Triff Cook: “People First”

The health system should allow doctors more paid time to provide a full educational breakdown per individual. For example, when a doctor has the ability to look at a patient’s socioeconomic status and adjust their prescription from an unaffordable medication they are unlikely to buy to actual lifestyle changes that would achieve similar results. As a […]

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The health system should allow doctors more paid time to provide a full educational breakdown per individual. For example, when a doctor has the ability to look at a patient’s socioeconomic status and adjust their prescription from an unaffordable medication they are unlikely to buy to actual lifestyle changes that would achieve similar results.

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Triff Cook (MBA, CMC) an expert in the field ofGeriatric Care and the Director of Client Services at Home Care Assistance. She lives in Atlanta, GA.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

My father was a surgeon and became a director of a hospice in his retirement. He was the one who recognized that people were living longer and needed help and care as they aged. He encouraged me to look at home care and the hospice industry.

I am from Springfield, Missouri in the Ozark mountains and when I went away for college, Branson, MO was just a tiny town near Table Rock Lake. When I returned, Branson was a booming entertainment area attracting many retirees and there were huge theaters and music halls. One evening, my parents took me to see Andy Williams in concert. Andy’s mother was in a retirement community there, and during intermission, he came on stage and told us a story about how he was waiting for the retirement community to bring his mother down to visit when an old lady sat down next to him. He struck up a conversation with her and decided to give her a thrill. He said, “Do you know who I am?” She said, “No, Sonny, but if you go to the front desk, they will tell you.” It was a joke, but it was the first time I realized some people had memory problems!

Can you share the most interesting story that happened to you since you began leading your team?

One moment that comes to mind is when my team was asked to take care of a famous civic leader in the last days of his extraordinary life. We had to find caregivers that would step up to provide the best possible care at the last minute and one of our staffing managers rolled up his sleeves and stepped in.

In another instance, we had a dedicated caregiver willing to walk two miles to get to work because the bus lines were down during COVID-19. We also had caregivers leave their families and quarantine for 3 weeks with their clients to keep them safe from COVID-19.

These stories are everything. They inspire me to bring my best everyday. I realize our office and staff are like a pro sports team, with everyone bringing their unique gifts and hearts to the table. When we all bring out our best the results we achieve are amazing!

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I was sitting at a table with a lady that had dementia with her husband and daughter. I gave them all a business card. When we got going, I focused only on the husband and daughter, leaving the lady out of the conversation. The lady picked up my card, started shredding it into many pieces and said “this is what I think of your home care”. The valuable lesson I learned was you should never talk about someone, even with considerable memory loss when they are in the room. Never again would I forget about engaging with everyone at the table.

What do you think makes your company stand out? Can you share a story?

Our company culture of caring for others stands out in our motto of, “People First” and great leadership from our founder and CEO Lily Sarafan.

In my initial training, just under 15 years ago, Lily coached me with a role play. I gave my best pitch and she said “You are saying a lot of great things Triff, but you are missing the most important thing, that is to really listen to what the family is telling you.” This is carried out in Lily’s leadership today and trickles down to how we care for our clients and families. Both Lily and I are still with Home Care Assistance!

What advice would you give to other healthcare leaders to help their team to thrive?

Leaders should listen and try to walk a mile in their team members’ shoes. When you think you have heard everything, listen again to what they say and then you can see the full picture of what they need.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. The U.S. is great at providing “sick care” over “health care.” The healthcare system is too focused on the one-size-fits-all and we don’t allow our medical professionals to thoughtfully diagnose the individual. We don’t look at the whole picture that is our patient, but often focus on tackling each health issue as they arise.
  2. Empower patients to take their health into their own hands while working with their health care providers as a team instead of opting for the quick fix. The downside to this, is often doctors and healthcare providers are limited in their options by the system set by Medicare.
  3. Western cultures have a tendency to devalue aging and older people. We need to embrace aging as an important component of everyone’s lives. We need to create a positive environment for aging. The family unit needs to work towards family resilience. If there’s a crisis with mom, and the family learns to work together to come to an optimal solution.
  4. Aging Life Care Managers shouldn’t be reserved for the affluent. Medicare should recognize and value/subsidize life care management for elderly. Especially due to the fact that many elderly don’t live near their family members. Care Managers can provide resources that act as preventative healthcare measures.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

