It often occurs that one’s professional path begins with a personal challenge or a pivotal life event. That was certainly true for Carla Payne, owner and founder of Aging Care Matters, a company that provides care management and Adult Day Care in the Triangle.

“Actually,” says Ms. Payne, “although I didn’t realize it at the time, I took my first steps on this path in my childhood. That’s because my father suffered from bipolar disorder—a condition that had a huge impact on the quality of life for our whole family. And toward the end of my father’s life, as his health continued to decline, I found myself in the role of principal caregiver. This is a common experience—even though I was living in another state, as the one daughter in the family, it fell to me to take on that responsibility.

“That experience—of trying to provide for his care, long-distance and on short notice—was overwhelming. He needed support, he needed to find a place for his care. I was forced to make decisions for him, with no support, no time, and no knowledge. It was a very dark time.

“There’s no doubt,” she acknowledges, “that this was a turning point for me. I started volunteering at nursing homes at the time of my father’s decline—partly to better understand the health challenges of aging, and partly to feel that I was in some way helping those, like my father, who were struggling.

“It was a powerful learning experience. And when my father died, it was the catalyst that prompted me to go back to grad school to study gerontology. That was my introduction to care management, and I knew I had found my calling.”

Avid Student, Problem Solver

What happened next in Ms. Payne’s journey is characteristic of her approach to life. “I’m a student,” she says, “and a problem solver. When I’m faced with a challenge, I want to know everything I can about it and all my options for meeting the challenge. I had seen, in my father’s case, all the problems confronted by people as they age and struggle with health issues. I was determined that there was a better way to deal with those problems and wanted to be a part of that. So, I finished my studies, joined a national association of professional care managers, and took a class on how to start my own business. Aging Care Matters was launched in 2018.

“That, of course, was just the starting place,” she says with a smile. “The business has grown, step by step over the last seven years, and so have I. I have a certification in care management. I am a fellow of the Aging Life Care Association, which is the highest level of advanced professional development, and I am the outgoing southeast chapter president.

“Most important, I have learned so much from my clients and their families about the needs and challenges of aging care—lessons that have been critically important in the development of the programs and services we offer.

“Our adult day care programs are an example of this,” she says. “We began with a facility in Wake Forest, and with a commitment to creating a space that was not only safe and welcoming but would provide older adults with both mental and social stimulation. When we added a second center in Durham, we encountered a very stark reminder of the difference between the quality care we want to offer and what has too often been the norm for adult day care.

“I’ll never forget coming into the Durham center for the first time, when we took it over,” she says. “I was appalled. It was uninviting, with an unpleasant, institutional feeling. The windows were covered with posters; you couldn’t see out. The chairs were just lined up; a TV was blaring a game show that was shrill; the lighting was harsh.

“All that has changed now. Like our Wake Forest facility, the Southpoint Center in Durham is now a welcoming place, able to address the varied needs of our clients. And with the purchase of Golden Horizons Adult Day Care Center in Durham earlier this year, I am privileged to continue the incredible work of its founder Douglas Van Coleman. Golden Horizons has long been a trusted part of the Durham community, and I am committed to preserving and expanding its impact—ensuring families have a safe, supportive, and engaging place for their loved ones.”

Aging Care Support: Many Challenges 

Adult day care services are just one of the components of the Aging Care Matters program. “There is no single approach to providing care for aging adults,” explains Ms. Payne. “Each story is unique; needs vary widely. For some families, just having a safe, supportive day care center to rely on is enough. Other families may need much more support in managing medical appointments and information or assistance with routine care. And I want to emphasize that this work is about families. It’s not just the aging individuals who need support; so do their spouses, children, or other caregivers.”

Aging Care Matters offers a variety of services, available as clients need them. “In addition to our day care centers,” says Ms. Payne, “we offer consulting services and care management.

“Care management involves many things,” she explains. “With my team of care managers, we help families at every stage of the aging journey. This includes crisis management and hospital/rehab discharge planning; it can mean coordinating home care and additional services. We provide guidance on transitioning to higher levels of care when needed as well as end-of-life education, advocacy, and logistical support.

“While we don’t do hands-on care,” she says, “we often help clients with their medical care. For example, I see one client every week and make her medical appointments, take her to those appointments, help her check in, and take notes to be sure everything’s covered.

