived in our shoes, right? And I don't even just mean minorities. I mean people who have come from lower income situations, right? If we don't have people in office who've lived that, they can't j- they, how would I expect them to really understand what the plight is of those people. Candace Dellacona: We vote them in to understand, Henry, so you're being a lot more gracious than I feel about it, because they are taking these platforms and they're telling us that they get it. And, people talk about Bernie Sanders, however you feel about his politics, he makes the point time and time again, which is we'll all need care, and not all of us have access to resources to pay for that care. And at a certain point, are we as a society, a society that wants to make sure that our marginalized, our sick, our aging loved ones have dignity while they need that care? And I think the answer for me and the society that I wanna live in is, for sure the answer is yes. And you've made it your life's work. Henry Mason, Jr.: 100% agree. I I think it's okay to say this. I met Cory Booker about a couple weeks ago, maybe three weeks ago, and right after that he goes on TV and talks about his father, or I think it's his father, who had dementia and passed away. And I saw that and I said, "Oh, I hate that," and I'm not saying him specifically, "people have to go through that to understand what we feel in that situation to then come back and make a difference." But I'm gonna say to him, because I'm very grateful that he did, most people would never do this. Most of them would never go on TV and say, "This is what I experienced and this is what we as a country need to do." And we need more people like that who we voted in office to come out and say, "I have also experienced this. Oh, and by the way, I have enough to do it, and it still was a struggle for me." So imagine how the average layperson feels on an everyday basis. And to your point, and I hate to keep kicking this horse, but if we don't figure out how to get the cost of living down, this sandwich generation that we're seeing right now is going to exponentially explode. And my biggest fear from this, my biggest fear, is what comes next, right? What comes right after this? The person who's my-- I'm A 4-year-old and a 98-year-old, taking care of both of them. That's my grandfather. At the same time, my mother was only alive two weeks to see my son, which is a different story. But for those two weeks I'm, I got a newborn and a mother dying, and the depression I would argue that most people would've gone through having experienced that. I'm in hospice, so my situation was different. I could not imagine someone coming out of that and having to go right back to work, 'cause that's what our society demands. It's similar to your other point about women. I have a problem when women have children and then someone tells me that person's gotta go back to work in two, three days, which is what I heard someone say recently. I won't say his name, but a guy that's in office. You gotta be kidding me. This is a joke, right? He wasn't kidding. He was very serious. So we're all in the same boat. We've all got problems here, and we've gotta figure out how to do this, and I think we're gonna be so much stronger together in the future. Candace Dellacona: We really are. And Henry, that's a really great way to end it. Advocating at Discharge --- Candace Dellacona: But before I let you go, one of the reasons why I started "The Sandwich Generation Survival Guide" is because, like you, I had access to resources. I was a little more educated in advocacy than the average person when I was caring for my aging loved ones. And so this podcast really has grown out from that need to mine our resources and create a community that you've done such a beautiful job with with your whole following. But before I let you go, what would you say, for our listeners, is the best bit of advice for family members who are trying to advocate when their loved ones are being discharged into someone like you, so your care? What should they be doing to become better advocates for their aging and, in some cases, dying loved ones? Henry Mason, Jr.: So one of the things I will say is that because we have to, we have to do a better job of this, of doing our own research. A lot of what you have a loved one going into the hospital and the hospital spits them out to a company or other such, you've gotta research that company. You've gotta ask them, "Hey, is this the best company for me?" Excuse me. Social workers are normally, normally pretty upfront and honest about that because when you take them home, you need everything set up for you. You need it all set up for you because you're not getting into the nursing homes anymore. So if you can get hospice, go get hospice. Go call and ask. It's no out-of-pocket cost to you. Home health, you can get it. Go, go-- Let us tell you, "No, you don't qualify." That's what you should be doing. And you sometimes, you can keep calling 'cause another company might accept you when one won't, and I could tell you the reason. I won't go into that, but you never know what that is. So make sure that's in order. The other thing I would say and I say this because I love people gen- like I genuinely love people. I really want people to take a better job or as best they can. Whatever life insurance policy that they can afford, I need you to get it. What- whatever it is. I don't care if it's 10 grand, 20 grand, whatever it is, I need them to get it because while these other costs are going up, when someone passes away and we don't have advanced directives in place, we don't have wills in place, assets that your grandparents have lived their butt off, paid for forever to keep up are falling by the wayside because you all don't have enough money to pay the mortgage for three months to get through probate, six months to get through probate. So we need them to make sure that they're also paying attention to those things as well. So hopefully that helps someone out there. Candace Dellacona: Listen, everything that you have shared with us today, Henry, has been a help. I've learned so much from you. I wanna thank you for your time, your expertise, and really for helping families and our listeners understand the landscape of the healthcare system, which is overwhelming. Conversations like this one remind us that this is not just a family issue, it's a societal issue, and we are connected. We belong to each other. The more informed we are, the better advocates we are for ourselves and for our loved ones and for our community. So Healthcare Henry, the one, the only, thank you so much for your time today. Henry Mason, Jr.: Thank you for having me. It was a pleasure. Wrap Up and Subscribe --- Candace Dellacona: Hey, survivors. Be sure to follow and subscribe to The Sandwich Generation Survival Guide wherever you get your podcasts so you never miss an episode. We're back with new conversations on the first and third Tuesdays of every month. If you're finding value in the show, I'd be grateful if you left a five-star review and shared it with other survivors navigating this season of life known as the sandwich generation. For resources and a full library of past episodes, visit sandwichgenerationlaw.com. Follow the conversation on Instagram, Facebook, and TikTok @sandwichgenerationpodcast. Until next time, take care of yourself while surviving and hopefully thriving in the sandwich generation.