  1. The health system should allow doctors more paid time to provide a full educational breakdown per individual. For example, when a doctor has the ability to look at a patient’s socioeconomic status and adjust their prescription from an unaffordable medication they are unlikely to buy to actual lifestyle changes that would achieve similar results.
  2. As a Geriatric Care Manager (Aging Life Care Manager), I advocate for more emphasis on long term care management, especially for older people, which would include education on all their choices (assisted living, nursing home facilities) and empower them to have a direct effect on how their lives play out. The body you’re inhabiting now has to take you to the finish line!
  3. I would introduce the concept of family resilience to a wider population in the U.S. For example, if mom has a crisis and one daughter living in the same city is at odds with her siblings living across the country, this often prevents effective management of the situation. By pre-planning mom’s aging options, we greatly reduce emotional and financial turmoil on the whole family.
  4. Aging Life Care Managers can actually save families money. They have resources to offer families that less affluent families may never learn about. Similarly to saving for retirement with a wealth planner, an Aging Life Care Manager can recommend many money saving options. Choices made now can save money and resources later like buying a house with a master on the main level or investing in long term care insurance. Medicare is health insurance, it’s not long term care insurance. If you want to age in place, it requires resources and preplanning.
  5. About 4–5 years ago, Labor laws concerning overtime for caregivers changed in our country. This hurt both caregivers and patients. Caregivers went from being more affordable for a patient to employ 5 or more times per week to only affordable 3 times a week unless they are paid time and a half. Patients then have to have more than one caregiver (especially in case of dementia when they are used to one caregiver) and caregivers have to find more work with different patients to supplement their income.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Individuals should proactively seek to be educated about what their options are in terms of medication and lifestyle solutions in relation to their health.

Along with health insurance and retirement funds, corporations should provide their valued employees access to non-medical care giving support and geriatric care management.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

I think a diagnosis of dementia is an example of those two tracks colliding. On the one hand, you are dealing with a fatal illness that attacks the brain in many different ways, which is a general healthcare crisis, and on the other hand, you are dealing with behaviors in a person who, in the beginning, looks the same and can function, yet it cannot be assumed that he/she can make appropriate decisions.

With dementia, abnormal behaviors can be subtle or pronounced. The disease can be confusing and distressing to both the patient and their family, when, for instance mom gets in the car and drives proficiently but ends up 100 miles away because she does not remember where she was going. This is an extreme example of a problem that creates mental health issues for the family members and friends. It can also drain resources.

I advocate for a deeper understanding of the illness starting with the patient, their family members and close friends and from there, we need to educate and discuss dementia as a society.

How would you define an “excellent healthcare provider”?

An excellent provider is someone who is not afraid to look at the whole person and make suggestions at all levels to change outcomes. Someone who can enable a person to make changes versus just talking. When we value each other more, we will be better/more mindful about the care provided — empathy is everything.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

It’s not what you have at the end of life, it’s what you leave behind that matters.

Are you working on any exciting new projects now? How do you think that will help people?

As you may have realized by now, helping people with dementia is a passion of mine. Our Mindfit and Cognitive Therapeutics program at Home Care Assistance offers resources to help our teams engage with clients with cognitive disabilities, helping people with dementia in ways that have never been done before.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

The book ‘Happy to 102’ is great and speaks to improving our healthspan alongside our lifespan (full disclosure: the book is co-authored by Home Care Assistance founders and our CEO). Funny anecdote: I was asked to give a talk on the book at a church and the leader asked me to change the name of the talk because one of the members of the congregation was 103!!

I also am fascinated with the Okinawan centenarian study and “Blue Zones”. Lifestyle choices made a huge difference in healthspan, not just long life.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Dementia and its many forms is a fatal illness that attacks all parts of our lives. It is heart-wrenching for the loved ones, confusing and painful for the afflicted, and a slow long burn of resources, from money to peace of mind. Using our resources to find cures and improve outcomes would be huge.

I’m really inspired by our CEO, Lily Sarafan, who is on a Task Force for Alzheimer’s alongside Maria Shriver and the governor of California to build an ongoing movement to promote Dementia care and new breakthroughs.

How can our readers follow you online?

You can find some videos of my talks on Facebook at and on Twitter @HCAssistance

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