Yeah, so I'm the director of Orange County Community Services. Within Community Services is the office on Aging, the Veterans Service Office and workforce development. In each of the three programs, we have programs that are serving seniors, obviously, the office on Aging, mostly 65, and older CBA, California Department of Aging programs, we receive the funding directly and some are done in house and then some are contracted out with the Veterans Service Office, about 75% of the veterans that we see on a daily basis are considered seniors as well. So we cross refer them depending on what kind of means they have. And then when it comes to workforce development, we have a senior employment program that we're responsible for managing as well.


Great now thinking about Orange County, and looking at the list of this common issues and concerns impacting older adults.


Oh, um, I guess under economic security, it says education employment. So. Right. Yeah.


And, of course, the examples are, right, what they are examples, right. They're not exhausted in any way.


Yeah, yeah. No, I mean, I think you you pretty well captured, like our top five, you know, the common themes that we hear we have a call center, and we get approximately 100 calls per day, for various reasons, but we track what they're calling for. And, you know, the top bar are listed here.


And of the of the needs on this list, and, you know, Please rank the top three that you feel are the most important.


Number one is definitely going to be affordable housing.


I think economic security and transportation would be probably transportation before economic security kind of on on my list based on what we provide here would probably be the top three. Okay. Well, I think I think one of them was, you know, health and disease and things that it's all very relevant, but we don't necessarily provide those support services. So it'd be hard for me to say how many people on a regular are trying to access programs related based on their need,


understand it, and I'm going to follow out with a set of questions for each of the three topics that you identify. So first of all, housing.


Because if you live in Orange County, it's quite expensive. And so depending on what their financial situation you know, was whether you know whether they own their own home or not, there are many people that have rented all of their lives and the rent just keeps escalating and their Social Security does not know out of the rain, the same rate, we also see that, you know, there's a to home income. And as you age, sometimes that's not always the case, whether it's because of divorce or death, and one person can't do it alone. And then, you know, of course, you know, we see those folks that do like the reverse mortgage to try to stay in their home. And then at some point, you know, they just have zero equity left, and so they really have nowhere to go. It also plays into, you know, some of the examples of the diseases that you've shared, like dementia. You know, there are reasons that people you know, are on the street. But But honestly, the stuff that we see, really is separate. And apart from that, it really is, folks that are living paycheck to paycheck, and are too proud to ask for services. I have, we have a client, and she lives in mobile home, it's I've been there, it's a beautiful, very well kept, she's been there for for many years. There's, there's services for people who are just, you know, homeless, or ill, but there really isn't services for people who are doing their best to stay in their home and have some income, but not enough.


Well, I mean, you know, there were pretty built out in the county. And I think, you know, trying to move a senior from, you know, San Clemente to Riverside County, you know, one the lose the bill to be isolated, because when they lose that social component that they're accustomed to, they want to stay in their home, they want to stay where their doctors are, they want to stay where their friends are. And so I think the barriers are the limited number of housing units available. And then the the number of affordable housing units that are available.


Yeah, I'm sure that's a huge factor, I also think, was I gonna say about that, you know, there's a lot of cultures where, where the families like, join together, so the grandmother, you know, stays with, you know, her son or her daughter. And if she were to get some financial assistance, she's not able to take them with her. And so you're separating the families as well. And so I think there's, you know, when it comes to their, their background, and their, the way they were brought up, I think that those factors come into play as well.


Oh, wow, you know, I wish I had a magic wand. And I could just build, you know, units for these people. So Laguna Woods, in my opinion, is a good example. But a more affordable setup than what's available there. You know, there, there's Association, there's a, you know, are all kinds of stuff. But if we just had, you know, if I had a bill, the ability to create a similar model, where everybody was welcome. And maybe you pay based on your income, but everybody, there's, there's something for everybody.


I don't think they plan to live as long as they they are. I don't think that people planned for that. And I also think that, you know, again, it's expensive to live in Orange County. And I think most are living, you know, off of their social security check, and they're living paycheck to paycheck.


Yeah. I mean, it's it's really the federal government deciding you know, what the increase to their social Security is.


Yeah, I mean, I think, you know, education level, obviously, you know, I think folks that are more educated, knew that it would, could or could be a problem and plan for that. I think folks over educated obviously got a better job and probably have some retirement, you know, that comes to them each month, I think that, you know, it all depends on the situation, whether they, you know, they come here and have to learn English and, you know, start out in the kitchen or something of that sort, there's not a lot left, you know, when you're in your weekly paycheck to save, right. And so, it's a big difference from working, you know, maybe a corporate job or a government job where we're very lucky, you know, if you don't save, they're basically saving for you. But, but I don't see that that was the situation for many of our seniors. And I also think many that are, that are current seniors were lived in a in a household where it was, the mom stayed home, and the dad went to work. And now we're seeing that these individuals are passing the male figures passing, and the female figure has never want one worked, done the bills, or you know, doesn't isn't eligible for the retirement, and then they're left with nothing.


Yeah, that's a tough one. I think they're, you know, we could do some better education, when it comes to, you know, financial management, financial literacy. You know, going through some of those scenarios, helping them understand even a simple thing, like writing a check. You know, we have we have, you know, Homemakers that come in, and, you know, need to pay their taxes. Because their husband did it for 80 years. And so just, you know, the just the, even the basics.


Well, I think that they're very, they think they're very independent, they want to come and go as they please, once you pull that from them, you know, it takes away from their ability to kind of, you know, do as they please. And the programs that the county has, while they are good, they are limited to non emergency type visits, so I can't pay for someone, or I can't pay my contractor to take someone to the mall. But I can pay my contractor to take you to the dentist. So there's a lot of things and places that they want to go for their independence to maintain their independence. And we don't have any type of service other than like the bus, Octa. And even with Octa, I mean, you're not getting from one place to another very quickly. And I think there's hesitation to use the bus system. I know, in some, you know, states in other counties, it's a normal, you know, way of transportation in Orange County, it's it's never been, it's always been frowned upon. I don't think I would want my mom taking the bus to the wall.


I think it's funding, you know, a, we could easily you know, if we had more money, we could reshape the current non emergency transportation to transportation, right, regardless of where you want to go, you know, we'll be able to take you through probably some limitations still, like, you know, probably couldn't take you to the casino or maybe adding a few additional stops within there, like the mall or the library or something like that.


I think if you're, you know, if you don't know the language, it could be a challenge. One, I don't I don't think you know, I don't know I don't know this, but I just have a sense that, you know, those bugs drivers drive for long periods. So their days are long, only 12 hours. And so they're not thinking about what every person on this bus is going to be stopping, and, you know, helping them on and off the bus. I don't think that that's something they can do. There are separate programs for that, like access to things like that, but at the general bus system, I think it's, you know, they're on a schedule. So it's, you know, it's very quick. And, you know, I think, again, I think there's, if they're not comfortable, or if they don't have another senior with them, I think they could get lost in the process.


