Editor’s note: Caregiving expert Annalee Kruger has spent decades helping families get better care for aging loved ones. She has also helped advisors become better advocates for clients and advised them on how they can encourage their clients to do the same for their loved ones. She owns Care Right Inc. and is co-owner of Plan4LifeNow LLC, which offers financial advisors a 10-week online Certified Elder Planning Specialist program. She started Care Crusade, a national campaign to improve the quality of care in hospitals and senior care facilities after her mother choked to death in a memory care facility. Her book, “The Invisible Patient: The Emotional, Financial, and Physical Toll on Family Caregivers,” was published in October 2021. Her most recent business venture is creating the Aging Strategy Coach Academy (ASCA), a training program for people who want a career helping others find the best caregiving, as well as a broader view of the healthcare industry and care options.
Our advisor contributor Brad Jensen recently caught up with Annalee Kruger to learn more about her.
Jenson: Tell us about your journey to becoming a leading expert in the field of senior caregiving.
Kruger: I attribute my childhood to my journey. My grandparents lived with us when I was growing up on the farm. I was an Iowa farm kid. Back in the 1970s, there was no such thing as assisted living. Back then, if your aging loved ones couldn’t manage safely at home, they either moved in with their adult kids or into a nursing home. I always grew up with my grandparents. My grandmother’s aging journey was very different than my grandfather’s. My grandmother’s journey was one of pain. She had chronic pain and disease. She was very sick and needed hands-on care. Whereas, my grandfather just needed socialization: spending time with the family, riding horses with us, helping us combine and bail hay, and driving the tractor.
In third grade, I knew I would be in the senior care profession; I just didn’t know what it was called back then because I was a little girl. I also worked as a candy striper in a nursing home. So, I’ve always worked with the elderly. I’ve always been an “old soul,” and my career has been a natural progression for me.
I got my social work degree and started working in a long-term-care center as a social worker, admissions coordinator, and marketing director. I eventually moved up to the executive director level. I always gave tours to family members who were blindsided by a sudden need for care. For example, the day before a parent would be discharged from the hospital, families would be given a list of facilities to tour because their parent would be discharged the next day. Another example: Mom was a caregiver to Dad, who had dementia, and I had to help the kids decide what to do. I was spending two to four hours with each family because they had so many questions. They would think [wrongly] that Medicare was going to pay for everything. They had relational issues such as “we made mom a promise that we would never put her in a facility.”
And sometimes family members just don’t get along with each other. The other thing I noticed was when I asked them, “Do your parents have a living will? A power of attorney? End-of-life wishes? A DNR [do not resuscitate] order? Funeral arrangements taken care of?” The answer was always the same: “I don’t know. Our family hasn’t talked about these things.” And then there was a very small number of families where the adult children tried to have family meetings with their parents to discuss these issues and they got so much push-back that they quit trying.
So after 18 years, I realized I had a good business model and created Care Right Inc. I started this business in Milwaukee in 2011. I went virtual right away. Back then Skype was the only option. Family members may have moved away from home for jobs, marriages, divorces, etc. The only way that I could facilitate their family meetings was to leverage technology back in 2011 on Skype. So, I was a pioneer in using video conferencing technology before the pandemic forced it on everybody.
Since 2011, we have served over 2,000 families. Because we take pride in the work that we do. Every single one of my clients, since 2011, has been from a word-of-mouth referral. As such, we’ve grown our business nationwide and beyond. I’ve got clients in 32 states and four countries.
We do customized 25-point aging planning. We ask about their caregiving goals. We find out what’s working well and what’s not working well. We do a care matrix. We do market research on care facilities in the zip code range that families want us to explore. The care matrix saves families the time, money, and angst of doing it themselves. We teach families about the different levels of care. We also help people understand how much care will cost and how to pay for it.
We help people make proactive decisions. For example, it’s important to do the tours of facilities proactively and be on the waiting list of three or four different care communities so if you end up in a jam at home, you have a higher probability of getting into a care community that you want and are not just going to end up with any facility that has an open bed.
