[00:00:35] Dannelle (Recorded): Hello and welcome to The Caregiving Soul. The Caregiving Soul Podcast is a series of conversations about what it’s like to care for loved ones in need, how we can better navigate the relationship, and the physical, emotional, and logistical complications we encounter as partners in care.  

[00:00:59] I’m your host, Dannelle LeBlanc. 

[00:01:04] [Music Ends] 

[00:01:04] Today, I’m speaking with Carl Hirschman, the founder of CareTree, a platform to help families and professionals manage care for their aging loved ones, giving them a centralized place to communicate, share health information, and receive recommendations on best practices to provide peace of mind. CareTree has grown now to serve approximately one third of private paid geriatric care managers, as well as home care companies, insurance providers, and thousands of families nationwide. 

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[00:01:43] Welcome to Carl Hirschman! 

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[00: 01:48] Dannelle: Hi Carl! Welcome to The Caregiving Soul. Thank you so much for joining us. 

[00:01:54] Carl: Thank you for having me today. Happy to be here. 

[00:01:56] Dannelle: I’m really excited for our audience to learn about your experience and how it impacts your company CareTree, technology, and caregiving, and how it can help us throughout that experience. I’d like to start by asking you about your three core values and how they connect to your caregiving experience. 

[00:02:24] Carl: Yeah, certainly, great question. I think the three core tenants for me, both personally and professionally, as well as from a caregiving perspective – one: it is ask questions. Two is challenge the status quo and three is systematize and try to eliminate inefficiency. 

[00:02:47] I think with asking questions, it’s so important to be comfortable asking those questions. And for me, I know oftentimes it’s uncomfortable. Like I have a little question in the back of my mind and I don’t ask it. And through habit, I’ve started to ask those clarifying questions so that I get that additional information. And whether that is like in relationships and in friendships, like thinking I understand what they’re saying, but then instead of just assuming, going ahead and asking a clarifying question, and maybe I’m completely off, or it like creates a deeper level of connection. Professionally, it’s asking our customers, our users, a lot of those questions, what they are doing, what their challenges are, and that’s completely transformed and guided how we’ve done our business and how we’ve grown. 

[00:03:37] And then from a caregiving perspective, it’s the same thing. I think a lot of people, including myself, were hesitant to ask a doctor questions. Oftentimes it’s like we do the intake and then we provide them a bunch of information. And then we wait around for the doctor, and the doctor shows up, and they do a quick check, and they give us a bunch of information. And then it’s, “do you have any questions?” And it’s like, “Yes…” [Laughs] And I think it’s critical to ask those questions. 

[00:04:04] And then if you don’t understand something or if something isn’t crystal clear, or maybe it could go two different ways, it’s diving deeper and continuing to ask those questions and be comfortable with those questions. I think people are afraid of asking stupid questions and there often aren’t stupid questions. Rarely is that ever really the case. As adults, you’re not gonna get made fun of. I think we’re hesitant to ask those questions from our middle school years of being terrified of looking dumb in front of the class. As adults, we’re much more forgiving and understanding. 

[00:04:39] Number two is challenge the status quo. Just because something that has been done a certain way doesn’t necessarily mean it’s the best way for you, or that it even has to be done that way. As a caregiver, you become an expert in your loved one’s disease or medical condition, and the unique nuances of it, whether it’s comorbidities, or lifestyle or personality, that’s affecting it, you know them and what is going to work with them. Just because a doctor or a professional says do this, that might not work for you. And you have to have the confidence to say this isn’t going to work for me. And communicate that and ask more questions, or get a second opinion, and realize that just because one person says it that way does not necessarily mean it’s the end all be all. 

[00:05:30] And then finally – systematize and eliminate inefficiency. This is a very big character trait for me. Personally, I figured out a meal prep plan and I’ve essentially eaten the same thing five days a week for the past seven years, just because I maximize inefficiency. And I know that 13 pounds of chicken fit in a crock pot and that’ll like, give me three weeks’ worth of lunches. 

[00:05:53] But then I do the same thing in CareTree and the software. Instead of having the whole world reinvent the wheel on best practices and things to do in a caregiving situation, why don’t we create these as tasks to automatically recommend it instead of somebody having to look this data up and figure it out. 