I mean, I think, you know, maybe looking at expanding an existing program that has some capacity, but including funding, because, you know, obviously, that's, you have to be able to pay for the service, but, or even looking at maybe, you know, expanding and maybe there's a small stipend, you know, like, you know, I don't know, $2 $5, whatever it may be. But something that's a little bit has a little more flexibility in where you can go. And it doesn't take you all day to get there.


Alright, moving on to the next question set of questions. I just read out the first one geriatric


care. I don't have much experience with or direct knowledge. I know it is available. And we do refer out to different organizations. But how I think the question was, how available


how assessable and adequate the following care or services are in our accounts.


So I think it's accessible. I don't know how adequate the services are.


I would have to say it's about the same.


yeah. So for each of those, we do have services. So someone called the call center, and we're to say, my mother needs some she's, you know, 85, and she needs mental health services, we would pull that up, and there are resources in Orange County. Were just a referral piece. Right. Okay.


Yeah. So orange County Health Care Agency does


Are they Yes, I think that they're accessible. I don't know how well received they are. They think that there is some hesitation from the general public when it comes to government services, and that they, you know, tend to frown upon them. Before even trying to access or figure things out. It's like, oh, that I gotta go to the government. I don't want free cheese. I don't want you know, you just right off the bat, there's kind of hesitation.


Well, I think housing will be will be one of them. I think there'll be some new isolation issues. I think that this younger generation doesn't communicate in the same manner that the older generation does. And kids nowadays have a different relationship with their grandmother than used to be the case. And if if the older generation isn't tech savvy, I think there's going to be some voids and really impact isolation issues.


Well, I don't think we can do it alone. I think that we're already mandated to do so much with such little funding, that the government's role really is to meet the state mandates. And we can't really do much more, because we don't have the resources.


And thinking about all the older adults rested in Orange County, who was getting the least amount of attention


when older adults are getting the least amount of attention, probably those that are self sufficient.


Thinking about all the issues facing older adults in Orange County, what issue is the overload, if any,


was gonna say the other thing is, it may be a clearer understanding of what services are available and what the county is responsible for, and what the state is responsible for, and what each individual city is responsible for. Because they think sometimes, you know, those lines kind of cross and it's unclear.


Now, in addition to what we have already talked about here, just dig a little deeper into your area of expertise. So thinking about your topic, basically, inclusion and equity in aging. Well


I think it's, I think the problem is, seniors don't know who we are or what we do. And so we're not capturing everybody. So it's very difficult when we do these surveys, or we have meetings when we only know a small group, a small portion of the population. But then when we look at the sheer volume of seniors that we have in the county, we don't know where they are. We don't know what their situation is. We don't know what their needs are.


What new or revised policies are needed.


I would think maybe at the state level, they could do such a better like allocation of resources based on like the total population, not necessarily like the poor total population of those in need, or those low income. There's no requirement that you have to be low income, but we don't have enough funding to assist, you know, the 500,000. You know, there's just, it's not. So we don't, we don't do a whole lot of outreach, because our funding is gone with just the people asking for the services.


Well, I think the California Department of Aging, it really comes back to the funding. You know, we could do twice as much as we're doing today, if we had twice as much staff and twice as much funding. And so you can always do more, but it really boils down to the funding.


Well, we're mandated by the state and to collect certain data and our data is very exempt. It's exhaustive. It's very expensive. And most of it is like unduplicated clients, we call them service units. Are each contractor is responsible for reporting those things as part of their monthly invoice.


Well, I think that, you know, some of our service providers would probably be helpful. They do this day in, day out. I think there's some volunteers that also, you know, assist in the programs when it comes to our home delivered nutrition programs, that would probably be helpful. I think you guys already have that full list, though. So I'm sure I think Claudia took a look at the list that you have. And I think we tried to clear everybody on there. So


one last question. Yeah, of course, of course.


I think of anything, it's, you know, right now being on the spot. I'm kind of always trying to wing it. But um, I think that yeah, definitely follow up with me and I will do the same if I have any.


I just read off this very last part at the This concludes your interview. Thank you so much for your time, you have been incredibly helpful on our research to our research. And if you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website www.smc.com. And you can leave an anonymous voicemail on our telephone line at any time. Then, of course, you can just reach out to me if you just have anything that you'd like to add.


Very good. Well, Tammy, thank you so much. Absolutely. Take care. Bye. Have a good


So the primary goal today is to identify what needs you think are the most important to the older adult population that you serve. Those who are 60 and older, we want you to think as broadly as possible taking into consideration of older adults, caregiver families and their community. I'm going to share my screen so you can see a list of common issue and concern impacting older adults. Please take a few minutes to read through the list and let me know when you're ready to begin and when you want me to scroll because it's it's a long list


Sure. My name is Deborah Levy and I'm the Executive Director for the Alzheimer's Association Orange County Chapter and we work with older adults who are experiencing a form of dementia or mild cognitive impairment and their families


thinking about Orange County and looking at the list of common issues and concern impacting older adults is anything missing from the list scroll


is not there and language barriers and cultural barriers and sexual orientation yeah good point


I'm making a note that up the next on the list including those that you suggested Can you Please rank the top three that you feel are the most important


Yeah, it would be great. I can only see a third of the list.


Okay, I will try to put everything in one page.


so I still just see from environmental concerns to unintentional injuries that's all I see.


You know, when when individuals get older, I think that their health becomes definitely a primary focus and insurance costs, you know, the cost of their care, making sure that they're able to be seen by a provider. You know, you have in here culturally and linguistically appropriate care. I think that's really important. Long term, like long term care, which I see under housing, per se, but


Not sure that I know how to like that I can answer that question. Yeah.


I do, but I'm looking at it from the lens of my agency. And so I'm trying right now to put a broader hat on. You know, from my agency's perspective, when it comes to mild cognitive impairment, and Alzheimer's disease, there aren't very many specialists in our area, and getting an appointment can be difficult. And now, there's two treatments that are available to slow the progression of the disease if it's caught early on. And physicians. It's not like widely used yet. And it's also the drugs are currently not covered by Centers for Medicaid and Medicare. So that's from just my agency's perspective.


May I dig a little deeper into why not offer Wiley and


Yeah. They've only been released in the last year and a half. One of them was had a kind of a controversial approval through the FDA. The second one is showing some promise and there's a third one that probably will be submitted for approval to the FDA. So there could be three Yeah,


Well, if I can pull information information out


so I'll just share something from our facts and figures. or So primary care providers say they lack the tools to care for patients and experiencing cognitive issues. They rely on specialists to fill the gap.


specialist physicians see a substantial number of patients 60 And older every year. Nearly four and five emergency medical specialists noted that they see 500 or more patients in this age group each year. Many geriatric specialists report seeing 500 or more older adults each year. A little more than one in three neurologists indicate that they see more than 500 patients age 60 and older each year. It's it, there's lots of issues one is, you know, primary care providers say that they lack the tools to care for patients who are having mild cognitive impairment issues and it's hard for their own specialists in our area


when it comes to Alzheimer's and dementia so I think it's really really challenging for folks to get a diagnosis and treatment


thank you for sharing. So when you think about economic security, how or why older adults struggle with this issue


again, I'm not an expert. So I what I've heard from you know, some of our constituents is you know, they have a fixed income and it's expensive to live in Orange County and that that is a concern as to how long our money you know will last before they they run out of funds


like barrier assists to see improvement in this area


probably more affordable housing for seniors in Orange County, that you know, it's quality affordable housing


