Thank you. Now, when you think about your three suggested top needs. Now I want to stay we don't have to go through them individually, but I will prompt you or probe with you if you don't cover, you know, each of them. But I want to know how and why are older adults struggling with each of those issues. And why are they struggling with it, and then housing and then healthcare access and delivery.


So I mentioned a little bit as I just processed, telling you the list. I think, for example, I was talking about just people losing their job or having to change jobs with as they're older, and that can be challenging their stigma in the workplace and the job market on older hiring older job seeking candidates. Potential physical demands of jobs as they as people are aging, that maybe they could have done their 20s and 30s 40s, but struggle in their 60s and 70s, even life expectancy is longer. And so yeah, I think as the job market changes rapidly, technological impacts on the job market and roles, there could be then become a skill gap, if now, you know, the demands the job the labor market are having like aI familiarity and technology, technological skills, and you're now at a at a disadvantage there in the workforce. So all those things, I think, are why that item is on the list. And why I listed it first, I think on on housing issues, you know, if you look at any by any measure, the Percent of residents of Orange County that are housing insecure, and there's definitions of that based on the percentage of your income, you're having to put towards housing. It's daunting. housing costs have gone up. They have not kept pace with wages, and therefore, it's impacting everyone. Obviously, not just older adults, but I think combined with the job insecurity, you know, unless you now own your home and you're benefiting from essentially the dividend on on baby housing values going up, you may be house rich, cash poor, there's that issue. But if you're a renter and rents are going up If you're on a fixed income, and you're between jobs and you've lost a job, and now, how many paychecks are you away from homelessness. So I think it's hard for me now to not to see housing affordability as a real concern, as we look at an aging population. And if you're on a fixed income, or have any kind of, you know, income insecurity, you could easily be priced out of the housing market or lose lose an apartment. So that's why on the housing front, and yeah, I think on the on the health care front, I think I talked a little bit about processing both, yes, there's some benefits and insurance coverage. But again, as the life expectancy goes up, then you're you're managing healthcare and needs that can be pricey. And as you get into the older years, so yeah, I don't know if that's, that's a specific enough for your question. But those are some reasons why.


Yeah, I think starting with, with the employment one. You know, I mentioned, like the changes in the job market, and I would connect to that perhaps the workforce development training, professional, you know, community college system, college system, vocational training system, etc. I think a barrier is, is that system that helps, but it might help build build skills, up to the challenge. So I think it's a barrier in the sense that is not where it needs. It isn't it exists, but it's not where it needs to be, I think looking at the pace of the change in the labor market, and the likely change is coming as the workforce ages, boomers so. So I think I would say the connection of like, is he to, you know, sometimes employers do upskilling of their incumbent workforce of their workers, you know, they provide a chance to continue to train their workforce. So that's obviously one way to help, you know, increase the skills of older workers, I think the other is have a training system that when someone's between jobs, they can get that skill to get the next job. I think the the lower wage and of our economy, there is a structural problem with our job market in the sense that wages have not kept pace with inflation, and cost of living, driven in large part by housing costs. Therefore, you know, even with little increases in the state minimum wage, pretty hard to live on minimum wage in Orange County. And so it's hard not to list among the top barriers to your barriers, question. wage, wages are inadequate, at the low end of the job market. And there's a kind of a, I think, a denial of that, in that, like, people don't want to see it right in front of our face, like, try to live in Orange County do a budget for me, in Orange County on minimum wage, on $1, above minimum wage on $2 above minimum wage on $3 above minimum wage. And if you're an older adult, then you have additional maybe additional costs, and now you have other health needs. And I think there's this notion like oh, yeah, you're going to be in your 20s and you'll have that entry level job. And then you'll you'll go up your career. So I think the barrier of wage stagnation wage pay the current pace of wage growth. And the structure of our new job market, of who is in low wage work is problematic is a barrier. Well, you increase the minimum wage, you unionize and create, you know, worker organizing increase wages and working conditions, you know, or the job market responds and says, We need to increase the wages. I welcome it. Sorry, no, I'm the one being interviewed. I can't turn the questions on you. I mean, healthcare access is not as much of my expertise or agency's expertise. So I might have to say, like, I encourage, you know, bringing in those interviewees who in that sector, which I'm sure you are doing. So I kind of don't want to speak at a turn for that. I mean, I think they're, it's complicated to navigate. Health, the healthcare system is confusing. Because I'm like, I'm not gonna go to my doctor, I don't know which doctor to go to, I don't know what is covered, I'm confused about my bills, I'm scared to go in. Because I know my copay is gonna go up or my out of pocket costs are going up, I don't even know how to understand. And so I think the confusing myths of our healthcare system, which is not something we'll solve overnight, I'm afraid is like, is part of imagined, as an older adult is trying to access care, they might delay going to the doctor, they might be nervous to be delayed doing a procedure because they're like, I can't afford it. And therefore their health suffers and is ripple effect. So if it was easy to navigate, and there was less uncertainty around what the cost would fall in on to people post insurance, then I think they'd have a healthier, older adult population because they would more freely access care. And of course, the quality here is probably really quite good. In Orange County, great hospitals and doctors in that system of care. And yet, I think there's not so easy to freely access at all. Always. So yeah, so access issues, cost and complexity come to mind as barriers.


Short answer yes. I, yeah, it's hard to know, like how to tackle that question. So as it relates to race, there is structural racism in our job market and in our society. So if you look at wages, they are their equity issues there. We look at employment rates, it is not the same across across all those demographic groups. So I guess starting with race as one of the equity measures are our factors. That's a concern, that if that impacts everyone that impacts older adults, as well. So that means lower wages, higher unemployment. So there's a lot of data on that, in terms of you know, for you know, what, what, what a what a white man makes in the economy compared to a black resident of Orange County, for example. So, I don't have the exact numbers at my fingertips. But to your question of like, Are there issues that are more exacerbated that that are unevenly fall across older adults that that comes to mind first. As much as homeownership rates. I don't have those at my fingertips either. I think on healthcare issues, there's there also, you know, equity issues around rates of illnesses and as well as access the life expectancy. So yeah, so I think there's there multiple, like systemic issues around race at racial equity, gender, that and probably disability and ability status to that one and that impact older adults, as well as people across Prosser society. Are there more, you'd want to know.


Um, they were just examples. So you didn't have to hit all of them.


Well, I mentioned earlier, just the kind of stigma issues around older workers, and there's something that we observe and that our clients kind of reflect back to us clients is the term we use for the individuals we're serving. And they, you know, talk, they have the feeling and perception of of being at a disadvantage and being overlooked. Maybe getting an interview. And then once they do the interview, it's like, they're they they perceive judgment around being too old for desert candidate. That shows up how, like, we put our resume together, and they don't want to look, you know, reflect their age, or years of experience too much. So, so yeah, in terms of how they're treated in the job market, that shows up. In terms of other biases, that we see a chrysalis, I mentioned that we also serve individuals who have been impacted by the criminal justice system, that means they may have a misdemeanor felony, and a prior prayer record. And even with changes in kind of fair chance hiring laws, obviously, that that still does impact their experience in the job market and housing market. So, you know, as it relates to your question of like, are different subgroups. Yeah, you have the you have the overlapping factor of age discrimination mix with racial bias and inequities mixed with gender bias mixed with so they're very intersectional cross cutting things that are happening all simultaneously. I mentioned, housing is one of my three things, obviously, like so if you're trying to apply for an apartment, and you have something on your record and the landlord is doing background checks. It can be harder to get an apartment so that you know, and then who has records, there's a lot of data that that reflects who law enforcement targets and what who gets, you know, caught up in the criminal justice system, and then who ends up in our program and we're trying to get a job through chrysalis. So So yes, is the answer to the question. Yeah.


Thank you. Now, again, related to economic security, housing and health care access and delivery. What do you suggest is the best way to address the needs or the issue


So I mentioned earlier when you're talking about barriers, cost of living and wages. And so I would say one is better wages. Again, in some ways, it's simple, like better wages and lower cost of living, especially housing and health care. So there's just a budget balance sheet there that can kind of simplify the the first answer. But But I would say that's where I'd start. Yeah, I mean, in terms of, you know, employment, as one of the issues, you know, are there investments, like I said before, and like skill, building opportunities to make sure the workforce can adapt. And as they get older, to how the workforce has changed, you know, he finished high school or college, and then, many years later, you hit age 60. And I say this as the employment service provider, so I don't mean to sound self interested. But I think, you know, we're one one program but I think across the county, are there resources to help older adults upskill reskill, you know find new jobs in a way that that meets their needs. In particular, that that comes to mind. So I then I think, yeah, what kind of housing and health care again, like I know, less about exactly how I would address those issues, other than make them more affordable. And that maybe means, you know, work with those experts to help answer exactly the how, but maybe it's, you know, navigating the healthcare system could be helped, I spoke to the complexity issues and acts as access as a barrier. Maybe we need more. Especially for older adults, assistance, health care, navigators, maybe some like that a community health worker is a model. That's, that's been utilized as a way to kind of maybe have peers, other older adults that could help the, you know, accompany people to a doctor's appointment, that kind of thing, just like navigating healthcare. So those kinds of things come to mind. It's good. Okay.


