Discharge from the hospital or a rehabilitation stay can be scary, confusing, and overwhelming. Things move fast, and lack of preparation can lead to unsafe outcomes.

Join Elder Care Advocate Laura Daniels, RN, as she provides an essential discharge planning checklist and walks you through every step you need to take for a safe transition home or to a new care setting. Learn how to advocate for yourself or your loved one from day one, what to expect during a hospital stay, and the key questions to ask your medical team regarding medication, follow-up care, and recovery support. Laura emphasizes that the most important care happens after the hospital stay and offers a free Medicare discharge checklist resource to ensure you're prepared.

• Learn the stages of a hospital stay and how to navigate the system.

• Understand the importance of proactive, day-one discharge planning.

• Discover key action items, like coordinating equipment, follow-up appointments, and support services for the crucial first 72 hours at home.

Chapters

00:02 Introduction to Navigating Elder Care with Host Laura Daniels, RN.

00:20 Laura's background as an Elder Care Advocate and founder of Care Advocates.

01:16 Care Advocates' process: Customized care planning and options (assisted living, memory care, in-home care).

02:38 Today's Topic: The overwhelming moment of hospital or rehab discharge.

03:32 Introduction to the Discharge Planning Checklist and key action items.

04:02 Offer for a free, four-page Medicare Discharge Checklist.

04:47 What to Expect During a Hospital Stay: Understanding the process.

05:27 Stage 1: Admission (Emergency Room vs. Planned Admission).

06:36 Stage 2: The Inpatient Phase (Specialists, Vitals, Rounds, Task-Driven Care).

07:44 How to Advocate for Yourself or a Loved One.

08:46 Key Questions to Ask from Day One: Plan, goals, concerns, therapy.

09:14 Taking Ownership of your admission and outcomes (bring a notebook!).

10:04 Asking about medication changes and starting discharge planning on day one.

10:48 Your Rights: Speaking up if you don't feel ready for discharge.

11:29 Questions to ask about the post-discharge plan (rehab, SNF, home health).

12:20 Hospital stay is a temporary stop; focus on what comes next.

13:42 Why Discharge Planning is Crucial: High risk of readmissions and complications.

14:50 The patient/caregiver is a key partner in the discharge process.

15:40 Overview of the Medicare Discharge Checklist components.

16:05 Checklist items: Home assessment, follow-up appointments, transportation.

17:04 Support Services: Home health, meal prep, and community resources.

17:34 Equipment and Medications: Ensuring they are ordered in time.

17:54 Emergency plan and 24-hour contact list.

18:28 The Crucial First 72 Hours post-discharge and need for support.

19:5 6Skilled Nursing Facility (SNF) discharge considerations.

20:25 Resources & Next Steps: CMS checklist, referral service contacts, Medicare helpline.

21:18 Final encouragement and a client story about an unsafe discharge.

22:39 Outro: Contact information and services offered by Care Advocates.

24:07 Free Consultation and contact details: 210-669-2222.

25:06 Closing remarks.

See omnystudio.com/listener for privacy information.

In this episode of Navigating Eldercare, host Laura Daniels welcomes Naeemah Marquez, a Licensed Master Social Worker and the Vice President of Care Transitions for Ignite Medical Resorts. Naeemah shares her expertise on the intricate world of skilled nursing facilities (SNFs) and post-acute care. They discuss the definition of a SNF, the critical role of a case manager as a "broker of resources" and discharge planner, and what families can expect during the admission, stay, and discharge process. Naeemah offers invaluable advice on setting realistic expectations for recovery, coordinating successful transitions, and the importance of family involvement to prevent readmission. She closes with a powerful story illustrating the profound impact of guidance and advocacy in a family's eldercare journey.