We also work with families to complete a “grab and go” binder to make sure they have all of their important information documented: accounts, passwords, VA paperwork for veterans, estate documents, long-term-care insurance, a list of professionals that are on your team: financial planner, attorney, etc.
The entire family unit is our client. We teach children to be “bold advocates” for their aging parents. Just because someone is paying $10,000 a month for care doesn’t mean they are getting the proper care they need. Furthermore, a lot of healthcare facilities have had massive turnover in leadership, and when there is no consistent leadership, staff may or may not be trained well and properly supervised. We do virtual care advocacy to make sure people get the proper care that they deserve.
So my whole life has been dedicated to helping families to have a more pleasant aging and caregiving experience.
Jenson: What services do people receive by becoming clients of Care Right?
Kruger: Care Right provides a customized aging plan. When needed, we do crisis management. We work directly with families that find themselves in a caregiving situation and need help. The aging plan includes crisis management solutions, family meetings, a care matrix, care advocacy, and support along the way through the difficult part of the aging journey so they can make informed decisions.
Jenson: Who might be candidates that advisors can refer to your organization?
Kruger: With respect to Care Right and financial advisors, what we are trying to teach advisors is how to build their professional team. They should have people like Care Right and they say, “We’ve identified that you need additional support and services but we’re not that person.” We teach financial advisors how to make referrals. Advisors can leverage my book and say, “We’re not the experts in caregiving” but you can contact Care Right.
Jenson: It’s interesting that your Elder Planning Specialist certificate program, through Plan4Life, is now offered through the Financial Planning Association’s online learning platform. What can financial advisors gain from becoming an “Elder Care Specialist”?
Kruger: Under Plan4Life, the financial advisor is trained to become an Elder Planning Specialist through our certification program. We cover important issues about aging that are not addressed in the CFP modules. Financial advisors gain a deeper understanding of the aging process: the caregiver’s role, legal issues, structuring and conducting a family meeting; creating ethical wills, end-of-life plans, legacy letters, and more. Financial advisors also learn how to build an Elder Planning Team and develop marketing plans as “niche” advisors who are elder planning specialists. Plan4Life advisors who go through our program typically say to other advisors: “I went through this Elder Planning Specialist program and I learned a lot.”
In 2024, we will also be rolling out the Pioneer Mastermind monthly group for those who have completed the Elder Planning Specialist program so that they can continue learning.
Jenson: Tell me about your new initiative, your Aging Strategy Coach Academy (ASCA).
Kruger: I’m creating this Aging Strategy Coach Academy, the first-ever international coaching academy addressing aging, family caregiving, the landscape of the healthcare industry, care options, differences between all of the different levels of care, dementia progression, the pros and cons of aging at home, how to interview home care companies, how to tour care communities with confidence, how to be a bold advocate, understanding death and dying, end of life, the importance of an Aging Plan and the “Grab and Go” binder of personal information, and how to facilitate family meetings, and so forth. ASCA is literally my 30-plus years of knowledge and experience working directly with families, seniors, and the long-term-care industry. I’ve created 175 hours of modules for this accredited academy. My intention is to launch ASCA by the end of the summer. As the title of this academy suggests, it’s a training program for someone who wants to become an Aging Strategy Coach as a career path, something new to both the caregiving and personal coaching marketplaces.
Jenson: My last question is a personal one: How does Annalee Kruger take care of herself?
Kruger: I enjoy reading. I spend time with my dog; I walk my dog a lot. I do other forms of exercise. I spend time with my family and friends. I go to movies. Next year, my goal is to rent a house in the mountains of North Carolina and truly unplug and recharge for a month or two and take a sabbatical. I need to be around nature and have peace and quiet.
Jenson: Thank you, Annalee!
Kruger: Thank you, Brad.
Bradley C. Jenson, CFP, CIMA, AIF, CAP, is a financial advisor with Lake Superior Financial Services in Duluth, Minn., and a member of the Investments & Wealth Institute, the Financial Planning Association, the MIT AgeLab’s PLAN network, and the ModernElder Academy.