So now it's gonna be another list, natural thing list. Just preparing you.


Good question. And I don't know if I feel like I'm definitely I'm necessarily an expert enough to give you precise rankings on those things.


Because your experience again, in your in your work, yeah, work.


So I would say, All right, yeah, maybe, maybe let's go down the list a little bit. And I'll kind of you don't have a scale system. They're just like, alright, so geriatric care, I think was the first one. Right.


Yeah. So I mean, I think in some ways, we're working with individuals like Chris Lewis, who are job seeking, and they're, they're not necessarily when I think of Geriatric Care. I think of maybe someone who's either retired or maybe not in the workforce. So it depends on what level of Geriatric Care I guess you're talking about. Okay, could have a definition problem there, but I would say, we don't see. See that see individuals accessing that As much as I couldn't speak to like how good or bad it is,


and then in this case is it can be working older adults is just anyone 60 years and older. So basic


health care for people 60 years or older that that care. Okay, I was thinking there was some other definition. Yeah, I would say mid level ranking of adequacy or that, that that question then that what's


Yeah, my impression is of long term care is that if if you have wealth and long term care insurance, and like, basically, there's a probably a very big gap of how people in Orange County experienced that, depending on their wealth and income, and that at the lower half of the, of the wealth and income distribution is not great. That's my impression would be that I would say, great if you're wealthy and maybe lower level in terms of how good it's meeting the needs of older adults.


And then mental health, behavioral health, and


so I think, perhaps better than five 10 years ago, but but I would still give it a a mid to high, I think, you know, Affordable Care Act, and those kinds of changes in parity across you know, kind of physical health as well of behavioral mental health, somebody has helped some, but I think the systems are still adapting, and they're still gaps. So I would say better, but a mid grade on that one.


Um, I think there definitely is room for improvement. They're both on like, you know, access to everything. Human Services are very broad, obviously. And we fall and Human Services. But but so I, you know, I also think of entities like the county and access to CalFresh, or access to other social services. And I think, there, there definitely could be improvements there both in capacity as well as like, outreach. And you know, service levels, like, for example, the percentage of older adults that are probably eligible for CalFresh. And that could help their budget and their food access, that are that are not accessing that benefit is probably pretty high and looked at the numbers in a while. And we'll try to help our clients access things like that. And yet, broadly, you know, human services could do a better job of helping for vulnerable older adults access that kind of benefit.


Thank you. Now, last two questions. I know, we have five minutes. So,


I mean, I get I'll get any, anytime you look at the demographics of our aging population. The challenge is that older adults in the next 10 years will be part of that swelling, of, you know, ageing, workforce and population. And so it there's risks for cuts to federal programs and Social Security or other programs that because of that demographic shift nationally, just like zooming out, not just Orange County there's there's risk there like resources shrinking as just our nation digests that generation, that that that ageing of the population. So if if they're cuts because of that, because they're they're one of those, you know, aging population, then there's there's risks they have to experience those cuts. That could be true, again, nationally or state or local. I think if you look at the pace of the gap in housing affordability measured and like, do we have enough units of affordable housing and Cal According to an Orange County, there's a sizable gap and the housing production is not keeping pace. Including, yeah, like long term care are different as my needs change. So, yeah, I felt a little broken record as I come back to like, housing affordability and access to jobs and and the economics and poverty. That's, you know, if we have a, if you look at the next 10 years, yeah, that's where my mind goes.


So broadly speaking, so the answer differs on like, what the City of Anaheim asked to do versus the county versus state. But just using that term government broadly, like, all of these issue areas, the ones we've talked about a lot, because I've listed them as what my three and the ones I didn't, we didn't talk about, you know, the government plays a role. And some of them are, are more general to the if you improve the housing and mobility situations, and you help everyone. But you also are addressing the needs of older adults. So some of them I think, are great because they can speak it as having a good healthy community. And the role of government plays is things like building parks, like I mentioned, parks, as one of the things not explicitly on this list, but typically, the government is the one kind of going to build a park, not, you know, some private corporation. And so therefore, if they do they create a space for social interaction and for exercise and for improved mental health, and for that has health ripple effects, you know, you create jobs by someone else to manage to, you know, help the park exist. So I guess that's cop out answer. But I would say to your question of like, the government plays a role in addressing all these needs. For sure.


So, my mind first goes to issues of homelessness. Because I know that obviously, there are resources and those focused on the issue of homelessness, if you look at if you talk to anyone that is studying that issue, and looking forward there nationally, nationally, but in Orange County to that is the fastest growing group of older adults experiencing homelessness. And I think it's not being overlooked, but I think I don't see necessarily a clear vision and plan for making sure we're ready to serve the population that will we'll see more and more individuals who are in that older demographic and experiencing homelessness. So that's what comes to mind first, I don't think they're again, they're not overlooked completely, but I think there's there needs to increase the look. And then you know, I mentioned this issue of like language access and whatnot. I sometimes think that people who are immigrants in Orange County and in this older adult demographic group sometime was getting missed. So that that's easy to overlook that subset of older adults that are perhaps, you know, not being even reached, you know, because of language issues, or just they're in another part of communities that aren't be outraged in.


No, no, I think it was a it was a good a good interview and good questions. And I think I'm curious again, as I try to answer them what my peers are saying in your interview. So I would love to get, you know, a copy of the report and the data to the extent that you share it with interviewees. So that would be about one request is gonna happen.


This concludes the interview. Thank you so much for your time, you have been incredibly helpful for our research. And if you find you have more to share, or you you know, like to give us additional info, please feel free to reach out to us. We're available on our website, you can reach me directly, or you can call our telephone line 949-415-6890. At any time.


Awesome. Yeah. Let's meet you and research.


Yeah, so we will definitely share the report. And I'm going to actually keep you abreast of the project. We have a newsletter monthly newsletter we send to everyone. So I'll include you just to give you progress. We're currently doing stakeholder interviews with about 100 folks. Expertise. Yes. So it's a big lift for our community health assessment. Usually it's about 25. But because of such diverse needs, and we're really trying to get a really a good landscape, you know, analysis. We are doing more stakeholder interviews, but next we'll be doing provider interviews, and then we'll actually talk to seniors themselves and their caregivers. So that'll come later in the fall season, but we plan to have the report completed and or whatever that may be whatever tool in the first quarter of next year. Okay. Timeline. Okay,


so now we're not for a little while, but that's a lot that look forward to. Yeah, we


got a lot to do. And we got a lot of people to survey man, I think


100 interviews like, Whoo, that's a lot. Yes.


Tim, this week, you close out my week, like, I'm, look, I'm done after this this like lunchtime. And


I don't want to be the one thing standing between you and your lunch. So, but it's nice to meet you. And yeah, please add me to the list. And yeah, thanks for the work you're doing. I was very thoughtful and look forward to staying connected.


Yeah. And I think we'll I think we'll be connected for other projects or anything you that comes to mind for you in terms of data and data analysis, you know, you can always reach out in advance, we'll see. We'll be happy, happy to help. You know, with that,


ya know, I don't know a lot about your organization. If I'm being honest, I'll check a website more, but hopefully, we'll have other chances to interact or cross paths. So


yeah, definitely. Because we're, we're so we created the OC equity map. That's kind of what we've been most notable.


Okay, so I definitely have seen those that are that whatever product.


Yeah. Cool. So that tool we definitely use to support folks with employment and, you know, property, like you said, and economic, you know, insecurity. So, yeah, I mean, if there's anything else that you feel like could help you all in your work, you know, we're happy to help.


Yeah, awesome. Well, it's great to meet you. And yeah, enjoy the weekend. You too. Nice meeting you as well. Thank you. Bye bye.


off, we'll go over the questions for the interviewer right now, the primary goal today is to identify that the needs assessment that you think are the most important to the older adults, the older adults or user, those who are 60 and older, we want you to think as broadly as possible team taking into um taking into consideration the older adults, caregivers, families, and their communities. So I'm going to share my screen so you can see a list of common issues and concerns like that are impacting the older adults. So I'm going to go ahead and share my screen right now.


Okay, so please take a few minutes and go over the list and let me know when you're ready to begin.


Okay, I've gone through the list. Okay, good. So,


we're going to go over the questions, the follow up questions will be based on this, on this table. Okay. So thinking specifically about older adults in Orange County. or engage


Okay. I think it has to do with by belonging to different organizations. And that sales organizations are all older adults. So I get to interact quite a bit with older adults, because we all belong to different organizations like the Carolinas, boards and foundations, etc. So it's good because being in a community service type, arena like that, it gives you an opportunity to interact with older adults and also share each other's cares and concerns.


Yes, basically, your role and how you engage with older adults. Yes. Okay. Yes. Um, so now thinking about Orange County and locate the least of the common issues and concerns that are on the table that impact all the older adults.