[00:06:12] And I think that’s the case in caregiving as well. If you can create those routines and you can write those routines down, I mean, that’s with Alzheimer’s and dementia, and that is one of the things that you have to do, that you’re taught to do, is create routines, but I think it works no matter what, so that if you need to bring somebody else in to help, if you’ve created a process that’s replicable, then it makes it so much easier to hand it off to them and let them just follow the process. 

[00:06:46] Dannelle: Absolutely. Wow. That is really huge. I’m wondering because these are huge lessons and obviously they didn’t just come out of the blue. They came from your personal experience and professional experience, and I’d love to hear about what it was like for you helping to care for your mom and dad, and how those challenges of caregiving led to technology based solutions and the development of your company CareTree. 

[00:07:17] Carl: Yeah. So, thankfully my parents are healthy. My mom – personally, she had been the guardian and conservator for a family friend since I was probably a toddler. And then she had kind of adopted the neighbor across the street, and then his widow, and then my grandpa, my grandma, her boss’s mom, like she’s a saint. So, she had been in all of these caregiving situations, and I was in the senior housing technology space. 

[00:07:48] They’re located in Iowa and she said, “I’m having to carry around a growing binder full of medical records in case the senior living community calls or one of the nurses calls and has a question so that I have the data to be able to provide an answer. And then they’re trying to call me, I’m at work. I’m in meetings, we’re playing phone tag back and forth, where it’s just a two second question that could be answered. And then I get the information and then I have to play phone tag with the rest of the family to try and communicate the information out there. This is a problem, and I’m sure it’s just a small town, Iowa issue. There’s some solution out there solving this problem. What is it?” 

[00:08:28] So, I started talking to all of my senior housing clients and saying, “hey, like my mom’s got this problem. How are you communicating with families? And what are you doing? Again, this is 10 years ago, and so you had smartphones kind of just coming out, or a couple years out. Wifi wasn’t even in all of the senior housing communities, not even close, only in a couple, like in the common area. So, technology was at its infancy in senior care. I would talk to them and they would say, “yeah, we’re having the same problem”. 

[00:08:57] Kept on talking to more people in the aging space and realized that everybody was having that same problem, communicating with families, and families managing the information. So, it was the keep asking questions. We assume that there was a solution out there, turns out there wasn’t, so challenge the status quo of, “okay, let’s go ahead and build this”. That was the path that led to CareTree being born. 

[00:09:24] Dannelle: That’s amazing. So, CareTree itself, this technology and other technologies that have been born over the last 10 years, hopefully, to varying degrees, help to systematize and eliminate the, the inefficiencies. Over the past few years, the pandemic has really changed how care was and is delivered in a lot of different ways, including the options that we have for remote care monitoring and communications. Can you speak to some of the benefits for care partners in using virtual technologies, whether we’re caring from a distance or providing in person care? 

[00:10:13] Carl: I think one of the big challenges in healthcare is you have your social determinants of health. It’s these basic lifestyle things that challenge the ability to optimize healthcare. Transportation – that’s a big one. If you can’t drive, or if you’re relying on external transportation to get to an appointment, that is a big issue, or to go pick up a prescription, to pick up groceries, or food, and that lack of reliable transportation and then access to those resources is something that drives a lot of people from aging in place, in their home, where they want to be, into a senior living community where that’s taken care of for them. 

[00:10:53] The pandemic has completely shifted that. Where right now we’re on Zoom, and years ago, a lot of people didn’t know how to use Zoom or weren’t like experts at using it. It wasn’t like second nature to be like, “hey, we’re just gonna go jump on a Zoom call”. And especially within healthcare, like that just didn’t exist. You went from hospital systems and healthcare systems where that was like 0.05% of their visits to it being 99.5% of their visit. 

[00:11:26] Now somebody who needs that appointment, doesn’t actually have to leave their home or somebody that needs that prescription, now it’s much easier and much more socially known and accepted, to be able to get those prescriptions refilled and delivered or mailed to you. It was successful two years ago. But now it’s become mainstream and culturally accepted for people of any age to do that. And I think those are things that are really going to facilitate convenience and help people to age in place and overcome these social determinants of health that culturally we would’ve taken a lot longer to adopt otherwise. 