“I often describe my job as a care manager as a ‘puzzle master.’ That’s because so much of what’s involved in a person’s medical care is compartmentalized—many individual pieces of a puzzle. A cardiologist or emergency room physician might handle one piece: What’s broken or bleeding? Rehab and physical therapists will handle another: Are you walking 20 steps and can you go to the bathroom? Home health is another piece; so is insurance. And everything involves paperwork. A care manager needs to see the whole ‘puzzle’ and make sure all the pieces fit together. Clients can use me as much or as little as they wish and, because I do see the whole puzzle, they can tap me into the process whenever the need arises.

“This can be a critically important role,” she adds, “when family members are out of state or out of the country—the very situation I experienced in trying to support my father. In those cases, I can be the ‘boots on the ground’ person and can check on the client and report back to their caregivers as desired.”

A Guide Through the Maze

“The challenges of meeting the needs of aging and ailing family members can be overwhelming,” says Ms. Payne. “The road ahead is rarely a straight path—it can feel more like a maze! And needs will inevitably change as clients age and their medical conditions deteriorate. So, a critically important part of my work is as a consultant and planner.

“This begins with a free consultation where I listen and learn about their situation and answer what questions I can. If families want to move forward, we’ll work to develop a plan—one that can adjust as circumstances change. Education is an important part of this process—helping people to understand options—from Medicare, Medicaid, and home health to anticipated changes in the medical conditions they’re dealing with. It often involves financial planning and may include assistance in finding an appropriate long-term facility. Put simply, my role is to support families in whatever way they need. And that role may evolve. A client might begin by using the adult day care center, and later—as their health declines—I might step in to help navigate more complex decisions regarding care and placement.

“We’re all on the same journey, aren’t we,” she asks. “As we age, we encounter many changes and challenges—and for each of us the journey is different. Health issues may be serious for some; cognitive decline may be a problem for others. Some have robust family support, others may deal with isolation and disconnection from family. What we all hope for is a good quality of life at every stage of the aging process, regardless of the individual challenges we face. “And the truth is, there are resources available to help us achieve that goal. But I know from painful, personal experience that understanding how to find and use those resources to help a loved one can be an impossibly difficult and heartbreaking challenge. We all need a guide through that maze. I founded Aging Care Matters because I want to be that guide.”

Transitions
on the Aging Path

“There’s probably no better example of the clients we work with than Lynn and Wayne Russell,” says Carla Payne. “Their story illustrates the two most important aspects of the aging ‘journey’ that so many people experience. First—and most important—this is a family affair; the stages of change and the challenges are shared. The other characteristic of this journey is that it is one of transitions. Needs and issues change, as Lynn explains.”

Wayne’s story is one of cognitive decline. “But,” recalls Lynn, “it wasn’t a straight path—some changes were gradual, others sudden. He had been showing some symptoms for probably fifteen years when, three years ago, we went on a cruise. The radical change of food and scenery seemed to throw him off a cliff. And, between going to bed at night and waking up in the morning, he didn’t know me; he didn’t know where we were; and he was terribly upset. His physical response to this stress was so severe, we went straight to the emergency room. And, following the cruise, he was hospitalized three times trying to help him regain his balance.

“He got better, but at that point, it was clear that he needed help—and so did I,” says Lynn. “We looked at two places, including Carla’s, that provided day care. And I remember asking Wayne which one he liked better—and there was no question. In the other, larger center, the people were mostly in wheelchairs and inactive—they didn’t even look conscious. In Carla’s center, the room was active, energized. People were talking and doing different things; it was definitely a better choice. And though small, I liked the intimacy of it.

“Wayne’s been there for over two years. When I first took him there, he thought I was his mother—in fact, that is how he introduced me. But with the staff’s attention and activities to stimulate his brain, he ultimately remembered who I was. I attribute that to the approach Carla and her group take. Carla’s an angel and her daughter is wonderful—all the people that work there have the biggest hearts. And everything they do has helped to improve Wayne’s brain function and to help him feel connected and safe. I don’t know what we would’ve done without them.”

And now Lynn and Wayne are about to face the next stage on their journey. “Wayne is about to go into residential memory care at Calyx,” says Lynn, “and, although this is the right next step for him, it’s a tough transition for me. During these last few years, Carla has been my rock. She’s not just Wayne’s care manager—she’s mine as well; listening when I needed support, keeping me centered, and helping to steer me in the right direction. And I know that this next stage is the right direction.

“When it became clear—to me and to Wayne’s neuropsychiatrist—that it was time for a change, Carla helped me find the right place for Wayne and to navigate the more complicated decisions about his care and placement. She continues to be Wayne’s care manager—and my support. Undoubtedly there will be other transitions ahead and I am grateful that Carla will be there to advise and support us when that happens.”