I can't think of anything. No, I think it covers a wide variety of  concerns so no, I don't think there's anything missing. Okay, perfect. Um,


Question under cancer, those are the only three because I also have skin, skin cancer and an exposure to prostate cancer. Yes, I can include that. So that would be one of my major concerns. Okay.


Another one would be health care access and delivery. Okay.


And probably disability with a third. Thank you. And so for the next questions,


I will ask you for each of the needs that you just mentioned. I'll ask this all the other questions. So first, I'm going to ask the questions, for related to cancer. Yeah. So so when you think about cancer


and why are our older adults struggling with this with this issue.


For me, it's because I have a history of it in my family. So for cancer is a major concern. Especially these two, which would be the skin cancer and the prostate. And the prostate is directly linked to my service in the military. So that's why that would be a leading concern for me was that the would answer the question or no.


this can you like be explained a little more about


Yeah, I think it's, it's it's really prevalent today. And I think it's the more cancer I don't ever remember growing up to hearing a lot about cancer. I think in the last maybe 10 to 20 years. It's become more prevalent and only because of environmental concerns and things like that and and just having family members that have gone through it. So to read that, that's why it's become a major concern, I think for us older adults. Okay, thank


Well course treatment would be the, to me the most concern. I think today luckily, I think most cancers are treatable if they're caught early. So the other one is probably the other one would be a diagnosis, making sure it can get the proper diagnosis and catch it early enough. Okay,


Oh, sorry. It's a screen froze for a minute.


Ah, boy, yeah, I would think there would be different differences only because I think of the environment that we're in it, and also the accessibility to health care. And I think some, some diseases like cancer are also there. They're certain like me being Irish, I have very light skin, so I'm very susceptible to skin cancer. So I think there are different ethnic and environmental causes that affect different groups of older people.


Yes, thank you for sharing. So what would you suggest is the best way to address


Well, for me, it's, it's getting regular checkups. And because of the ones I'm going through, I get checked at least every six months for skin cancer, and I get a PSA check for the prostate, every six months. So I think you have to stay on top of it. And anytime you detect something like, I've got a little thing, mole on my Leg gonna have taken off next week, you've got to be able to immediately cease if you've seen something in the old thing and say something. So as soon as you see something like that you need to get to your doctor and make them aware. that's good. Thank you.


So now we're gonna move on to the second need that you mentioned, as we're gonna move through health care, health care access and delivery. So I'm gonna go ask the same questions for this, for this need.


Means the main thing is, is the type of health care plan that you have. For instance, I have I have united healthcare. I've had it for 20 or 30 years. And I really think that the different health care plans really affect things such as cost availability, you know, getting appointments and treatment. And so I think that really is all about what health plan you have, and how accessible it is.


Well, I think one of the one of the barriers is just the availability of health care professionals, I think, I know where we have a shortage of nurses, for instance. Getting appointments sometimes can take take a while. Because what I see is that when I go in a doctor, a doctor certain Doctor schedule is not available maybe for a month or two. I read that just because of dealing. I mean, let's face it, the population that's going to be the majority is going to be old. And that means a lot of people seeking health care and And I think one of the barriers is just being able to get into see a healthcare professional as soon as possible. That's not always possible to do it. Like I can't call today and get in tomorrow, I'm sure it can. Unless it was a life threatening emergency, then that's a different thing. That's a big barrier. Thank you.


Well, actually, I can only really talk about myself. I think I've been very fortunate that I've been able to have pretty good access. And, and when I needed to, I was able to get the care I needed. So I can't really talk about any other type of groups of people. But myself, I've been actually very, very happy with the care and access that I've had.


Yeah, what what do you suggest is the best way to address healthcare access and delivery.


I think it's really important to understand the axis of how you go about doing that. For instance, I know I have to, when when they doctor find something, I have to put in a request for a treatment. And I know that, that I have to request that to be sure that my insurance company pays for it for one thing, and then the other thing is to said I get A a timely response as far as being able to take care of the situation. So once for, for instance, I had an MRI on my knee, because I was having some knee problems. So they found out the possibility that, that once I've had the MRI, the sorry, I had x rays on that. And then once they, after the X rays, I had to go and get a consultation of what the X rays showed. And then I if there was any treatment necessary, I had to get a an approval from the healthcare to get that treatment. So I think it's really important to understand how the system works, to be able to get the best access.


Okay, thank you for sharing. Now we're gonna move on to the 3rd need that you listed.


Well, I think as I said, I'm tied into a group of community service people that are all at my age or even older. And knowing that we have certain disabilities, for instance, vision, or hearing loss, or even cognitive decline. It it makes you aware of the aging process, I can put it that way that I myself have some hearing loss. My vision, they're, they're monitoring cataracts right now. But I think being around older adults, gives you makes you more aware and of what is happening as you age.


and what barriers exists to see an improvement and the area of disability and the need for disability.


I think one of the barriers is ourselves. I think many of us are in denial as far as to where we go to have the same abilities that we had when we were younger. As we get older, we may not want to face the fact that we're losing our vision or losing our hearing or, or something is physically wrong. I think for us, we have to be realistic with ourselves that this is a natural aging process and things are going to happen. So if that makes sense.


Well, I think the thing is, once you do recognize and are realistic, that you are having problems with vision or hearing, you've got to, you've got to do something about it. And once you've taken that barrier away, you've got to go through the process. And let somebody know that you need to have your vision checked, you need to have your hearing checked. So I think it's, again, knowing the process of what you need to do to get take care of your health.


I'm not sure about other adults, I know people have different have different ideas about their health care system. And the access to it, and how they, how they're processing what they need to do. And I hear about that, but I don't know. It's it's a group thing other than it's just the fact that, again, facing reality. But as far as other groups are concerned, because I'm in a number of groups of older Americans, I know people talk a lot about, about their access and how they're what they're dealing with. Let's put it that way. So


thank you. Moving on to the next question.


I think the first step is basically to admit it, that you have one. And then once you've you've done that, do something about it. But also make sure that what you're doing is medically feasible. I mean, I know people that go online and look for cures. I mean, you need to talk to a professional and find out what you actually need to do and then follow their advice.


you. Thank you so much for sharing. Now we're going to move on to the next questions. i We're now going to need the table. So I'm now I'm going to stop sharing my screen.


How Yeah, accessible, how accessible and how I adequate the geriatric care is.


Um I think overall, I haven't had any really big problems of accessing what I needed as far as health care is concerned. And I've been very pleased with the different health care professionals I've had to interact with. I have a GMP who I've had for years and she's very detail oriented, very, very exact and her diagnosis and what needs to be Done. And I've never had a problem having access to her. So, overall, I think I'm very, very pleased with what I've been have encountered so far with the with the


system. I think so for my for my own self, yes. Good. Okay.


Because that's, that's, basically, we know that somewhere in the next five years, over half the population, there'll be over 60, or something. So it's going to put a strain on the healthcare system. So I'm hoping that we have enough people that are going to get into the healthcare field, that's going to be able to take care of us, basically. So long term, yeah, I think it's gonna be a challenge to tell you the truth. Because if the healthcare system is not overwhelmed today, it might be on the verge of being overwhelmed. So no, I don't know if that portends Well, for the future. Okay,


thank you. How accessible and how adequate the services are.


I don't think I've ever had to use those services. So I'm really not sure.


I know, I've seen. I know, there are organizations out there that deal with mental health and, and, but I go, I don't know too much about them.


I've heard of them, but I don't even remember who they are, what the organizations are. Okay.


Again, I've not had any kind of interaction with social services at all. I know there are quite a few places out there where people can get social services and but I've never had to access them. So I'm not sure how accessible they are. But it seemed to me that that just based on the on the on the population of Orange County, I know there's a lot of need out there. Because I'm an organization that provides service to the community. So we're, well we're aware that there are people out there need and there seems to be a number of places where people can go to get that need satisfied. So okay,


thank you. Moving on now to the next question. Boy


probably because of the population yet All right, it's gonna the challenge early I think is going to be to that the healthcare system remain accessible to everybody. It's it's just seems to me that we're gonna you know, I think COVID One thing COVID proved was that when you have any kind of a, a chronic disease like that, you the whole hospital overwhelmed and everything else and I think hopefully we won't have another thing like COVID But the problem again, as I said, that is that the, with the aging population, the challenge is going to be able to take care of everybody, no matter who they are or what they can afford or can't afford. And to me that that will be the biggest challenge. And I think part of part of the good thing that's come out of this recently is that people are more aware of things like COVID, and other diseases and how to prevent them and, and take precautions, I still see people wearing masks, which is good. So and and I think we're making more of a point about you being proactive with your health, I think that's, that's, that's gonna be a big challenge, people have to be proactive and take care of themselves, basically. And that's a challenge.


I think the challenge also is to make people aware of how the environmental effects are health. Because there are environmental factors, some you can control, again, that that have a big effect on our health. And we need to start paying attention to that. So the challenge would be to get that education out there to the population and make them aware of all the things they can do over the next 10 years to improve their quality of life and their health.