Again, you know, language, the language barriers we have a very diverse population here I don't think that all agencies are set up to be able to translate into different languages to speak to individuals with different languages or different backgrounds cultural sensitivity training for employees within an organization


I think that there's a lot of work that needs to be


done what do you suggest is the best way to address this need


when you think about safety, how or why older adults struggling with this issue


it just came to mind when I looked at the list that it wasn't there so you know safety within their own home you know if they're living alone and I've seen unintentional injuries you know falls so I think about about safety in somebody's own home making sure that you know, they're they're eating not everybody has you know, is living with other family members you know, that if they're living in a multi generational you know, household they're there people that are there to, you know, watch out for their loved ones, but if they're living alone, I think about communities, you know, what the safety is in communities. You know, last night we were having, having dinner with some older adults, and they were sharing a story about, like, artificial intelligence right now and getting scammed. You know, if they got a call and AI is using, like, a loved one's voice, to say, like, I need help. And not knowing that they're being scammed, you know, and maybe giving money to a thief, you know, unintentionally.


I don't know that I have the answer to that.


I'm sure that there are, but I don't have examples.


What do you suggest is the best way to address this need


I don't know that I have an answer to that either.


Okay. Can you please describe how assessable and adequate geriatric care in Orange County


I'm not sure that I might be the best to answer some of these questions and in turn that I'm just not an expert in you know, in the field.


Yeah, I understand. So, like I mentioned, you can choose to answer the question in part in full or not at all. Based on your expertise. Okay.


I don't feel like I'm an expert in that either.


I don't feel comfortable answering that either.


No, thank you. What do you think would be the biggest challenges older adult will face in the next 10 years


I do think the prevalence of Alzheimer's disease and the growing population and if we're we don't make bigger strides you know to help with memory loss and


being able to help individuals is it is a big problem


I don't know that I feel equipped to answer that either.


Thinking about are the older adult resident in Orange County who is getting the least amount of attention


I don't feel comfortable answering that either. I'm gonna be a great interviewer


I just want to you know assure you that our answer will be confident now interview will be confidential.


You know, my agency focuses on Alzheimer's disease and dementia. The county of Orange just applied and received a Healthy Brain Initiative grant for the next two years. So I'm think that that's going to be a great, you know, kind of first step for the for the county and being part of taking part in the Healthy Brain Initiative.


If we can dig a little deeper in your area of expertise, thinking about Alzheimer's disease and dementia, what are some way you know that Alzheimer disease and dementia is working and not working for older adults in Orange County.


So you know, I you are already aware that Orange County has the fifth largest population of seniors aged you know, 60 years and up We're expected to see substantial population growth through 2060. So


So when you think of Alzheimer's disease and dementia, how or why older adults struggling with this issue


one of the things is, you know, dementia patients are more likely to require assistance for a range of instrumental activities of daily living like transportation, finances, medicine, management, outside services.


I'm looking at just some of my statistics here that Orange County residents with Alzheimer's disease, about 37% belonged to non white racial ethnic groups. So we definitely need to be looking at, you know, linguistics and interventions that are culturally tailored to this population. There's definitely a staffing shortage of skilled workforce, it's pushing more elder care back on to families.


Looking at some of my notes. Yeah, take your time.


The caregiving piece is a major component as well. The impact that it has, if a family is caring for their loved one in their home, you know, just the economic and emotional strain that that takes on a family. We need to address, you know, those issues as well. Respite Care is a big component that I hear over and over and over again, from families is that if they're caring for someone with Alzheimer's or another form of dementia, that the caregiver, it's not just about the patient, but the caregiver, the toll that it takes on the caregiver and needing to provide respite care, so that they can take a break and and do other things. And the stress that it takes on a family if they're working outside of the home, while taking care of somebody with Alzheimer's or another dementia. You know, those are those are real problems and how do we work with employers to educate them about you know what it's like to care for somebody with Alzheimer's or dementia.


I've had different experiences for different group of older adults from different backgrounds.


Yeah, I mean, the cultural sensitivity and language and all of that plays a role for sure.


I don't necessarily have an answer. You know, I can talk about what we're doing to address it that I can't talk about, you know, bigger picture.


Yeah, that's whatever that you feel is, is appropriate.


Um, so the Alzheimer's Association, you know, we, we have support groups that are taking place. We definitely need more qualified volunteers, you know, who, who can help facilitate support groups in a variety of languages and a variety of communities. We're doing education programs, you know, in the community, on a variety of topics that can help caregivers that can help family members from that can help those who are early diagnosed with the disease and help them as they navigate the process. You know, we have a 24/7 helpline to be able to provide referrals for families and a multitude of areas. So I don't know that like the county needs to recreate certain things that we are already doing in the community. Our helpline can be translated into 200 different languages. So I think we could be definitely be a partner for the county, as it plans its, you know, master plan on Aging, to be able to use our 24/7 helpline. You know, we're doing DEI work in in community at all levels. We're investing in research. So, you know, currently at UCI, the Alzheimer's Association is investing a little over $1.7 million in research here in our own community and about $56 million worth of research in the state of California. We want to do prevention. So healthy brain, you know, initiatives within the county, we want to be able to educate young people about the importance of taking care of their brain. And weight, just like we talked about cardiovascular health. Over, you know, 20 years ago, we now need to focus on teaching kids about, you know, taking care of their brain and how that also aligns with you know, taking care of their bodies. And that needs to be part of like, just our nomenclature. knows, you know, we want to raise awareness about the disease because one in three seniors over the age of 65 will die with Alzheimer's or another form of dementia. We want to work the Alzheimer's Association wants to work with help systems to be able to provide the resources that they may not have in house that they don't have to recreate that we already have.


Yeah, those are just some of the things that we, you know, that we do in our community.


We use, you know, we use the Alzheimer's Association produces a facts and figures report annually. You know, we use that as a roadmap quite often. You know, the state of California has information that we utilize as well. The census, you know, census data is another, you know, component that we use.


Well, right now, for us, it's a federal, it's a federal issue, not necessarily a state issue. But at the federal level, you know, we're urging the Centers for Medicaid and Medicare to change its policy on covering this class of drugs, to treat individuals, you know, with early, early stage, you know, cognitive decline. And then we sponsor pieces of legislation in all 50 states, through our advocacy and public policy efforts. We're working on, you know, pieces of legislation right now in the state of California, that we want to pass. And we do that annually, where we identify


our priorities kind of for the year. You know, one of them, for example, is is training law enforcement and first responders on how to


training them on on how to deal with an individual if they believe that they could have some cognitive issues, you know, maybe they're experiencing some they've wandered. And or they're having an outburst or reaction, a hallucination due to you know, dementia. And so we're, we're working with the state of California to get legislation passed to train, you know, all first responders about dementia, dementia care.


No, I think that you probably have everybody covered.