• 00:02 Welcome and Introduction to Navigating Eldercare

• 00:20 Host Laura Daniels (Care Advocates Founder) Introduction

• 00:45 The Mission of Care Advocates

• 01:42 Introducing Guest Naeemah Marquez and Her Background in Social Work

• 02:38 Naeemah's Inspiration and Drive in Care Transitions

• 03:07 Defining a Skilled Nursing Facility (SNF)

• 03:34 SNFs as a Bridge to Recovery

• 04:00 The Role of a Case Manager/Discharge Planner in SNF

• 04:39 A Typical Day for a Case Manager

• 05:22 Supporting Patients and Families During the Stay

• 05:54 The Admission Process from the Hospital to Ignite

• 06:41 Average Rehabilitation Stay Length and Determining Factors

• 07:10 Most Common Types of Therapy (PT/OT)

• 07:39 Setting Realistic Goals: The Care Conference Meeting

• 08:08 Advice for Families to Ensure Successful Recovery Post-Discharge

• 09:34 Common Challenges: Patient Acceptance of In-Home Caregivers

• 10:54 Coordinating the Next Steps: Transitioning Home or to Assisted Living

• 11:51 The Interdisciplinary Team (IDT) Process

• 12:21 Key Resources and Referrals Post-Discharge (Skilled Home Health, Hospice, Visiting Physicians)

• 13:49 What Naeemah Wishes Families Understood About Skilled Nursing

• 14:17 Setting Realistic Expectations: Not a 100% Return to Baseline

• 15:14 The Patient Journey from Admission to Discharge

• 16:39 How Ignite Medical Resort is Different (Luxury Rehab and Hospitality)

• 17:39 A Story That Defines Naeemah's "Why" (Sister of a Patient)

• 20:50 Laura's Appreciation for Naeemah's Advocacy

• 21:27 Naeemah's New Role as VP of Care Transitions

• 21:54 Naeemah's Goal for Her Team: Realizing Their Role as Advocates and Change Makers

• 22:50 How to Contact Ignite Medical Resorts

• 23:39 Closing Remarks and Free Consultation Offer from Care Advocates

See omnystudio.com/listener for privacy information.

Join host Laura Daniels, founder of Care Advocates, as she welcomes Roxanne Burgener, a Licensed Nursing Facility Administrator at The Estates at Shavano Park. This episode provides essential guidance on one of the most critical steps in the elder care journey: the transition from hospital to a short-term skilled nursing/rehabilitation facility (SNF).

Roxanne shares her more than 35 years of experience in healthcare, detailing what a skilled nursing facility is, what sets The Estates at Shavano Park apart, and the meaning behind their "No Pass Zone" policy.

What You Will Learn:

• Understanding a SNF: A clear definition of a skilled nursing facility and the difference between short-term rehabilitation and long-term care.

• The Transition Process: A step-by-step walkthrough of what happens when a patient transfers from the hospital to a SNF, and how to ease anxiety during this critical time.

• Key Advice for Families: Top three tips for making the hospital-to-rehab transition smoother, including the importance of bringing familiar comfort items.

• Respite Care: How families can use this valuable short-term stay option to prevent caregiver burnout and who is an ideal candidate.

• Selecting a Facility: Essential questions families should ask and what to look for when touring a skilled nursing facility, focusing on quality of care, cleanliness, safety, and staff interaction.

• The Heart of Care: Roxanne shares a deeply moving personal story that illuminates her passion and calling to work with older adults.

This episode is a vital resource for families and healthcare professionals seeking to make confident, informed decisions about post-hospital recovery and care.

00:00 Introduction to Navigating Eldercare and Host Laura Daniels

01:34 Welcome and Introducing the Topic: Transitioning from Hospital to Short-Term Rehabilitation

01:54 Guest Introduction: Welcoming Roxanne Burgener, Licensed Nursing Facility Administrator

02:10 Defining a Skilled Nursing Facility (SNF)

02:22 Roxanne's Calling: What Inspired Her to Work in Elder Care

04:12 Host Recap: Defining the SNF Setting

04:36 The Estates at Shavano Park: What Makes the Community Unique

05:32 Person-Centered Care and the "No Pass Zone" Policy

07:07 The Transition Process: From Hospital Discharge to SNF Admission

09:39 Advice for Families: How to Make the Transition Smoother and Less Overwhelming

11:47 Understanding Levels of Care: Short-Term Rehab vs. Long-Term Care

14:24 Specialized Services: The Role and Value of Respite Care

16:15 Guidance for Families: Key Questions to Ask When Selecting a SNF

18:38 Final Reassurance for Families Facing the Rehab Transition

19:08 "This is Why I Do What I Do": Roxanne's Inspiring Story

23:14 Conclusion and How to Contact Roxanne Burgener and The Estates at Shavano Park

24:14 Final Thoughts and How to Contact Care Advocates for a Free Consultation

See omnystudio.com/listener for privacy information.