[00:12:06] Dannelle: That is so true. Carl, when you talk about asking questions of a healthcare provider, you talked about asking questions of your clients, I’m wondering, in what way do your clients experience a reduction in stress, in overwhelm, even potentially reducing caregiver burnout? What kind of stories do you hear from care partners about how technology has helped them through their journey? 

[00:12:39] Carl: Great question. I think the biggest thing is access to information at their fingertips. The largest group of people that use our software are professional geriatric care managers, like what my mom did, it’s just they do it professionally. If a family isn’t able to do that themselves, or doesn’t have the expertise, they can hire this person to do it. 

[00:13:00] For the care managers, what our software has done for them is, has centralized all of their client information. So, that medical folder that my mom was carrying around is now all at their fingertips, on their smartphone, or on a website, so that no matter where they are at, if somebody calls and has a question, then they can pull it up and have that information at their fingertips. 

[00:13:24] Emergencies don’t happen conveniently. You’re not able to run home and then find that manila folder that has the advanced directives and everything that you need. You need it right now. To be able to have that at their fingertips, and to know that it’s there, and whomever may need it, they can get it to. That, I think, provides the biggest peace of mind for both the families and the professionals. 

[00:13:51] And that’s what we’ve seen on the families who are working with professionals that use our software, or families that are using it internally, is they know that if they need information, they can turn to the app and do it. Instead of having to make a phone call, instead of having to send a text message and wait, they know they can just log in, get the information they need right then. 

[00:14:15] Dannelle: Correct me if I’m wrong, but that access to information sounds like it could be, or it is, part of what you were talking about in automating tasks, and creating routines, creating a process, and having the ability to communicate without having to go home and get that manila folder. It’s something that’s transferable and it’s accurate. You don’t have to worry about, in the case of an emergency, forgetting some critical detail. 

[00:14:49] For caregivers who may not be tech savvy, and, you know, feeling overwhelmed, sorting through all the options available, what do you recommend we look for so that we can make an informed decision about what kind of technology to consider? 

[00:15:08] Carl: When it comes to technology, [Sighs] I hate to say this, because I love innovation and I love new companies and new technologies, and we were one of those, but I would say, look at longevity. Look at how long has a company been around and why are they in this space? The ones that have a ton of money, like venture capital money behind them, and they have to make a quick buck and they have to show investors that. And so like they make a big splash and then they fall off the cliff and evaporate versus somebody that has just been around consistently, they’re more likely to then be around in the future as well. And that most likely means that they are not necessarily the smallest. Well, they may be a small company, but it may not be the flashy thing. 

[00:16:00] So, Epic, with MyChart, they’re the behemoth of medical records. Like half of the hospital systems use them. They’re not going anywhere. Apple is not going anywhere. Their technology may change, but they’re also big enough that they will provide some type of off boarding or transition process. And we saw that with Google and Microsoft years ago when they got into healthcare and then they got out, but they provided a transition process so that you could take your data somewhere else. And so that is what I would look for. 

[00:16:29] And that’s also true on devices. You want to have it be interoperable and that there’s gonna be longevity there. And instead of like the new and flagship thing, look for something that’s been around and is going to continue to be around. It doesn’t necessarily mean that it’s bulletproof, or that it’s actually the coolest thing, but what you don’t want is to purchase something and have the company be defunct in two years. That’s where it pays to be a little bit more cautious and a little bit safer on what you’re looking at from technologies and devices. 

[00:17:05] Dannelle: Carl, there are so many different apps and devices to choose from. Can you give us some examples of some simple technologies that may exist on our smartphone or that we can use to help us to monitor, to communicate? What examples do you have that you think we may not have thought of? 

[00:17:30] Carl: Yeah. I mean, there are some really kind of low-tech basic ones – FaceTime. Like, to get a visual, just have an iPad and do FaceTime with somebody, or like a Ring camera, where it can have the motion sensing, you can be alerted. Those are cheap, like non healthcare things that you can do. You can have the Alexa and you can set reminders for somebody so that it tells them to then take a medication, or whatever it may be. 