Well, I think that programs that are that are government funded, need to continue to be funded. And also because of what we're looking at over the next 10 years, increasing the population, and we're probably going to have to increase the funding. And I think that's, that's something that we can help impact by staying in touch with our, our politicians and those that are voting for health care. And to make sure that the, that we let them know that that's a priority for us as older citizens, that we have that health care, not not cutting Medicare, Medicaid, or even social security, that all these are vital to the health and well being. So I think that's, that's it. Thank you.


I think you know, it also has to do with social status and financial status. There are people that that can afford certain services, and there are others that can't they have to rely on on government funding or help from agencies. I think that that's something we we have to


admit that not everybody is treated equally in the system. That different groups may not be treated the same as others. And sometimes they're treated differently because of their status or their or their wealth. So that's something we we need to be aware of, and really help the people that need it the most.


I think I think it's the people that have a lower income. That art, some of them because of the financial ability or cannot afford for instance If you take a look at medications, and the cost of medication, I'm sure there's some families that just can't afford it. I mean, when you're trying to feed a family and, and, and, you know, working three or four jobs, I mean, it's just horrible. I don't know how people can, you know, have big families today and survive, just it's just the cost of living and everything else is just as real are making it difficult for us to get exactly what they need. support their families and their health.


I'm not sure. I think one of the may be the mobility issue. I'm not sure. I think that may be a big problem for some older adults who do have those mobility issues.


That's one I can think of, but that comes to mind anyway.


we're gonna go over some questions. Just in addition to what we already talked about. We're going to just go a little deeper in your area of expertise. Thinking about your opportunities to volunteer and engage across across all generations, what are some ways that is like, like, the opportunities to volunteer are working are now working for the older adults and parents.


I think the good thing is there's plenty of opportunity to volunteer


places like food banks or or even able to people, the Meals on Wheels, something like that. I don't think there's any lack of opportunity to volunteer. I think it would depend on on. And older people, I think have a, especially for my generation to have more of a desire to help people in need, and are more willing to volunteer. So I think things like food banks, probably a good one, to help people volunteer, and just wherever the opportunities are.


And one of the things also being a volunteer. The other thing that begun, because I'm with Kiwanis is mentoring the youth of today. I think older people really love to give back to the younger generation, and share with them their experiences. And just I know I read to first grade class every Thursday. And I know a lot of people that I know go to the library and volunteer their time they're working with youth. So I think that's a great thing, because not only does it doesn't help the youth, but it helps the older person realize they still have value. And I think that's very, very important.


Thank you so much, and what new or revised policies are needed.


Yes, what new or revised policies are needed


I'm not sure if I can even answer that one. I'm not I don't know.


this political like agenda. Let's see government policies or no,


policies that are related to opportunities to volunteer and engage across generations. Yeah, there are new or revised policies are needed


I would guess, it's just I think it needs to be more, more awareness, and more. Publishing are those opportunities to let people know, basically, what can be done, and what help is needed. I think many of us may not know, in our own communities, what kind of volunteer opportunities there are. And I think that needs to be much more out there by these different organizations that need help.


Thank you, and who, or what entity is best suited to address the issue


think you've got the organizations themselves need to need to let people know what's needed. And also, you have places like libraries and senior centers, and places like that, which operate and give seniors a place to go. But it also can be a good place to, to engage seniors in community service and, and, and giving them opportunities to do things in the community. So I think that the senior centers are probably a great place to to get get the word out there and also engage seniors.


One of the things that that I, I find a very good source is AARP. Because they are specifically for older people. And they often i know i That's one magazine, I read cover to cover because it's gotten so much better relevant to, to seniors. And I think that's a very good source of for all older people to find out. Statistics, I give a lot of statistics, as far as health and things that you can do to improve your health improve your life. So for me, that's one of my main chores.


I know. I read the LA Times every day. So there's a specific column. There's a there's a one columnist that writes specific column on aging. His name is Steve Lopez. And I read that every day, every time he has a column I read. And of course, it's very relevant articles about what's happening in Congress. So the back seniors, different bills Legislation in California and nationally. So I think that's a good source to Great, thank


No, I think we're already our club, for instance, has already signed up to do a group interview, a group survey when it comes out in August. So the different service organizations around like the waters and the The elks and the rotary and everything. Those are great opportunities because most of those have seniors, as the majority of the members, so as I said, I know our cornerstone is going to do the group survey when it comes out in August. So


awesome. Thank you so much. I'm sorry. Yeah. If necessary, like for anything that


something else you can always contact us. So yeah, this improves the interview. So thank you so much for your time. You have been incredibly helpful, too. So like I say, if you feel like you want to share more information feel free to to reach out. So to a contact and also you can also do it through the website. Yeah, then please share it right now.