Thank you. So this concludes our interview. Thank you so much for your time. If you feel that there's more to share, please feel free to reach out to me or you can also reach out to our general phone number and our email as well and leaving an ominous voicemail, or telephone line at any time. I'm gonna stop the recording now.


Okay, great. So we were just talking about and I didn't hear anything you had said. So if you can repeat it, what are some ways housing is working, and then not working for older adults in


Yeah, if you have a voucher or you get into a unit, then you're it's subsidized. We need more of it, for sure. To meet the needs. I think one of the things that I mentioned and not to be a broken record, but on permanent supportive housing for chronically homeless, we're building in the services to wrap around, but in general, affordable housing. We're, you know, seniors that just as low income as they age, what services can they access to age in place, because their rent is taken care of, but, you know, now they need daily living activities. And it's not like they can afford, you know, contract. Like I said, some of that maybe just their coordination and access to their mainstream benefits. But it also depends, if they don't have family members. It's extremely difficult for an individual and navigate the system without somebody to help. Yeah. Oh, yeah. Oh, the working part is we're housing that that meeting. So I mean, we're, I mean, housing is getting built for, for seniors. And that that works. The voucher program works. We just don't have enough of it right now. That addresses the housing needs, you know. So, yeah,


You know, on the housing development side, and the permanent supportive housing side, we have a funding strategy, we've, we've looked at homeless needs, I think it'd be great to have the data from this needs assessment, right, to see if we need to pivot in the type of senior housing that we're developing. So it may, it may change the policy right. On what we're looking at. I mean, we need additional funding for the voucher program. It's, you know, like I said, we have a majority of the people on our voucher program or older adults, we just don't have enough to serve. Everybody. So definitely need that.


In our conversation, you mentioned a bunch of different organizations, including the county, but also CalOptima. And also you were referring to private partners as well. Who are what entity is the best is best suited to address housing needs of orange, Orange County, older


adults. Cuz I don't know who the who like.


Yeah. So in our conversation, you mentioned, you know, what you're doing at the county, you mentioned county Optima health as a partner. But you also mentioned that you think there should be a public private partnership, so private entities as well, although we didn't name anybody specifically.


Yeah, again, it's a partnership. So it's government private. That's their job. They, they know how to, to develop affordable housing. So our partnership with them is in developing that housing, but we generally make the policies right if we, if we said 50% of everything we have to do has to be senior housing, then that's the way it's going to be right if we base it on a needs assessment. So some of those privates, some of the private is the health care industry, especially for older adults. So CalOptima right is for because I, we deal more with low income individuals. So Cal Optima is in there, but there are a lot of private providers. Right. I think there are a critical component on the health care needs of the older adult population.


We don't have a general hospital for right homeless in the county. So we rely on the private network, Cal Optimas. All of that. To, to pay for that, to provide that service. Yeah.


How do you keep these programs accountable.


So on the purpose part of housing side, we have a housing funding strategy, we rely on the point in time count of the homeless, they generate demographics. The last assessment we did is we've we've built some housing, and we've made some progress. But we still need 2396 permanent supportive housing units to meet the needs of our homeless population. In the county, our permanent housing needs were not shelter and transitional, or just straight permanent housing. And we need just about as much of that, and just regular affordable housing. How many units are we building of housing. And as I mentioned, everything is needed in the county, it's very hard for a right to say that anything is a needed older adult, transitional youth senior Mental Health Services Act eligible. So we're trying to, you know, develop everything. So we have, you know, senior housing units other. Like I said, it, this assessment will be great, because we can look at the senior population to see what might, but as far as on the housing side, when we measure outcomes, it's, you know, the Housing Choice Voucher. Each time we do a waiting list, we're keenly aware of how many people are applying, but how many people we can actually serve. And that's one metric. On the development side, we know how many units we need, and how many units we have, and how many units are in development.


So I suppose you have to take into consideration the housing element analysis that's done. Yeah,


the interesting thing about that is, is it's based on that you have enough available land for your future needs. And it ends up being a number. And I think I mentioned one of the barriers is land, right, getting land for affordable housing development. So I think it's a critical piece and you know, getting appropriately zoned and available land for this.


I think it's interesting because you also, you have to know how much of that maybe just will get built without any subsidy, we're on sort of the low that really, the very low income and extremely low income and when we're trying to build those units. So that's where we focus. And so the housing element, a critical part where we're a partnership in that, and on the very low end, the extremely low income units getting built, because you you can't get those built unless you have a subsidy. They just don't get built in the market place. So yeah.


All right. So almost almost the end here. Just wonder, is there anything else is ours and anyone else we should talk to, other than your two colleagues that I'm gonna definitely call and follow up on.


Um, yeah, so you've already got the two people I just cuz Michelle is just involved in development, she may say exactly the same things, I might say, January is a little bit more involved on the housing authority side, which is more, she serves a lot of one on one senior. So you'll get a good perspective of I mean of people in general, but and then I'm sure you're talking to Office of care coordination, Doug back, or Zuly, Melendi. From their perspective on, on homeless older adults. And, I mean, if you're, I don't know, if you're, you're speaking to housing developers that are have built senior housing developments or nonprofit partners that have been providing services in the housing area. to older adults.


Yeah, well, we're interviewing 100 people. isation. So lots of them, but you know, happy to take any other suggestions. Even after this call, if you think of somebody and say, Oh, Katie, I forgot to mention so and so. Just let us know, and we'll add them to the list. It's always better to talk to more people, even if they say the same things, you know, we'll have it on record. So super important for us to, to interview them if you can think of them.


I was my my husband's a teacher. He's got a teacher conference in Costa Mesa. So I guess we're headed down there because he has some of that tonight. It's on Cinco Demayo.


Well, we're gonna go Maxon probably with everyone in town. So if there's a restaurant we can go to, but I'm gonna go chips and salsa in today. Yeah. Well, thank you so much for your time. Okay, appreciate it. If you think of anything, and you'd like to, you know, ping me with either a resource or something else you forgot to mention or program that you're working on information on that program. Please feel free. This is meant to be an open door to you and to everyone in the community and just don't hesitate whatsoever.


So good morning. Good morning. Hi, my name is Torhon Barnes, and I'm a member of the research team at Evangel. See, we're a local nonprofit conducting, conducting sorry, the county of oranges, older adults needs assessment. Thank you for your willingness to take part in this interview. The purpose of the interview was to identify 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. So this interview will last approximately an hour and with your permission, or discussion will be recorded only for transcription purposes. And note taking, the recording will not be shared with anyone and after transcription, the recording will be deleted. If you do not feel comfortable being recorded, please turn off your camera and change your name attached to your picture. Your responses are confidential, meaning that we will remove identifying information in the report. Excuse me, but please note that your participation is voluntary. You may choose to answer all questions in part full or not at all. I may also withdraw from the interview at any time. If you're unfamiliar with any of the terms used, please let me know. And I'll provide an example or definitions. Yes, thank you. Yeah, great. So the primary goal again today is identify what needs you think are most important for older adults, those 60 and older. In Orange County, we want you to think as broadly as possible, taking into consideration the older adults, their caregivers, families and their community. So I'm going to share my screen. And this list, it'll be a list of common issues and concerns impacting older adults. Like you. Excuse me, I'd like you to take a look at that list and let me know when you're ready to begin. One second.