Laura Daniels welcomes highly respected senior care leader Mona Talukdar to discuss memory care, particularly focusing on the advantages of small, home-like communities. Mona shares her inspiration for creating specialized environments, explains how memory care differs from standard assisted living (focusing on mind support, specialized training, and environment), and offers essential guidance on knowing when it's time to transition a loved one. The conversation emphasizes safety, clinical-level care in a non-institutional setting, staff training in communication, individualized engagement, and how families can maintain a vital connection after the move.

00:00 Introduction to Navigating Eldercare

00:20 Host Laura Daniels: Guiding Families through Care Transitions

01:23 Introducing Mona Talukdar and Today's Topic: Memory Care

01:43 Mona's Background and Inspiration for Seasons Memory Care

03:09 What is Memory Care and How Does it Differ from Assisted Living?

04:29 When is the Right Time to Consider Memory Care? (Safety & Caregiver Burden)

05:58 Early Warning Signs Requiring Higher Support

07:37 Seasons' Care Philosophy: Routine, Predictability, and Joy

08:58 The Balance of Clinical Care and Social Wellbeing

09:28 Staff Response to Behaviors (Agitation, Sundowning, Wandering)

10:27 Environmental Features and Safety in Memory Care

11:48 Fall Prevention and Managing High Levels of Care

12:59 Family Connection and Emotional Support After the Move

14:24 Coping with the Guilt of Transitioning a Loved One

15:06 Engagement and Quality of Life: A Day at Seasons

16:03 Importance of Engagement and Avoiding Isolation

17:00 Adapting Activities for Different Stages of Decline

17:51 Collaboration with Physicians, Hospice, and Outside Providers

18:59 Role of Nutrition, Sleep, and Movement in Cognitive Support

20:25 Handling Changes in Resident Needs and Higher Care Levels

21:11 Advice for Families: Start Learning Early and Plan Ahead

22:15 Changing the Perception: Memory Care is Not a Last Resort

22:36 The Value of Small Settings and Deeper Relationships

23:17 A Success Story: Getting a Mother "Back"

24:09 Conclusion, Contact Information, and Listener Call to Action

See omnystudio.com/listener for privacy information.

Host Laura Daniels and Jimmy Caldwell of Imagine Wellness, a 16-bed residential care home, discuss choosing the right assisted living. They highlight the personalized care, exceptional 1:4 staffing ratio, and holistic approach found in smaller settings. The episode emphasizes why families should start the care conversation before a crisis and how genuine compassion leads to residents truly flourishing.

Chapters:

00:00 Introduction: The Eldercare Journey

01:45 Focus on Small Assisted Living Communities

02:22 Meet Jimmy Caldwell, Owner of Imagine Wellness

02:43 Inspiration for a Small, Boutique-Style Home

05:05 Core Values and Holistic Care Philosophy

06:57 The Impact of the 1:4 Staffing Ratio

08:25 Peace of Mind and Staff Consistency

09:23 Small Home vs. Large Assisted Living

11:14 Flexibility and Individualized Care

13:06 Success Story: A Resident Blossoms

14:57 Advice: Plan Before the Crisis Happens

16:39 A Typical Day at Imagine Wellness

18:04 Setting Expectations and Transparent Communication

19:34 Accommodating Hobbies and Personal Touches

21:11 "Living Still Happens Here" Philosophy

23:30 Contact Information for Care Advocates & Imagine Wellness

See omnystudio.com/listener for privacy information.

Navigating Eldercare — Assisted Living, Demystified
Host: Laura Daniels, RN, founder of Care Advocates
Guest: Stacey Shaffer, Sales Director, Gemstone Assisted Living

00:00–00:58 | Show & Host Intro
Laura Daniels—geriatrics RN and founder of Care Advocates—introduces the podcast and how she helps families after hospital/rehab stays or when home-care needs change.

00:58–01:54 | What Care Advocates Does
Customized care plans, placement options (residential care homes, assisted living, memory care), and ongoing support. Today’s focus: assisted living, with guest Stacey Shaffer.

01:54–03:20 | Meet Stacey
Laura highlights Stacey’s grace, empathy, and resourcefulness—someone who connects deeply with families at vulnerable moments.