Okay, great. So, in a minute, I am going to bring up my screen, I will share my screen with a list of common issues and concerns impacting older adults. And then I'm going to ask you a series of questions relating to this list, but the lists will stay on the screen. You don't have to memorize them. It's pretty comprehensive. But in thinking about the questions, we will be asking you, I would like to you to think about older adults as those who are 60 years and older. And think about them as broadly as possible, taking into consideration they themselves, but also their caregivers, the family members, and the community. All right, so let me share my screen okay, and you should be seeing a table one, which is a representative list of common issues and concerns. Okay, take your time and review this list and then let me know when you're ready. And then we'll start the interview. Okay, okay, great. All right. So thinking specifically about older adults in Orange County, for our records, can you please tell us your role and how you interact or engage with older adults. I do so in both my personal and professional career, so my personal career, I have a 88 year old mother who lives in a senior independent senior apartment community in Old Town orange. And so I I spend a lot of time with her and her friends and spend time taking her to her geriatric doctor and a whole bunch of other physicians and, and assist her with her transportation and food and caregiving and all of that. And then on my professional side, as city manager of Huntington Beach, I interact just in general with seniors. As for older adults, just as because they're members of the Huntington Beach community, and we also, as you probably are aware, we have a very active senior center in Huntington Beach that provides a multitude of services. So personal and professional life. I work a lot with older adults. Wait, thank you. The only thing that maybe can be added is and maybe it's implied or I'm not seeing it but is civic engagement. Okay, is how older adults engage with their local government or regional government. Great, great. Okay. So of the needs that's on this list, including civic engagement. Can you please rank the top three that you think are most important when it comes to older adults I'd say the top three would be housing economic security and Probably health care. Just kind of a tie for me of health care caregiving behavioral mental health kind of. Yeah. Okay. Yeah. Yeah, for sure. Okay, so for the following questions, we will take them, you know, one category at a time. And for the third category, you can broaden the scope of health care to include those other things that you mentioned. But let's tackle housing first, because that was number one on your list. I think as you indicated the population is getting older faster is getting older and it's getting older probably at a rate faster than the production of housing and land in Orange County is at a premium. And and the costs, even affordable housing is still very challenging for a person on a fixed income of Social Security. I believe, here in Huntington Beach, our average Social Security check is $1,700. And makes living very difficult for food and, and housing, etc. So. Yeah, so I think housing is just increasingly difficult. And I know, anecdotally that some seniors have limited choice to cohabitate with family members, as maybe family members have moved out of state or live elsewhere, but their, their social. Net is maybe here in Huntington Beach, and it's just, it's a real dilemma. I think part of it is the availability of public funds to help subsidize housing so that it's affordable housing. There's political concerns that urbanizing suburban communities is, is is that by building more dense urban housing may or may not be consistent with a community's vision for its low density. environment. There's always just barriers of whether the housing market in a local jurisdiction is such that it attracts housing developers. And then just the type of housing needed, whether it's long term care type housing or assisted living type housing versus independent housing, I think, just the the range of housing options that are needed, may or may not exist in a community or may or may not be of interest to the marketplace related to given jurisdiction. You know, particularly I'm thinking about as an example, disability status, their levels of income. I think generally, yes. People, people with Older Adults with lesser economic means may not have the resources to obtain housing for themselves. So we we see a fair amount of older adults and are in Huntington Beach's navigation Center, which is which is our shelter for individuals experiencing homelessness. And, and waiting lists are pretty long for affordable housing. And for housing options that take section eight vouchers and the like. So it's I think definitely economic means has a big influence on the the ability to attain housing. I, I can't really speak to I don't have firsthand knowledge about older adults who have disabilities. However, I would, I would assume it's it's a challenge. But I couldn't speak to it accurately. Think there's probably no one best way to address it. Certainly, the marketplace like existing housing needs to be more receptive to taking housing vouchers, market rate housing to take housing vouchers to to allow people of limited means to get into a stable living situation, I think building more housing that is appropriate for communities that's affordable is is another way to think encourage figuring out ways to encourage intergenerational households. As you know, as far as is a good strategy, I think, in some communities, the you know, the ability to have accessory dwelling units on in neighborhoods is a very beneficial to. to older adults. I know that I live in Old Town orange, and there's a lot of accessory dwelling units. And I know we have very good friends whose elderly father was living independently in San Diego but needed help and and so they built an accessory dwelling unit in their backyard, and now he lives on their property with them, but separate from them. So I think there's ya know there's many different tools in the toolkit that are needed to to address the housing needs of older adults. Yeah, yeah. So now we're gonna go over to the second topic that you raised as your number two item, which is economic security. Yeah. Well, I think I think the cost of living in California is, especially in southern California is not insignificant. And when when people have fixed incomes such as Social Security $1,700 A month like here in Huntington Beach, and our average apartment one bedroom apartment here in Huntington Beach is Between $2100 and $2400 a month, it is just very challenging. And so mobility in Huntington Beach is pretty good for seniors, because we, our Senior Center provides really, really great senior transportation. And, and so that's a really helps people get around. And I was, and there's, you know, there's programs thankfully for like Meals on Wheels and, and other other food related programs for that can provide a lot of nutritional assistance but I think a lot of it does come back to housing and and the cost of housing and then the the fixed income that older adults may be on. I think a lot of it comes down to housing costs, I think, I think seniors ability to increase their fixed income through jobs or, or other means may be limited and challenging at times. I don't have any specific reasons why except maybe distance from potential jobs or the nature of potential jobs may be such that are just maybe not a complete barrier, but challenging. Yeah, I mean, I just think the overall inflation cost of living macro economic factors, you know, our, our barriers and challenges economic security, medical costs, insurance, all of that. Yeah. I think in part, it's more more creative types of living environments that would potentially be less costly. So like cohousing type. of projects where people live in smaller spaces. There's communal, common areas, including kitchen, a single kitchen, and people. You know, it's basically like a cooperative where people take care of each other and work with each other. And it doesn't necessarily need to be mono generate or mono age groups, it can be intergenerational in nature. Yeah. Yeah. Okay. And onto the last of the three is health care in general. And you also mentioned caregiving and behavioral health as well. One is the insurance dimension, whether or not they have adequate insurance to to provide the care that they need. And whether or not they have an advocate or an ombudsman or a family member who can help them with their health care. I also think the virtual health care services, the TelaDoc type thing is a is a great blessing in many respects. However, again, I think, older adults, and I don't have any stats in front of me, but the familiarity with using technology related to TelaDoc type services I'm not aware of. But I would imagine that's a barrier to some, but it could also be a real, you know, could be a real blessing to many if you have their mobility options are limited or their insurance options are limited. Being able to gain access to healthcare, at least at a, at some level, virtually would be very appreciative. But I know with my mom's several times we've timed TelaDoc type services, and that's been really beneficial to her. But yeah, yeah. Yeah, so I mean, I do think that isolation is, that was something that is a challenge I know even with, with my mom, and we see her a lot, she's got friends, but sometimes I, I, I see that she has spent too much time alone. And that may just be six or eight hours, but I can tell that it has an effect on her and her forgetfulness and her ability to articulate and communicate because she's been silent for six or eight hours. So I think the notion of having you know, a regular being in a communal environment and and being engaged is is something that concerns me for sure. Yeah. Yeah. Yeah, I mean, I think like, I know, one of my mom's friends, she had Medicare. And that was her only. That was her only insurance and the type of care that she needed. She was having a really hard time getting because the doctors I think the doctors weren't taking Medicare or something I can't remember exactly. But she was having difficulty, I think transportation to and from many of my mom's friends don't have cars and whether or not they have family members in the area, at the time that they need medical care, that's, you know, that's always a challenge for them. So they end up kind of overusing one of their, one of their friends in the department who does still drive and I know that causes her a lot of stress to shuttle people to their, their appointments. So mobility is a big deal. The monetary side of it is a big deal. And and I also think that when the behavioral health side of things and know that there's been a few times where my mom has been visibly depressed, because it was like an anniversary of my dad's death or an anniversary of my sister's death. And and I talked to her about maybe having her talk with somebody, and she saw that because of I think, largely because of her generation, she saw it as a stigma to talk with a therapist or counselor. So that's, that's an issue. I think so. I mean, I think you know, people, people who have cognitive challenges, or mobility challenges, they may have a real may have more difficulties and getting access to medical care, the mental health care that they need. I think it seems that people who have good insurance and have family around to support them financially and otherwise can get better get access to better health care more readily. I do know that like I mentioned earlier, there's a couple of my mom's friends who barely had enough money to pay for the apartment that they in the building and they live they didn't have much leftover and and it was was very difficult for them to pay for transportation or what have you to for food, or going and getting medical care and a they often sacrifice their nutrition and then that caused a decline in medical care as well. Yeah. So what do you suggest is the best way to handle to address this need I think the degree to which there's models out there. So like, in huntington beach we work with be well, and we have the mobile mobile vans that will come to anyone's home, who needs any sort of support for their behavioral or mental health needs. And and I think that's, you know, that's part of it. Having more in home care is probably a beneficial approach. I know. My mom's geriatric doctor will send a somebody to the home to take when she needs to have a lab test, blood drawn for a lab test, because of my mom's age and mobility, and they'll bring the lab tests to her. So I think, I think just I don't have the magic answer. But I think the more that part of our, our community culture is that medical services can come to the people and the older adults. Whether it's virtually or in person, I think it's a it's a worthy idea. Much like DoorDash for food. Yeah, something of that nature. Yeah, I guess that would be called Uber doc. Yeah. Just that there's having my, my wife and I took care of her Alzheimer's inflicted mom, and then after she passed her Alzheimer's inflicted aunt over a span of almost 20 years, and we did have in home caregivers. But again, I mean, they, they, they had the means to, to afford those in home caregivers, and otherwise, it would have fell on 100% on my wife and me. Right now with my mom, I spent a lot of time every week, probably six to 10 hours. With, with my mom taking care of things at her house, taking her grocery shopping, you name it, taking her doctor's appointments. And we have we're trying to have somebody come in once a week just to help out. But it's you know, it's it's very expensive. And on top of the housing and a lot of I don't know how a lot of families afford it. Yeah, yeah. Definitely a big issue for a lot of families here in Orange County. Okay, so moving on, I'm going to ask you now about access and adequacy of different types of care services for older adults, has nothing to do with this list anymore. So I'm gonna go ahead and stop share.


Well we, my mom moved down here in 2017, from Arizona, and luckily, we had a family friend who happened to refer to us a wonderful geriatric doctor. And we had that doctor or up until present time, but she's retiring in July. So on my own, I really did a lot of searching for a geriatric doctor. And, like I went through Yelp and some others and I wasn't having much success. So I reached out to the doctor again, our our current doctor, and she pointed me to UCI's Center for my what's called senior medicine or something. And, by dumb luck, we got an appointment last week with a wonderful geriatric doctor who I know is going to take great care of my mom. But I will say I was frustrated trying to find a good geriatric doctor on my own. And I don't have a I don't have a good sense of there's a lot of Internal Medicine folks, general practitioners, but I don't have a good sense of the adequacy of Geriatric Medicine providers in Orange County. And, you know, if I was to generalize, I would say, it's probably not enough. Yeah.


Yeah, well, so, you know, speaking just firsthand experience only working with both of the two geriatric doctors that I have, it's, it's as much about the adequacy is conveyed to me in as much about them understanding the unique health needs and the behavioral and mental health needs of seniors as it is, knowing what resources are out there. Or a whole host of tangential needs of older adults. So I've talked to I received resources from a geriatric doctor on everything from activity groups, for socialization to the Alzheimer's of Orange County hotline, so that I could get some support has taken care of my mom with her increasing dementia. So, you know, it's I use the geriatric help providers that I've been exposed to, I think the adequacy of the services as a provider are more than adequate.


I don't know if this is factored into your calculus for your mom yet.


Well, when looked at multiple assisted living communities, and, and I know that there's, there usually is a waiting list, but it's usually not insurmountable. In terms of time, the real issue is money. And some of them as I understand, May, if you run out of money, then you may be able to rely on Medicare for continuing on, but most of many of them are market rate, and they don't participate in the Medicare arena. And then, I do know that there's because our neighbors had had found a wonderful place where their father, small group home of I think it was, five older adults, and the amount of fixed income that their father had plus a little bit extra was what it costs or for him to live out the rest of his lifetime. And he was very happy and they were very happy with the care and so so I think there's, you know, and I'm just this is more anecdotal than anything that I can generalize, but I have an experience that there that there's a shortage of long term care, however, I would suspect That really depends on economic. The economic means of the individuals because based on our homeless population here in Huntington Beach, there's not an insignificant percent that are homeless that are that are older adults. Yeah.


I think generally, generally, I do mean, at least from my, my limited experience, I find the care seems adequate. I do know coming out of the pandemic, one of the communities I visited was pretty short on staff. And were they were really challenged by that. Yeah.


I'm really not sure about that. I am not sure if there is adequate services for older adults. I do know that. There there's, in like, our Senior Center here in Huntington Beach, there's counselors there social, social service, social workers there to support seniors in need, like I mentioned earlier, be well, we have to be well vans who will support in any way they need to people with behavioral and mental health challenges, including older adults. But I'm not, I don't really have a good sense of supportive services for mental and behavioral health at a county wide level.