So thinking specifically about older adults in Orange County. Please, for the record, could you also first tell me your name, your role and how you interact or engage with older adults in Orange County.


So my name is Gloria Alvarado. I'm the Executive Director of the Orange County Labor Federation. We work with not only with working individuals, right, but we also work with retirees, and I'm talking about individuals 60 plus. And in my former career, I manage a senior center for over 10 years. So I'm very, very familiar with the issues that seniors face.


You know, if yes, I'm looking for it. And I'm not looking. I'm not finding anything that is career or work. One of the biggest issues for some of the seniors are that one, they retired 60 to 65. And they're still feel young. And so, um, they live in their own homes, but they are and I'm looking at the words that are describing those those behaviors or those issues, and loneliness, and lack of usefulness and ownership of pride is one of the biggest things that I feel is missing in the overall services that we provide to certain seniors. There's only a few senior work programs, and look, they will work for an hour, they will work for two hours, they don't care as long as they have that ownership and that pride that says I did something


So, first is the behavioral and mental health. And I'm gonna say that I'm, I'm very I don't know how to rank this too, because I think emotional well being it's already been taken care of the health, but also transportation and mobility being key. No, I don't know what to rank those.


So I you said the first one was the mental and behavioral health. Yes. Okay. All right.


Thank you have to look at two things, you have to look at the benefits that are already existing for like example. They're struggling because of their cultures, because some of the programs are not culture savvy. And I think that's where the respect comes in. You have a large community of API, in Orange County, you have a large community of Latino, you have a large community of African American, of seniors, and they all think differently. And so if you don't have a multicultural, more more multi language, language program, then you you lose somebody, you miss somebody, so they fall into the cracks. Just to give you an example. That's why behavioral and mental health are so important. Majority of the seniors in Orange County who are living, they live with a family still. So they depend a lot on that behavioral, I want to say support, when the families decide that it's time to move him out. Or for them to be, you know, to have their own environment. One is because the family style, something happens, Alzheimer's, dementia, you know, a lot of families cannot handle that, maybe the homes are too big for them. And so they need to move them into something smaller. So now they're independent. Nobody understands that there has to be a transition, they don't know how to function without their family support, any their support where so the senior centers, I always promote the senior centers, because I think they do a good job. But if the senior center that is assigned to them, or to where in their neighborhood doesn't have cultural friendly activities, then again, they suffer more. And so they go into this depression, I don't belong, you know, that sense of lost continues to be there even before they actually face you know, whatever difficulties may come. And that's just one example. In the Latino community.


Yeah. So So look, respect and I just mentioned one example. But with respect, again, we go back to if you look at the menus, on food, again, right, something simple something as simple as that. SeniorServ is for the most part, the county kitchen, right that sends meals to the seniors. You look at the food and yes, it's, it's it ranks in the dietary component that they need to follow. everything, but there isn't. It's not cultural culture savvy. And you know, like the tamales for us that will eat as make tamales every Christmas. When you eat the tamale that they've served, they're like, this is not a tamale, this is not what we consider. So again, it's cultural. So lack of respect, in that sense, not knowing specifically what it is, and what people eat, and what people expect with their meals. And what happens is that senior serve delivers the meals and they don't eat. If you serve a sandwich to a Latino family, they're not going to eat, that's not food. That's not real food. That's a snack. So it's connecting that. So that's the lack of respect, and then immobility in transportation, as much as we want them to be active. Unfortunately, they don't have the fortitude in their bodies to be able to, to go to the grocery store, buy groceries, and walk from the grocery to, you know, to their homes, with bags of food. Not only that, again, we go into the mental health issues, but the physical issues have a lot to do with it. That's why a companion is always good. That can, you know, help them cook and help them do all that because the lifting and the pulling, and it just makes a big difference.


And then again, transportation and mobility, very important the language we have, we used to have very good programs, the dial a ride, I think right now it's called access. But some of the operators don't speak Spanish, or don't speak the language that is needed. And so a lot of the seniors hesitate. need adult children to make the appointments. And so again, if we were able, it would, it would be very helpful. It will be we could add a language or called cultural connection, right, in all those needs.


I think it's about funding. I don't know if through their Medicare or their medical or whatever insurance they might have. If it is as limited as it is for us adults, you know, for me, if I call my insurance, they can between three and five sessions, depending what I need, supposedly. And that's supposed to be enough. But when you're, you know, when you're in that age, and you're supposed to be fighting this new era in your life, I don't know that three to five is enough. And I don't know if the seniors know how to detect the need for counseling or the need for support. So I think it should be embedded in in the regular checkups. I think it should be embedded in in some of the activities that we do with them. And the office on Aging, for the most part helps a lot. But the help is at the senior centers again. So maybe extending the benefit, not only a help nurse for checkups, but maybe having a behavioral and mental health nurse, perhaps extending the services to them might be helpful. I don't I think that that's what it is those those are the barriers, I think it's more money, or location, and then capacity.


And what about the barriers that exist to see an improvement in the respect with respect,


you will hoping you would think that Orange County has realized that we need to mirror that culture that the cultures and the people that we serve until that happens, we're still going to have that problem. And that's the barrier. I don't think there's there's enough of us out there that can actually handle right all the services. I can tell you that. When I came I used to run the Santa Ana Senior Center. And when I came to the Santa Ana Senior Center, we had about 35 people coming in regulars and a few stragglers that will go once a month or what have you. Because being gospel, it's it's fun. It was fun for them. That was the one activity that that actually invited people to come in. But I realized you know there's there's a lot of young seniors that want to exercise So why not put a physical you know, so look like we're doing right now that needs assessment needs to be done actually inside also. And if you go right now, we tripled our attendance in one year. And the reason why is because one, I spoke Spanish, immediately, all the Latinos in Orange County came to me, because they wanted to have somebody that spoke Spanish that resemble who they are, who they were. That didn't mean that others left no, one of the biggest things that I realized is that we had a large Chinese group that needed somebody that spoke Chinese. So then I partnered with the Asian American Senior Center to provide that service, and Vietnamese communities as well. So we had Vietnamese, Cambodian, Chinese. And what I did is I actually partner with them, instead of hiring somebody, I partnered with them so that they could provide services, or at least have activities inside the center, a couple of days a week so that those seniors felt like, Oh, we're doing the next step, we're taking an extra step to accommodate them. So I think, the minute that mirrored throughout Orange County, I think that's going to make a big improvement in the in the level of respect, because the the seniors feel like, okay, they don't respect who I am. Therefore, I'm not part of this. And that's why wherever you go in any senior center, you will see the lack of connection. And so, you know, that's how we can improve.