03:20–04:50 | Stacey’s Background & Trust Building
From Marriott sales/marketing to senior living, Stacey brings a “no isn’t an option” service mindset. Trust starts with listening fully before suggesting solutions.

04:50–05:48 | Family Emotions & Burnout
Top emotions: guilt (not keeping loved one at home), stress (logistics), and real caregiver burnout.

05:48–07:37 | What Assisted Living Is
24/7 awake staff for quick response and ADL support. Replicating that consistency at home is hard across multiple shifts.

07:37–10:04 | Common Misconceptions

1. It’s not a hospital or skilled nursing facility.

2. Move-in doesn’t equal decline.

3. Cost fears—many options exist.
   Laura adds: diagnoses like dementia or feeding needs don’t automatically require nursing homes; many can be supported in assisted living to age in place.

10:04–11:58 | The Sales Director’s Role
Part therapist, part designer, always a resource. Honesty first—even if that means referring elsewhere. Every move-in is customized.

11:58–13:28 | Personalized Care Plans
Details matter: wake times, hearing-aid charging, brace application, favorite TV channels. Consistency gives residents and families confidence.

13:28–14:50 | Details & Dementia
Story: Mary Alice’s love for purple woven into daily outfits—small touches build trust. Dementia (e.g., Lewy Body) can often be supported in assisted living unless there’s wandering/safety risk.

14:50–16:07 | Aligning Expectations
Use insights from both resident and family (what Mom says vs. what actually works) and translate that clearly to the care team.

16:07–17:39 | When to Start Looking
As soon as you’re helping with more than one ADL. Early tours allow the loved one to participate and prevent crisis-driven, limited choices.

17:39–19:28 | Independence & Quality of Life
Assisted living can increase independence by removing fear of falls and missed restroom trips, freeing time for activities—art, church, exercise.

19:28–21:44 | Touring Tips
Observe residents (appearance, mood), ask them about food and entertainment, watch staff interactions (smiles, greetings), and check cleanliness on an “average” day. Aesthetics are nice, but care is the priority.

21:44–24:00 | From Guilt to Peace + “Fast Eddie”
Families gain peace when the team uses everything learned to tailor care. Stacey shares “Fast Eddie,” a stroke survivor who joined a community “Dating Game” event—finding purpose and love.

24:00–25:31 | Wrap & Contacts
Stacey’s direct line: 702-358-1168.
Laura offers a free consultation: 210-669-2222 | AdvocateRN.com.
Subscribe and share the show!

Listen / Watch
📅 Sundays, 8:30–9:00 AM on 930 AM The Answer.
🎧 Available on all podcast apps.
▶️ Full video episodes on YouTube.

Contact Laura for a Free Consultation
📞 210-669-2222
📧 laura@advocatern.com

See omnystudio.com/listener for privacy information.

Confused about Independent Living? Join host Laura Daniels, elder care advocate, and guest expert Tina Tedford, Sales and Marketing Director at Franklin Park Sonterra, for a candid discussion about this often-misunderstood senior living option. With over 30 years of experience, Tina shares what sets independent living apart from assisted living, details the vibrant daily life and amenities available, and explains why proactive planning makes all the difference. Learn how communities like Franklin Park offer seniors a resort-style experience—focused on freedom, companionship, and choice—and explore real-life examples of residents who found a fulfilling "new chapter" in community living.

00:02 Welcome to Navigating Eldercare & Meet Tina Tedford

01:17 Tina’s Journey: From Nursing Homes to Independent Living

02:13 The Role at Franklin Park Sonterra: Senior Living with Style

03:09 Independent Living vs. Assisted Living Explained

04:25 Is Independent Living Right for You? (Contrasting Resident Types)

04:30 The Proactive Couple: Seeking Freedom and Amenities (Bill & Susan)

06:21 The Social Senior: Combating Isolation (Margaret)

07:48 The Reluctant Senior: Overcoming the "Nursing Home" Fear (Harold)

09:11 Invitation to Tour & Contact Tina (210-404-1444)

10:15 Creative Solutions for Couples with Mixed Needs

12:53 A Day in the Life: Amenities, Activities, and Social Engagement

14:27 Resident-Led Committees and Community Involvement

15:47 Privacy and Choice: Introverts are Welcome, Too

16:38 Easing the Transition: Help with Downsizing and Moving

17:39 The Importance of Pre-Planning: Talk to Your Parents Now

19:08 Final Advice: It's a New Chapter, Not the End

19:46 Shifting Perception: Resort Style Community, Not a Facility

20:21 Tina's Inspiring Story of a Blind Resident

22:34 Closing Thoughts & Contact Information for Tina and Laura Daniels

See omnystudio.com/listener for privacy information.