Here in Huntington Beach, I think it's fairly accessible, I think a phone call to the senior center will, will be will be very helpful to an older adult, whether it's for transportation needs, food needs, or to connect them with somebody who could be a portal into housing. I'm not sure that it's as easy in other communities Yeah, I just don't, I just don't have a sense of it. I think the friends at my mom's circle in senior apartments that she lives in I've seen them I've seen a couple of them really struggle. And they've never really mentioned reaching out to any, any mobility service or any food service or, or any of that to help them through their struggles. So I just I'm not sure.


That's fine. That's fine. Okay, so now we just have a few questions left remaining in the interview. You know, thinking ahead in 10 years times, specifically in your purview as city manager for Huntington Beach. What do you think of the biggest challenge facing older adults in 10 years


I think we're, we're gonna need to make sure that that there's definitely more choices of housing in Huntington Beach for people to age in place. The cost of housing here is, is unattainable. And for, for, definitely for newcomers or for young college graduates or whatever, without support from somebody. And so I think housing is really, really important for seniors in the next 10 years. I think making sure that that cost burden is, is reasonable for a senior on fixed income. I'm, I think just continuing our transportation services we provide and probably increasing. So I think, I think making sure that sense of community is really important to focus in on that I am concerned that as time goes on, people and people may be more and more into these iPhones and, you know, maybe socially isolated, except in the virtual world. So making sure that the great opportunities of sense of community and social cohesion occurs. And and then, of course, just making sure that there is adequate accessibility that health care and mental and behavioral and physical health care.


Well, that's, that's a challenge. Because sometimes I feel like the government gets in the way of where we create these incredible bureaucracies and make it more difficult for seniors and others to get the services that they need. So, I mean, there is a role for sure. And I think our our seniors should be our seniors and our senior members of the community and our members that have physical and mental disabilities and and should be afforded the greatest level of government assistance, so that they can have a basic minimum quality of life. And I don't know exactly what I mean by that basic minimum, but, but I certainly know that working families are you know, they're spending a lot of money just to make ends meet themselves. And so somehow, some way government needs to be involved in connecting seniors and older adults with with the supportive infrastructure that that they need to have a good good set of years during their golden years. Yeah, yeah.


So now thinking about all the older adults in Orange County, who is getting the least amount of attention


think those who are who don't have extended family nearby thereby and those that don't have economic means to to sustain themselves.


You know, that's a tough one. I mentioned civic engagement earlier. Because I sometimes feel that there's an incredible amount of value placed on our youth and making important public policy decisions. And sometimes I wonder if we're exerting enough effort to caretake our seniors from civic engagement and public policy standpoint. And just in general, I sometimes feel that they're incredibly vulnerable population, and yet they've dedicated so much of their lives to being productive members of this society that we're all a part of. So, you know, I That's a really tough one. Yeah. All right. I don't know. Yeah, I don't know. I think that's a good one as civic engagement for sure. Because I feel that a lot of times it's scams that are communicating with them, and rather than, and they're very cautious and leery about who they're engaging with. Okay, so we're ending our interview, I just have one last question for you. This is gonna be a tough one, too.


Yeah, well, I am so impressed with Huntington Beach and all that we do in our Senior Center. Everything from travel services to social activities to loaning medical devices, canes Walkers providing meals on wheels, transportation, the matching creating opportunities to match people up with housing, just the list goes on. I'm so unbelievably proud of the city. With the services it provides, its seniors. I think we could in the improvement realm is I think we could do and I'm not aware that we have one and have been in this role for 10 months now. But I think we almost 11 months, I guess, I think we could do a like a the equivalency of a of a master plan or or elements in our general plan for our senior population so that we could thoroughly explore what we are doing and what we could be doing and what needs to be done by nonprofits and, you know, just connecting the dots, bringing up the level of awareness and connecting the dots to resources. Great, great. Great.


Yeah, I think the get her name for you. I definitely think that you could talk to


Michelle yerke y e r K e. She's a social services supervisor with with our community and Library Services Department. And her number is 7143741521. Okay. She briefed me and, and just help help me. Kind of get a better lay of the land. In huntington beach and she's very, very knowledgeable.


Great. Okay. Great. I will reach out to her for sure. Terrific. Terrific. Yeah. Yeah. Well, thank you so much for your time. It has been incredibly helpful to us. If you find that you have more to share or that you forgot to mention something, feel free to reach out either email or phone. We will take it whenever you have it to give. And in the future, too, you will be seeing us do community a town halls or meetings. It is really to just engage the community on this effort and really to get them to take a community survey. That will be later on in the fall. And I will be happy to share with you those specific results from Huntington Beach residents because we are set out so I'll be happy to share that with you after we're done. That would be absolutely wonderful. Okay, okay, you got it. So, thank you again, and I look forward to connecting with you for the community town halls. Awesome. Thanks for all your work to do. Okay. Thank you. Bye bye.


Yeah. So good afternoon. Again, my name is Tohron Barnes and I'm a part of the advanced OC research team, a local nonprofit conducting the county of oranges older adults needs assessment. Thank you for your willingness to participate in this interview, and the purpose of the interview aside to define the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of Orange County's master plan for aging. This interview will last approximately one hour. And with your permission, our discussion will be recorded only for transcription and note taking purposes, the recording will not be shared with anyone. And after transcription, the recording will be deleted. If you do not feel comfortable with being video recorded, turn off your camera while you phones though just that's a problem. And your responses are confidential, meaning that we will remove identifying information in the report that your participation is voluntary. You may choose to answer any question in part full or not at all. You might also withdraw from the interview at any point in time. I'm familiar with any terms I use, please let me know. I'll provide examples and definitions.


Thank you. So again, the primary purpose of today is to identify the needs that you think are most important to older adults. And that is those 60 and older. And we want you to think as broadly as possible taking into consideration older adults, caregivers, family and the community. So I'm going to share my so you won't be able to see my screen, huh. That's the thing that I didn't know. So I guess I can read them off to you. Because I have a list of common issues or concerns for older adults. And so I wanted to be able to look at that but I'll read them off to you and and then we'll proceed so we have Alzheimer's disease and dementia. We have behavioral and mental health, we have cancer. We have caregiving, we have communicable diseases. We have community and family safety, diabetes and obesity, digital divide, diet, fitness, nutrition, disability, economic security, emotional well being environmental concerns, and this is like drought, wildfires, pollution, emergency preparedness, health care, access and delivery, heart disease and stroke, homelessness, housing, pain relief and physical comfort. Personal Care Management, you know, again, hygiene, you know, ADLs, respect, respiratory conditions, tobacco use, transportation and mobility and unintentional injuries like car accidents and falls. So these are the common issues and concerns for older adults currently.


Yes, my name is Denise Bennett aerobatics. And I am currently a Community Services supervisor overseeing Senior Outreach Services. I work directly with not only urban seniors, but within Orange County, not only their families, but caregivers, their support systems. And from there, we provide case management, we provide resources, as well as research resource linkage, and just to ensure that they're receiving the services that they not only qualify for, but that would really increase their quality of life.


Thank you, Miss Bennett. And so thinking about the list that I did share verbally with you.


You know, I am looking at it probably goes under housing or either that or behavioral health. But one of the big areas of concern right now is hoarding and individuals are, are in the community, not only Irvine but throughout Orange County, who are at risk of homelessness because of a hoarding disorder. Unfortunately, although it is part of the DSM five, code enforcement gets involved and we've seen this way too many times where a receivership is put in place and the senior is removed from their home with no plan of where they're going to be relocated to, that's part of our job is to assist the senior with not only, you know, connecting them with some nonprofit that could assist with housing on a temporary basis, basis, but challenges is most of the time, they don't get their homes back. And now, they're propelled into homelessness, living in shelters, trying to find, you know, any type of housing, not been a big, big issue, we're working with quite a few people that have gone through this, and one of them remains homeless, he's been homeless for 10 years, because his home was taken through the receivership process. And unfortunately, even though they sold the home, there was nothing, you know, he didn't receive any, any funds for that. So that's a one big area. And part of it too is that say, for Section Eight, the we have quite a few participants that we go into their homes, and provide caregiving tour service to them, because they're coming up for an inspection. And we want to ensure that they're able to keep their section eight voucher. And so through fundraising efforts through the city, we're able to pay for just the the light, you know, housekeeping, light cleanup, but if I don't know if you're familiar with already, but sometimes it's, it's more than just light housekeeping, it's really going through and contracting with an agency, which could be 1000s and 1000s, and 1000s of dollars, to help somebody you know, get their home, in the condition where if the inspector comes, if they pass an inspection, they keep their section eight housing, they stay housed. So I think that's one big area that I found as a gap in our community. Housing doesn't recognize that our housing division doesn't, you know, behavioral health, it goes through code enforcement, you know, so that's, that's an area that I feel that really can be expanded upon, because we're seeing it more and more. And now that we're going back into seniors homes after the pandemic, we're able to go back and do those home visits, we're finding more and more hoarding issues, along with of course, loneliness and isolation. But we are seeing that there are far more hoarding situations than we've had before. Okay,


thank you. Now, I'm gonna read the list again, because I want you to rank the top three.