I think funding it's a big barrier. OCTA, once upon a time, and I'm talking about, I want to say 2005, at a special grant for senior citizens. And what they did is they actually allocated a certain amount of funding. And they said, here's this money. Office on Aging, decide what you're going to do. So some of the senior centers said, Give us vouchers, or seniors love to have vouchers for taxi because they walk. So Huntington Beach, for example, had vouchers. But here in Santa Ana, what they wanted was the ability to go to the supermarket and the ethnic supermarkets and shop and then bring them back home. So what we did is, with the money that they gave us, we actually adapted to buses, to small bus buses. And we hire drivers within the city. So that money that was allocated, you know, we use it for that. So we had trips to the market, we got trips, if you had a doctor's appointment, that was nearby the supermarket, we will drop you off, go to a supermarket, and then come back and pick you up, that kind of thing. I think the barriers are actually, once again, doing a needs assessment within our local groups, and look Abrazar is one of the services that came came up to be very helpful. Because they provide, you know, transportation to the senior center or to their centers. But also if you collaborate with them, they will bring them to the Senior Center, the active senior center. I think it's I think it's in the orange, where the the sidewalk, it's light up, and then the crossing path. Wherever there's a senior home, it's also it has a light so that it gives an extra safety, you know, measure for seniors, just things little things like that. I know. The challenge is it's the investment but I think if if we find out that that's a big need I think all of us could put together and make it happen for them.


Yes. Unfortunately, those who those who are generational savvy, right, those who have been in the United States for more than for more than three generations, they have no problem communicating, they have no problem accessing benefits. And fortunately, is those that are new, that do not have access the benefits nor the programs, nor the level of respect that they deserve.


And the what and the mental health and, you know, behavioral health and mental health area, do you feel there's any differences and experiences for different groups,


same issues, yeah, sometimes lengthy language barrier, and just the capacity to know where to go, and what to access the benefit. Again, the seniors who are new, newly retired, or newly in that, as a senior, they don't know where to go. And usually they're dependent on their adult children to do research. And so sometimes that, unfortunately, that adult children are living their lives. So they cannot do that additional support, you know, believe me, I'm getting afraid. I'm going to be 55 this year, and it's scary. It's like, Oh, my God, you know, I'm getting into those years, I better get ready.


I think we need to look at the programs that are in existence. We need to bring those who interact with the seniors day in and day out. So again, utilize those avenues. I think that will be step one. Okay.


See, that's a little bit more challenging. Because it's easy to pull the data and know how many ethnicities we're serving. That's the easy part. The difficult part is finding partners that can help bring services for the that are cultural savvy, that are by bilingual right, and that understand the need and know how to find solutions. Again, there's a lot of a lot of nonprofits that are doing a lot of that work. But I don't think there's anybody, there's something connecting them. And I know there's multiple meetings and levels, but some of the nonprofits that are out there. Seniors are not their priority, usually is youth. And I'm talking about the the ethnic agencies, their youth or they're young, a young adult or adults, but they're not focusing on seniors.


Again, I think those who are somebody in charge, right, have a of transportation throughout, need to sit down and look at the capacity up making. Like even modifying some of the routes or modifying some of the services so that they are more senior friendly.


Now, this is going to be a little bit difficult because I want you to give me info on access and adequacy and access for various senior services. So please describe how accessible and adequate each of the following care or services is in Orange County for older adults. Yes. So one is geriatric care. Two was long term care. C is mental behavioral health and substance use treatment. And four is human and social services. So again, one is geriatric care to as long term care three is mental, behavioral health and substance use treatment, and four is human and social services. Now adequate and accessible are each of the following services.


Um, I think direct directly to help that I can say, geriatric care. It's one of the easiest out of the four because of the Medicare. You walk in and you have Medicare automatically. They know you're a senior, or you're you're a special needs individual. So I think that helps. And there, is there enough care, I don't know. Because one of the things that I've seen, and don't get me wrong, I just think it's business and the business communities out there for profit. One of the biggest things that I've seen is that seniors constantly change their provider. And every time they change their provider that the new provider gives them an incentive. And the provider also earns, right because they got new customers, but the seniors don't know how to evaluate one program versus the other. So the level of care. I really don't know, because I see this happening constantly. And some of the seniors, you know, these are the complaints that I get, Gloria, I need you to help me because these new doctor won't give me the same medicine that I was taking. They want to give me the generic form. Oh, because my new insurance doesn't cover my old doctor. Oh, because they were gonna give me a little gift. I'm like, Okay. Yes. Bring it bring the information. Let me read it. And you know, you cannot change again until the following month. So for that month, they're stuck. And it happens so often. And I think we need to look at that, too. So. So yes, the characteristic geriatric care is available. I think that's, that's the easiest one of all of them. Now, long term. There is care out there. But you got to look at the facilities. And one of the mic counseling to the adult children, when they had to make the decision to turn their loved one into a long care facility. I would tell them, look, smell, listen, right. And feel. Don't say much. But use your other senses. If you walk into a long term facility, and he has a foul smell. And I will do tours, just to actually grade a few so that when I recommend it, I knew what I was talking about. And I kid you not. There's a couple of them that are very, very successful businesses because they're always packed. And you'll even have to wait in most doctors recommend them, but I wouldn't want my parent there and I wouldn't be now that I'm getting closer to the age, I wouldn't allow my children to put me in a place where it smells. Or is there support systems around them, right, so that they can not just give up and be in bed, but they can remain semi active, as much as possible. And I even said, feel, because one of the biggest things that I've seen is also, you know, the capacity of getting information for the adult child to make that decision. Sometimes there's no, there's a pamphlet, but it doesn't have concrete information. And so you need to feel it, you need to touch it and see it and read it and ask questions and have that assessment ready, you know, to make those decisions. So there are there are a lot. There's lots of long term facilities, not all of them will be some that I would recommend. And I think the county should do some visits, surprise visits, to kind of find out and base it on that if you open the door in the minute you walk in there smell, there's something wrong because somebody is not. And I know accidents happen, especially with seniors. And I know most of them. When once they make it to a long term. They have to use the adult diapers and all of that, I get that. But if the facility is really clean, they keep up with it. Because there's facilities that are amazing, and that you walk in and it smells beautiful. And it's not that they're the smells are hidden. No, it's just smells really good. And you can see that it's clean. That's the kind of level you know, that's how I was grading it. So I know I'm being extremely honest. But that's that's how I feel. I think it's very important news.


No, please continue. Now I wanted to go back to geriatric care, because you think that it's adequate. You said it's accessible.


I don't think so. And it is not adequate to the amount of seniors that we have here. And there's a senior tsunami, I heard this a couple of in a couple of meetings. There's a senior tsunami that's coming on. Yes. So yes, and we're not ready. I don't think we're ready. I don't think a lot of our doctors are ready for what's coming in. And especially because this new wave of seniors that are coming into the senior population, are going to be the ones that have been exposed to the social media and the advances in technology. And I don't think that I don't think the medical community is ready for that.


Thank you. How accessible first, and then adequate,


It is nearly impossible to find support nearly impossible. When you ask for something like that. They refer you to triple A and say, Oh, look at their listing, or I mean, a look at their listing. And you're like, that's not what we need. The senior doesn't need that. 12 steps. Well, some of them do. But it's a mixture, but it's medicine. That's where they're getting their high. And now again, these new wave of seniors, we have been exposed to the benefits of cannabis. So it's a different level of needs that we're going to be having.