Navigating Eldercare provides essential guidance and practical solutions for every step of the elder care journey. Host Laura Daniels, a Registered Nurse specializing in geriatric care and founder of Care Advocates, brings over 30 years of expertise in advocacy and care transition planning. Each week, Laura shares expert insights to help families and professionals make confident care decisions for seniors in transition—whether after a hospital stay, rehab, or when home care needs change.

In this episode, Laura is joined by Michael Zendejas, owner of Homewatch Caregivers in San Antonio, a certified dementia care specialist, and a veteran. They discuss the vital role of in-home care, differentiating it from home health, and exploring the comprehensive services an agency provides, including assistance with activities of daily living (ADLs), specialized care for advanced diagnoses (like Parkinson's or Alzheimer's), and crucial respite care to combat caregiver burnout. Mike emphasizes the importance of choosing a licensed, insured, and locally-owned agency, focusing on caregiver matching and the critical support provided during the first 72 hours of hospital-to-home transitions to prevent readmission. This episode is a must-listen for anyone seeking to understand in-home care options and the value of planning ahead for the care journey.

Chapters

00:00 Introduction: Navigating Eldercare with Host Laura Daniels, RN

00:31 Laura's Mission: Guiding Families and Professionals Through Care Transitions

01:28 Care Advocates: Services and Philosophy (Customized Care Plans, Advocacy, Support)

01:55 Introducing Guest Mike Sandeja, Owner of Homewatch Caregivers

02:23 Mike Sandeja's Background and Service to Seniors03:23Inspiration for Starting an In-Home Caregiving Agency

03:52 Defining In-Home Care vs. Home Health

04:39 Services Offered by Homewatch Caregivers (ADLs, Specialized Care)

05:14 Who Needs Home Care? (Falls, Post-Discharge, Chronic Conditions)

06:54 Understanding and Utilizing Respite Care

07:54 The Reality of Caregiver Burnout and Self-Care

08:37 Misconceptions about In-Home Care (The Caregiver Team)

09:33 What Sets Homewatch Caregivers Apart? (Local, 24/7 Decision Makers)

10:35 Agency vs. Private Caregiver (Licensing, Insurance, Backup Care)

11:32 Matching Caregivers with Clients (Skills and Personality)

12:21 Caregiver Onboarding and Training Process

13:25 Involving Family in the Customized Care Plan

14:18 Creative Solutions and Preparing the Home for Discharge

15:26 The Most Important Question to Ask a Caregiving Agency

16:21 Focus on the First 72 Hours: Hospital-to-Home Transition

17:15 Reducing Readmission Rates and Coordinated Care

18:43 Service Agreements: No Long-Term Contractual Obligation

19:28 Where Caregivers Can Serve Clients (Assisted Living, Communities)

20:41 Mike Sandeja's Advice: The Journey Starts Now (Plan Ahead!)

21:35 Why It's Critical to Not Wait for a 911 Emergency

22:34 Contact Information for Homewatch Caregivers (210-346-1172)

23:29 Conclusion and Contact Information for Care Advocates (210-669-2222)

Professional Affiliations:

• National Placement and Referral Alliance
• Alliance of Professional Health Advocates (APHA)
• National Association of Healthcare Advocacy (NAHAC)

Laura's approach combines professional expertise with heartfelt understanding, making her an invaluable resource for families facing the challenges of elder care decisions. Her commitment to improving quality of life for seniors shines through in every interaction, making her the perfect guide for listeners navigating their own elder care journeys.

📅 Tune in Sundays at 8:30am–9:00am on 930AM The Answer or listen anytime on your favorite podcast app. Watch the full video episodes here on YouTube for added insights and resources.
Contact Laura for a Free Consultation:
📞 210-669-2222
📧 laura@advocatern.com
🌐 www.advocatern.com

See omnystudio.com/listener for privacy information.