I'm not gonna send it to you by email. Okay. Yeah, I'm sorry about that. That's why I hate that you can't connect on Zoom. But again, it's Alzheimer's disease and dementia is one behavioral mental health to cancer. caregiving for the communicable diseases five, community and family safety, six, diabetes and obesity seven. The digital divide. Eight. Diet fitness and nutrition nine disability 10 economic security, economic security, yes. 11 emotional well being 12 environmental concerns 13 health care access and delivery 14 health care disease and stroke sorry, heart disease and stroke 15 homelessness 16. Housing 17 pain relief and physical comfort 18 Personal Care Management 19 Respect 20 respiratory conditions 21 tobacco use 22 transportation and mobility 23 and unintentional injuries 24.


Okay, top three homelessness emotional write it down emotional well being. And let's see the third one would have to be I think behavioral health. Okay, thank you.


you know, I think I don't know. I think that's a tough line. Let's keep it the way I have it. Yeah. Go with your first intuition. Right.


Right. So again, homelessness, emotional well being and behavioral and mental health. Yeah. Okay.


Well, going back to the homelessness again, I do see a lot of not a lot, but I have seen quite a few even Irvine residents become homeless because of hoarding. They don't acknowledge that there's an issue. And when I try to work with for individuals with the that experience hoarding behavior, they don't see it as a problem. And so for them to get assistance is very difficult, even going in and trying to clean up their home. You know, two weeks later, it is close to the state that we let that you know, it was in when we even first initiated contact with these participants. And so that right there, for homelessness, I do see that that's the biggest problem. Other reasons that seniors are homeless or remain homeless, is kind of goes to their their economic security or their economic situation where they can't afford an apartment, they were renting a room, that rooms no longer available for them to rent, they're living on a very fixed income, and trying to find any kind of rooms for rent right now is very difficult for seniors, and so that's, that is an area that have caused homelessness as well. We do work with those participants. And in we work with nonprofits, to pair them up. So at least a hotel voucher can be provided till stable housing, can be addressed. We work with, again, many shelters in the community, to serve a variety of different seniors with different situations. But I have one right now who just wants to live in his car, he's been provided housing vouchers, and he just feel safe in his car. And, again, there's a variety of reasons. But you know, I think I do feel that there could be more affordable housing units available right now, I'm sure as you know, that waitlist within within the county are could be up to 10 years for affordable housing, that's causing homelessness as well, when an individual is waiting for housing that they can afford, they can't find a room for rent, you know, they're there in their cars, we worked with property management that had available units. And we were able to they they had an opening, we were able to identify at least four finds within the last year, seniors who were homeless and be able to, you know, connect them with affordable housing. But that's, that's rare that it even that they even open up. And I think it's just because of those relationships that we've fostered with property management. And it's a second floor and there's no elevators. So first come first serve. And we're getting seniors in there. So we are seeing an increase of homeless seniors even within the city of Irvine. And again, it's it's a variety of mental health, lack of income, a very fixed income. And in the all these things are are not being addressed, whether it's their own, you know, by their own choice, or they don't feel that they have access to these mental health services, transportations a big one. So they all we I mean, your list was great. And they all overlap in one way or the other, which is, you know, pretty interesting. So that's why it was so difficult for me to choose just the three. That's the area of homelessness.


Yeah, that's a great question. You know, coming recovering from the pandemic and being able to go back into the homes of seniors. Our team has seen an increase of loneliness and isolation that may have been present in the community before. But now it's predominant. We are finding that there are so many seniors who either don't want to leave their home. Even in our strategic plan, survey, senior said that, you know, they have felt an increase of loneliness and isolation since the pandemic. And you know, having, especially access to mental health services is difficult. It's a barrier for many participants when they don't know how to access services. They don't have the transportation to get to therapy. There's not enough therapists that will go into to seniors homes to visit them and you know, doing home visits. We are it, we have them sue the city ramped up our friendly Visitor Program. And I know the county has a great program through the Council on Aging, the reconnect program. But it's, it's still not enough there, there really, were looking at this, as well as how do we find those individuals who are isolated, we know because they're, they come to us through referrals, but those that are not referred, it's just really marketing to them, and letting them know what we do through the city and through the county, and through other partnerships, and being able to combat that isolation. And again, through through programs through rent friendly visitor programs, and just increasing those access to mental health services. And it doesn't help that many of the wait time for individuals to seek therapy could be months. And, you know, I know quite a few participants, we do provide transportation to and from their therapy sessions. But there are just a lot of barriers for individual receiving mental health services.


hoarding disorder, it does get worse as individuals age, it's not something that they wake up and they they start hoarding, but it's now it's issues that have not been addressed. And, and again, the biggest challenges is because many people who hordes don't believe that they have a problem, they don't feel that it's unreasonable. When we go into their homes, it behind, they will be very ashamed to let anybody in. But that's because they're afraid that people are going to move their stuff or take their stuff or tell them they can have their stuff. So they're, you know, that's, that's difficult when they cannot, they're not aware, they're they, they, you know, have poor self awareness of any kind of hoarding behavior. And so part of it is just educating them on what is hoarding, what, you know, what, what are the different levels of hoarding. And, again, why it could be such a hazard to our seniors, whether it's a huge fall risk, we you're not able to get out of the home, if there's a fire because of the blocked windows. And again, once code enforcement gets involved, code enforcement gives them violations and says you have, you know, three weeks to, to become compliant and remove this and this and this and, you know, have the egress available for staff or city staff code enforcement to come through that causes so much stress. And this is where I'm really proud of our team to be able to go in and help seniors navigate through some of these challenges when they do get those core code enforcement letters and maintaining compliance. Because once they though code enforcement letters keep coming and coming, they pile up, and it just becomes incredibly overwhelming for the senior. And that's not something that staff can work with a senior in a week and get it done. I mean, this is long term, it took a long time to collect all of their possessions. And it is not an easy process of being able to you know, go through their home and help them you know, tidy up, if you will. So again from that from that standpoint, it's really more of their lack of, of self awareness of what is hoarding and and that they even possess the behavior of hoarding


Um Well, I think first and foremost is just breaking down the barriers of how do they get to their appointment when they don't drive the stress of trying to figure out how they're gonna get there. We look at that and we have our volunteer driver program where we we train volunteers community by volunteers to be able to provide transportation to seniors for medical appointments, non emergency medical appointments. And so that is one barrier for individuals not receiving service is transportation. Once Once we break down that barrier, it's really working with individuals and self determination if if they're willing to receive the assistance, mental health services, being able to get there is one thing, but for them to be receptive of it is another. And we do see a lot of individuals like this one individual is telling you about is they will live in their car over getting any kind of mental health services, because there's that stigma of I don't want to receive mental health services, there is nothing wrong with me, I do not have a mental illness, and I do not need those services. So that is, that is one of a barrier. But really what we can do to to help this individual or individuals navigate through it is through education, and reducing that stigma of receiving behavioral health services, and really reframing it as you work for emotional wellness. It's not for, you know, per se, you know, mental health illness, it's really, really to promote emotional wellness. And so by by reframing that I do feel that we make a great connection with many seniors in the community. And through building rapport with case managers, whether it's short term or long term case management, we're able to educate participants on what resources are available, what services are available, and how they would benefit from certain services, including mental health services. That answer your question.


Yes, No. Any of the barriers exists to seeing improvements with homelessness.


me think about that one. Again, I think, more affordable housing options, more shared housing options. I think one of the biggest things is we have individual seniors who have large homes in Irvine who are empty nesters, who could not only benefit from renting out a room to another senior. But with the city and code enforcement, I think you can only run out to one, you can rent one bedroom out not more than one. But those are barriers that are put in place when we're looking at even shared housing. The city of Irvine has a list. It's like an internal list of individuals who want to rent out rooms or if they have a mother in law's quarters that they want to run out. And they come to our resource center. And we have that list. The challenge though, is, again, they can't run out more than one room. You know, and if we don't take liability, so we do set up individuals who need a room and then who have a room to rent. And then we kind of step away from that. But there's just not enough right now there's not enough affordable housing for for families and seniors, for that matter. So I think increasing that opportunity, I know that the city of Irvine is going to be building more apartment units, and quite a few of each development is slated for very low income and low income and moderate income for families and seniors so that that's what we're seeing. But, but even then, they maybe have 20 apartments available and they're getting 1000s of applications. So the need is certainly in the community for more affordable housing, but also to if they if we can remove some of the barriers with the restrictions on property rentals. I think we'll be able to see more individuals being able to rent rooms throughout Orange County, but specifically the city of Irvine. Right.


Well, for instance, an individual with a disability that cannot drive, they have far more barriers, to getting to places, whether it's medical appointments, a chore to you know, complete errands and chores, it's not as easy for them. And you have somebody that not only has a disability, but they're on a lower income scale, they can't necessarily afford the transportation. And so that definitely is a, you know, they puts them at a disadvantage over individuals that do have money for transportation, or that they can drive and they can, you know, are mobile, and they can get to their doctor's appointments and, and such. So there are some disparities, absolutely.