No, to be honest with you, I will always refer them back to their doctors. So that the doctors can actually suggest a program that one is covered by their insurance and two that can provide the services immediately.


There are not as accessible as they could be, and are not adequate, because they do not provide services to underserved communities. And I talked to you about the language and cultural detachment. Let me let me say something about the substance abuse. Because this just happened and I want you to go, I know me and my stories, but the senior lives by himself, rent, rent and garage. Okay, so he lives by himself, rents a garage, get socials, Social Security. So that's how he's able to survive. So he was drinking with his friends, they run out of beer, and he's driving, he's still driving. He's 78. He's still driving. So he volunteered to go to the liquor store. The next phone call that we get, is the son calling us asking for help, because he drove through the liquor store, because he was that drunk. So he's taking his meds he's drinking, he's depressed, of course. So there's mental health and all of these needs. Now, I'm laughing now because the son doesn't know what to go what to do. He called him and he asked, please let me call my son. And of course, PD allow him to detain him, he's going through the DUI process. And yet, no one has stepped up to give him help. i We don't know. We don't know what to send him, where he's going to feel comfortable, where they're going to talk to him in Spanish, where they're going to be able to tell him you know, if you mix this medicine with alcohol is not going to be pretty, so you'll get drunk faster, or what have you. Anyway, so he's been with his social security check. He's paying all the fines, he's going through all the classes. So you know what that means. That means he's not buying something. He's not buying, rather than food, whether it be food, or rather be medicine, but he's not buying something. So now, there's no additional services to prevent this, because the easiest remedy will be take away his driver's license. But then the guy will not be able to be mobile, though, when he sober he can drive. He's responsible driver. The problem is that mixture, right, so


So you know, that's the story, because I hear it often. You know, I hear it often, and especially for the seniors. And yeah, I mean, his his ability to, you know, move around and drive as he's older is less. So then when you mix it with alcohol, and you know, medication that's going to even be more impaired. You know, his reflexes may not be as fast, but he's still responsible without that, you know, the other elements. Yeah.


And he's an asset to other seniors. It takes other seniors around. So yeah, so in the social services, I think, I think one of the biggest and most successful program in the social services arena, is the food and commodity program. I think that reaches a lot of seniors. And that should be a connector to other social services. Again, I think as you give him a box of food, you can actually have some intake, have him sit down just like the web, what is it the wick, you know, how they give food to parents, but before they get give them a box of food, they actually sit them down and talk about nutrition and talk about you know, they have additional classes going on, without the parent knowing that they are attending a class, you just get there and you sit down, and therefore your captive audience, right. I think the seniors should do something like that, to promote you know, activities and socialization and social services that are available that seniors might not know, in just just one city in Orange County, in Santa Ana, we have seven senior living facilities, okay, these are active seniors that live on their own. Most of them have companions, you know, like in home support services that go in and, and, you know, clean their homes or cook for them or what have you. And they are connected to a senior center in the city, but not all of them. And so I think somehow we need to connect those seniors to whatever else is available. Okay,


I think I think the biggest challenge is going to be inclusion. I think we forget, forget about them in a lot of conversations. I think looking at everything, this is the first time that something like this has been done, and I think is long overdue. But I think you know, they're not included in the long term conversations. I know the county does, because, because we have to, I'm sorry, because there's budget for them. There's allocations for them, like, look, any government in the city government, they're not thinking about seniors, they're not thinking how to surf. They're looking at what they have, and they think it's enough, because they're checking a box. So I think inclusiveness is going to be one of those big, big challenges. And right now, there's there's three, four words that that are very popular, and it's diversity, inclusion and equity. And those three are going to be the biggest challenge for the next senior wave that's coming in.


In your opinion, what do you think government's role should be in meeting the needs of older adults in Orange County,


I think we have pay our dues, I think it's time for for for them to care. And these are seniors who, again, the new wave, it's gonna be so much difficult, because I think we're more outspoken. And we have the technology, at least we know about the technology. But I think that's why the challenges are going to be there because it each local government should acknowledge, right the same way they look at youth the same way they look at adults, the same way they looked at other, you know, groups, they need to look at the seniors that are coming in into their cities that live in their cities, that still pay taxes in their cities, and that, you know, vote in their cities, because the seniors are one of the highest population in the elections that actually vote. So we need to look at that. And it's all seniors. And the only reason why they got together and made that a CD of seniors. It's because these are an ominous. I hate to say it, but these are the English speaking, strong, educated, and somewhat. I want to say wealthy, but not wealthy, maybe secure,


economically secure. That's why they became a city because they, they were able to interact and actually create that notion. Look, that's going to be a challenge for all of us, because we all want to we all want something like that. And what's happening right now, in the seven, just just one city, I'm telling you seven buildings full of seniors, and they're detached, they're not connected. And look, I know that the Office on aging does an amazing job at least tries to do an amazing job. I know that the number to call and make a complaint, or make a report. It's now in multiple languages. That's not enough. The Office on Aging, they don't know. No. So it's that lack of connection. We're not telling people who we are. We're not promoting who we are, and Health Affairs and information affairs and all that good stuff. It's good. But it's only a bandaid. It is not enough. We need to make a stronger effort to connect the community to the services.


Now thinking about all the older adult residents in Orange County, who is getting the least amount of attention,


unfortunately, are Latino, Hispanic so seniors because they're not in in. In that big, big mix. Majority of Asian American seniors are connected to Senior Centers. The Latinos are not because it's the grandma and grandpa who live at Home. Yeah. So they don't know. They are the underserved, that truly underserved. Okay.


Again, that sense of dignity and respect. I think one of the most successful programs I've ever seen was the senior work program. Imagine the Youth Work program, but with a senior emphasis. They can lift, right, they can push, they can pull, you cannot have an overwhelmingly mop or sweep or nothing like that. For a couple of hours, because that's all what the program tells you used to tell us, we could not work them more than three hours, because that was the capacity right that they had. But it was so nice. One, having everybody applied, very simple application, they will dress up for it, just you know, and every three months, you will do an evaluation in you'll have to let go of that senior and hire new one. Because that senior needed to go somewhere else. So we can rotate it among programs. Wow. For me, that was the best program ever. Because the senior will dress up, bring the level of responsibility. They knew what they had to do in the receptionist. Assignment, they always have to smile, welcome, everybody, make sure everybody signed in. And they became friends with other seniors. So even though we have to rotate them out, that senior will come back, they will go work for our somewhere else, and then come back to the senior center because they knew everybody. And then I want to be a volunteer. I want to be a volunteer because I know everybody. We had, you know, the other job assignment was the coffee. It was only 24/25 cents a cup. But the person had to be there, set up their coffee, make sure that they had cups and sugar and cream and whatever, and be in touch with the money and walk around with their coffee pack. Would you like Mocha, that kind of thing. It gave them that dignity, to say, oh my god, I can work still, because I do a good job. And look, some of it doesn't have to be paid. Some of it can be volunteer, because one of the biggest programs that was very successful was with the Santa Ana Police Department. We had some seniors who were trained to be intake workers. So when you go to the window, if you I think they still have it. The people that are sitting there are volunteers and their senior volunteers. But they work for the police department Imagine that. And they're there to say good morning, you have a ticket, what is the purpose of your visit, and then they will just guide them. If you're here for ticket, got that window if you're here for this cola window. I'll find out that as easy as that. And the police will give him a nice official shirt. And to for them, that was enough. Oh, I can go to the dance today because I have I have to go to my job with a police department that is dignity. They belong there still, they feel that they are doing a good job. They have that sense of pride because they're putting all of their skills and their knowledge back into useful you know, connections. And look, we have so many programs. Why are we not utilizing them at the libraries. Any any government office shall have a senior greeting everyone that walks into that office. I know I know it's an extra it's an extra level of work. Because some of them need a lot of loving, caring and they're gonna have a million questions. But I think that's that's what we can do for them. Let's bring that back that dignity back