[00:18:00] Going with the basic stuff – Schlage and Kwikset, they make smart deadbolts so that instead of giving caregivers, or handymen, or anybody, a physical key, you can give them a code and you can control how long they have access to it. And then you can be alerted when they enter or when they exit, you can revoke access. If mom or dad are leaving, you could then get alerted of that. myQ does the same thing for the garage door opener, so you can connect it to the garage door, so you can be alerted when it opens, when it closes. Through Amazon, you can then even get deliveries and have them put it inside of your garage using their Ring functionality. So, those are some basic things just to get a situational awareness of the home. 

[00:18:51] People want to turn to technology. I think you need to centralize the information, but centralizing the information can be overwhelming. I often recommend before you take a step into the technology, talk to an expert, hire a care manager. Or talk to a home care company, talk to a home modification company.  

[00:19:12] Adding the new technology piece, that’s giving you alerts, and then you don’t know what to do about the alerts. So, you just end up with alert fatigue, and nothing happens. Find the professional that you can then go to and say, “hey, what am I supposed to be doing here? What am I looking for? What do we really need?” Let them guide you through that process. 

[00:19:32] Dannelle: Thank you so much for mentioning that, Carl. The importance of asking questions and talking to an expert, like a geriatric care manager, someone who does home modifications, and these are things that don’t cost money upfront to have those types of consultations or conversations to learn about what we don’t know, so that we don’t have to reinvent the wheel. 

[00:19:59] I think that that’s such an important point because we are at risk, oftentimes, of being overwhelmed and risk of caregiver burnout. I’m wondering how else we can use technology to help reduce that risk, in addition to asking those questions? 

[00:20:20] Carl: If you have that professional involved, it really kind of dives down into, you have to understand your unique situation. So, you look at the basic social determinants of health, healthy eating, sleep, transportation, medications, moving around the house, find ways to be monitoring those very basic things and make those simpler. Like sleeping, you can buy super cheap motion detected lights, so when you get out of bed, the lights would turn on, so that you’d be able to find your way to the bathroom without tripping and potentially falling. and then having a cascade of events. That is something simple. 

[00:21:01] Again, doing kind of the basic passive or active monitoring, that could be from a camera that you set up in the home, or a habit, or routine, to regularly engage with somebody, doing a FaceTime, or scheduled zoom, or a phone call, or whatever it is to make sure that they’re awake and moving. 

[00:21:21] If you have a camera, you can then see if somebody in the kitchen are they accessing the refrigerator, and helping understand those things. Doing grocery delivery to make sure that food is continually getting there. I think a lot of it is just start with the basics first and then you can go into more specific disease type monitoring. 

[00:21:42] So, if you have a smart scale or a smart glucometer, then you need to know what deviations you’re looking for. So, it goes back to talking to the professional on like how much weight change is okay. And then you need to be reminding them to do it. So, a lot of the technology and a lot of the solutions, it comes down to really basic stuff. 

[00:22:03] And then I would go back to find a place to store this information and communicate so that it’s not all on you, so that you can take a vacation, so that a sibling has access to the data, so that if something happens to you, the family isn’t in a lurch because of that. And that’s what we see happen so often in aging couples is the one spouse is handling all of it. And because of that additional stress and burden, something happens to them. And now you have the spouse that was having issues – the family’s having to take care of them and healthy spouse is out of the equation. So now it becomes like, “okay, we don’t know what to do”. If you had spread the load, then you may not be in that situation. 

[00:22:49] Dannelle: I’m so glad that you brought that up. The importance of having the support behind the primary caregiver so that we can take a vacation, so that if there is a situation where we get sick, or we’re incapacitated for some reason, that there’s backup. It feels like this is the right place to also emphasize the need to have the appropriate legal documentation, authorizing access to specific information, accounts, or other digital resources to communicate with healthcare providers and financial institutions, etc. 

[00:23:30] Carl, I am not a technology savvy person. Personally, it took me three days just to get my printer fixed. [Laughs] So, I’m gonna ask the question. What are we missing here? What else do we need to know as care partners related to technology? 