Well, I think first of all, it needs to be recognized as as it is in the DSM five, where when code enforcement is going out and issuing citations, they're not addressing the mental health behavior behind the hoarding, they are saying it's a safety issue. And of course, absolutely, it is. But what's missing is that component of okay, they there's there's hoarding, and helping them understand what hoarding behavior is. And, and what we're trying to do with our code enforcement is, is pairing code enforcement with social workers. So social workers go out with code enforcement, that that the social workers are able to assist the senior in becoming compliant within the code enforcement. And that's, that's missing right now. And it's missing. I've even think throughout the county when I was with the Office on Aging, for Orange County health care agency, older adult services, I found that as being a clinician, we were called out when it was already going through receivership. And it was a little too late at that point. And so being pre emptive, and proactive in our approach, and as soon as could enforcement identifies hoarding, that, you know, social services social worker. With us, it's the city of Irvine case managers are called out to be able to do our best to provide resource linkage and services to these individuals before it becomes a bigger issue where they're removed from their home.


Now, what do you suggest is the best way to address the issue surrounding homelessness for older adults in Orange


That's a tough one we are working right now with with be well, we are initiating a health and wellness office through the city of Irvine, that is really going to focus on mental health and homelessness within the community. And so we're really excited we have some stakeholder meetings, there is funding coming in not sure how that funding is going to be allocated. But it's it's a nice little chunk. And what we're looking at is what are the best ways to prevent homelessness. And I think that's where it's really initially going to start as homeless prevention. If we could work with individuals at risk of homelessness before they become homeless. That that is that's crucial. Although Yes, once they do become homeless, we do a we don't have housing vouchers at the time or at this time, but we are looking at how can we best serve individuals who become homeless in the city of Irvine. But again, that's something that a survey is being done, and it's being worked on as we speak and, and that's what the stakeholders are meeting to decide is what is the best way to offer housing to families and seniors who become homeless within the city. So I don't have much of what they've come up with on that. But I do know that they are working on it and really tackling homeless prevention, working with at risk individuals and, you know, hopefully that's our way of preventing homelessness. But once they are homeless, looking at how to to rehouse them in into safe, secure housing, stable housing.


You know, that one is interesting, because again, for, for me, going out into the community, we have seen so much an increase in in isolation, what we have started doing is increasing our friendly Visitor Program, we implemented compassion calls, where we're providing individuals weekly calls with trained therapist, just to kind of, you know, check in see how things are going through that we do have individuals who have experienced suicidal ideation. When that happens, we're calling the police and the CAT team out immediately to respond to any kind of, you know, after we do a suicidal risk assessment. But again, I think being in contact with these individuals, and being able to educate them on what's available, even those that just feel lonely, we're getting them taxi rides to the senior center to offer offer, not only a nutritious meal, but socialization as well, whether it's socializing through the eat through the meal, you know, eating meal process, but also with the health and wellness activities and classes and education seminars that we hold at all three senior centers. And so that's one of the things that we implemented, it's just about those taxi rides, to be able to get individuals because a lot of what we're seeing is individuals who are isolated, lonely, because a large portion of them don't drive. And whether it is they drove before the pandemic, and now they don't, or they've had to give up their license, or they couldn't get it renewed. So working with that, and again, making sure that we're breaking down the barriers, to allow them to be able to, you know, to engage in social activities, is a big key for us. And so, again, that's one way we've is by offering that free transportation service. keeping in contact with them, keeping them engaged, one of the ways we're thinking is if they can't come to the Senior Center, how do we bring the senior center to homebound seniors who are experiencing isolation, digital divide is a big one as well, where we do go into their homes, and teach them how to use Zoom, maybe load zoom on their iPad, their tablet or their phone. That way they can connect with their families, and it's not a phone call, they get to see their loved ones. We did that through the pandemic. And we're continuing to do that now. In fact, our case managers go out with an iPad to every single home visit, to be able to offer if there's any kind of you a training that we can do to help them engage with technology and feel more comfortable with using Zoom. And but also on the same token, I know there's going off but teaching them the safety features of you know, learning technology and and what is phishing, and what to look for, for scams and an email. So we do teach them the really cool aspects of technology and, and trying to combat isolation, but we're also giving them those really important, important education. Talks, if you will, on just the safety of technology, we do see a lot of isolated seniors, when they do get those phone calls saying that, you know, they won some money and that they, you know, they're really excited for this senior because they want $450,000 The only thing they have to do is, you know, give us the good pay the taxes up front, we see that a lot. And we do see the isolated seniors falling into falling victim to these scams because these criminals on the other end are so good at engaging the seniors, especially the isolated ones, building their trust, and then scamming them for money. So, again, trying to engage them, but also educate them.


You know, with our health and wellness, I'm really excited to report that it is, it is focused on mental health, mental well being, and homelessness and, you know, prevention, homeless prevention. And I think now, they're really, and I'm saying they, but for me, my experience is the city is looking at at this saying, you know, this, this is a big deal in our community. Mental health does exist, but really reducing the stigma. So individuals feel like they can receive the assistance that they need. Partially to its cultural, there are quite a few cultures in Irvine is incredibly diverse. But we work with many different cultures that view mental health in different, you know, aspects, where some cultures will say, Absolutely not, I will I do not want to talk to a therapist, I will not talk to a therapist, where others are saying yes, in fact, we need therapists at the senior center, because we would like to go and talk to someone once a week or, you know, twice a week. So, with that, it's just education and reducing stigma, by reframing the services and, and, you know, reframing it, you don't have, it's not about mental health and mental illness, it's about, you know, really the emotional well being, you know, so I think that again, the city is doing an outstanding job, I know that, that working with the county, they're also doing a great job on of supporting even nonprofit organizations to provide counseling sessions, therapy sessions, to individuals, from all different cultures, speaking a variety of different languages. In fact, we have contracted language service where if we're working with an individual and they're experiencing, you know, maybe they need a therapist, and they're reaching out to us because they want our assistance. But language is a barrier, we use our translation services. Although we do have staff, case managers who speak Korean, Mandarin, Cantonese, Farsi, and Spanish, we still offer services in other languages to ensure that language is never a barrier for individuals receiving the assistance that they are in need of. So again, you know, breaking down that stigma, reframing and education educating individuals on on the services that are available.


You know, from my experience, I do find that individuals have access to geriatric care. Don't I don't see. I mean, yeah, I'm not that familiar with this one, per se. So I don't know if my rating would be extremely fair. But what I have heard when we do work with individuals, that they do have access to geriatric care, and they, they do take advantage of it. And they're pretty happy with the medical services that they receive.


And is accessible and adequate. Yes. How does long term care


it's not not as acceptable unless you have money to pay for it. And that becomes a challenge. So that is definitely an area of concern. And that really does benefit individuals who have the means to choose not only a A great facility for long term care. But again, with the economic status, they're able to have more leverage on on where they're placed opposed to those who don't


know how accessible and adequate is mental health, behavioral health and substance use treatment in Orange County for older adults.


You know, the accessibility is an issue, what I've heard. And what I've seen, and what I've experienced is that there are long wait times for appointments, especially for individuals really needing services right away. The county has been really great and responding. When we call out for you, whether it's outreach and engagement, older adult services coming out to assist an individual. So, or even the CAT team, we've had great response. But it's just when they're trying to call for whether it's, you know, through their insurance, to access therapy sessions, the long wait times the long wait times, just to book an appointment, one individual waited well over an hour, and they just hung up. And so it's at that point, it's not accessible. And it's more discouraging. I see. From my experience in older adults, when you have all these barriers that I have to sit on the phone for an hour to make an appointment, I won't get an appointment until, you know, three weeks from today, that's as soon as the appointment and I need to find my transportation to get there. So those are a lot of challenges that make receiving mental health services, just not as accessible as they should be. Now adequate. Um, I think it could be more, I know, it could be more. It's, it's not adequate.


Now that you know, of any seniors services or programs in Orange County that provide mental health support to older adults.


Yes. Which is one area, but I'll have to get back to you some of the other agencies that we work with.


Um, you know, that one is a tough one. I don't know that I could. I don't know that I'd really be able to answer that one fairly. Because I don't have the experience with working with individuals. My team does, they would be able to answer but I would not want to give you an answer that is skewed because I heard you know, from one person or the other. So I'm not as familiar with that to be able to answer that question. Okay. But what I do know is that and I will share this. We assist individuals with applying for CalFresh. And we do work with individuals. And it's very successful. By the way, we we've had great success with assisting individuals with signing up for CalFresh IHSS. We do many times work with individuals in requesting an increase for services. So we are hands on when it comes to that. Very grateful for IHSS hours that are allocated to individuals. So from that standpoint, and through even MSSP we do have that experience and our team works very successful with those social service agencies. Okay.


Well, the biggest challenge I think will remain housing, affordable housing. Another one will will be transportation