[00:23:49] Carl: I would say don’t be scared of it. I mean, technology now is completely different than technology was 20 years ago, where you could get the blue screen of death on your laptop. You don’t get the blue screen of death on your iPhone. It doesn’t happen. Worst case scenario you could maybe reset your iPhone, but you’re gonna have a lot of stops happening before you get to that point. Fundamentally, just don’t be as scared of technology. 

[00:24:17] Going back to like, not asking questions because of looking stupid in middle school, don’t be scared of technology because technology was hard to use 20 years ago. And then technology doesn’t have to be super high tech. There’s apps that are designed to help guide you. Those apps like are designed to help eliminate the efficiency and help you not reinvent the wheel. That can help you through the process. 

[00:24:41] If you want to use something like CareTree to manage the information and communicate, but you can also do what just works for. So, if it’s a Google Doc or even a Word document shared on Dropbox, that the family uses, just start to document some of that information so that instead of it just being in one person’s brain, that it is accessible to the rest of the team, and then they can start adding onto it. 

[00:25:08] It’s not gonna happen all in day one. And I think that’s something that people have to really focus on is you’re not gonna solve the problem in a Sunday afternoon. Just take bites of it. As you remember something, just have a convenient place to put the information and keep building upon that. I think that works with any of these long complex projects. 

[00:25:29] And in building CareTree, like I wanted it all in day one and what we have now, it took 10 years to build and with caregiving, it’s the same thing. Like you can’t just fix it all right now. One little piece at a time. Then when you go to the doctor’s appointment, all you have to do is just add the new information opposed to being like, “ugh, I’ve gotta write 50 years worth of history here”. Just start somewhere and just make small progress. 

[00:25:57] Dannelle: One piece at a time. Carl, outside of caregiving, what is something else that you’re also passionate about? 

[00:26:08] Carl: My parents think I’m really stupid for this, but I enjoy ultra-endurance events. Like this past fall, I did an Ironman. The summer before I did some 50-mile runs. This year I’ll probably do another Ironman. If not, I’m actually on a waiting list for a 250-mile run. So, I’ll probably do a hundred mile for these 12- and 24-hour events run by special forces guys where you show up with a 50-pound backpack on and do whatever they tell you to for the next 24 hours – normally involves getting wet and sandy and carrying extra heavy stuff long distances for no other real point other than challenging yourself personally. These are the things that I do for fun. 

[00:26:53] Dannelle: Wow! A 250-mile run, Carl? Talk about taking one step at a time. [Laughs] 

[00:27:00] Carl: Exactly. 

[00:27:02] Dannelle: You would not be finding me doing an ultra-endurance challenge for fun to save my life. [Laughs] Well, that explains what you have achieved. This has been really excellent. Thank you so much for joining us today on The Caregiving Soul podcast, it has been a pleasure talking with you. 

[00:27:25] Carl: You too. Thank you very much. And thank you for what you’re doing. 

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[00:27:30] Dannelle: Thank you for joining our conversation with Carl. As I became more directly involved with organizing, and eventually managing, my father-in-law’s medical information as his designated health proxy, what I didn’t have was a centralized location to efficiently communicate what was going on with other family members or care providers, which meant more time and effort spent trying to make sure the appropriate people had necessary information and updates.  

[00:28:08] One of the primary benefits of a centralized platform with capacity to communicate, store, and document our loved one’s information is that it provides an opportunity for multiple care partners to better assist as additional care partners. I hope this episode allows you to consider some of the ways technology could benefit the way we help care for family and friends. Whether we use a technology platform that’s specifically designed for caregiving, or we adapt an everyday technology like a shared calendar, Alexa or Ring, we have options to better organize a care team.  

[00:28:55] For more information on Carl and CareTree, check out our show notes.  

[00:29:00] Every episode of The Caregiving Soul has a page on empoweredus.org, where you can find the extended show notes – including tips and takeaways, transcripts, and relevant resource links.    

[00:29:16] If you’d like to share your own tips related to this topic or connect with us, visit the Empowered Us Contact page or reach out to us on our social channels.   

[00:29:28] The Caregiving Soul is an Empowered Us Original presented by Good Days, hosted by me, Dannelle LeBlanc. If you liked this episode, be sure to rate and subscribe to this show wherever you get your podcasts.    

[00:29:46] And remember, the right care includes care for you.  

[00:29:57] [Music Ends] 

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