Well, thank you so much for scoring. Yeah, this concludes our interview. Thank you so much for your time you have been incredibly helpful, especially with all your recommendations to our research. And if you find that you have anything else to share, please feel free to reach out to me to contact us on either through our website events oc.com or you can leave in an anonymous voicemail on our telephone line 949-415-6898 at anytime.


Once again, I will stop sharing and stop recording now


Sounds good. So the primary goal for today is to identify what needs do you think are most important to older adults, the older adult population you serve. And that's defined as those who are 60 years and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their communities. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And please take a few minutes to read through the list and let me know when you're ready to begin. So I will share that list right now.


Yes, yeah. Okay, I can see it now. Cool.


So for our records, can you please tell us your role and how you interact or engage with older adults.


My role is program manager at HOPE Commmunity Services, a nonprofit organization. And my role, the tasks that typically, my role is to support other program manager who leads in the senior programs, and I help support him through, you know, giving feedback with the senior adults and including our ESL citizenship classes, our food pantry, and our other community workshops and programs. And I also have direct day to day contact with the seniors. So every day whenever they need help, or whether it's through the program that interaction or just like when seniors come after the church. So that's how with the seniors.


Um, no, I think this covers a lot of what impacts the older adult.


Thank you. And other needs on the list, Please rank the top three that you feel are most important.


The top three I would say are the diabetes and obesity. Just because of the population I work with, it's primarily Vietnamese, so a lot of the foods they eat. And I would say that diabetes and then nutrition kind of go hand in hand. But diabetes first, and then nutrition, basically access to nutrition, and food, and then healthcare access. Thank you. Yeah.


So the next set of questions will be related to these three that you listed. So we'll go through each of the three needs that you listed, and we'll go through all the questions.


For the diabetes and obesity, I think I was weighing heavily more on the diabetes and I feel that if they don't learn about the foods that they eat early, then later on it kind of carries with them like the habits and the patterns. But then on top of that a lot of the foods that they're used to, as a child or like growing up, especially if they're from a different country, and then they come here. And they're, their probably foods are being made differently, or they have access to different foods, then they don't know that if they don't kind of take control of their health or like, know of like, you know why eating too much rice isn't maybe too good, or those little different, like rice cakes or different meals or having too much salt in their meals like that can affect their health.


was the first one. Okay. Yeah, yeah. Okay, for the first one. Specifically, diabetes,


or diabetes, it's information education on it. And the barrier there would be language, so or language and then also understanding so sometimes that you can educational information on diabetes is translated, but the community members might not understand. And another barrier would be kind of reluctance to change their habits. Or maybe they don't feel that it's that big of a need, or they're ready so old, that they don't want to like change their minds. Maybe they feel like it's too late. And probably like for checkups, or it would be like even deeper dive into kind of maybe transportation like getting to the checkup, or maybe they don't know, or maybe they have symptoms, and then they're not really sure what to do, or, yeah, but I think overall, a little must be a major barriers, probably just, that's how they're living their life. And it's hard for them to like, change it. Yeah.


Yeah, I think most definitely, probably where they live, if if they're kind of surrounded by same culture or like same environment, or they lived there all their lives, that maybe that's how they will kind of view their health and then definitely, like transportation, where they live and where they can access. Yeah.


I think, first is education and seeing how it can be how it can be addressed in an easier to understand way and also to maintain like a cultural competency. I feel like a lot of health information mostly is kinda like black and white, where this is the information, this is what you should do. But maybe it might look differently for either different culture or even different older adult. And then after that would be sort of like so after all the information like what to do then diving into that action plan, like seeing, like assessing how, where they are right now, and how things can be changed if it can be changed and definitely like following up having to make content follow up, whether it's teaching the like a family member to follow up or making sure that they check up with the doctor.


Yeah. Thank you. So now moving on to the second topic of nutrition. So I'll go through the same questions.


so kind of already talking about, I guess like foods that they eat. A main thing about nutritious food is probably like access to access to markets, in places where there are healthy and like affordable food options. And not only that, but there are like certain foods that maybe they are used to eating. So then even when they have access to the nutritious foods, or groceries, they might not know what to do with it, or they might think it's unfamiliar, or they don't know if it's like healthy, or even if it is healthy, they want something that's good. So I feel like that is kind of the issue there.


Yeah, definitely. And I think definitely, in terms of social, social economic status, and also like who they're with. Or are, provide them with food or things like that. So I think that there are definitely different experiences for those older adults.


I, again, like advocating and creating more of like marketplaces, it targeting certain areas where it might be a little farther for so like, if there is like a section of a bunch of older adults living probably either in like an apartment complex or, or if there was like data on where there are certain crowds of older adults, like making sure that they have access to a market with familiar foods. And if not, and on top of that, like education at maybe a community center, about why it's important to, to have nutritious foods, and maybe like how to cook them or, you know, a lot of different cultures, they can like food is their main source of social comfort as well. So like maybe getting them together, and eating once a month or something like that. Yeah.


Thank you. And we're the 3 need now that you identified, so thinking about health care access, How or why are older adults struggling with this issue.


For health care access, I feel that most of the older adults are aware that, you know, they, they're getting older, through my interactions with them, especially when we host like health fairs or do health related workshops. A lot of them are taking medicines, and so they know what to do. But I think that there are still a good number of them who are not sure what their insurance covers, or are not maybe remember to go to their annual checkups or go to go to the doctor when they need immediate help. Or if they see like some symptoms, a lot of the time, older adults, they might not know what to do next. And then I would say that another main issue is transportation and getting there. Yeah, that's all I'll say for the first part.


Thank you, and what barriers exist to seeing improvements in this area.


So transportation, getting to the appointments, sometimes when you family members can't help get them there. Or taking the bus, maybe they're unable to on their own. And with that comes with the high cost of insurance. Even if it's available to them, there still may be extra fees that they don't know, and it'll come back to them. And also language barrier. If If an area is kind of crowded with everyone who's the same from the same background in terms of culture, then it might be hard to get doctor's appointments. And also like the quality of the service might not be as good as others in terms of health care and health insurance. So that's also an issue for or So those are all barriers, I would say. about health care access.


Yes, yeah. For for sure in terms of having the family support versus older adults who live on their own or have to get to these appointments and older adults who maybe know more English versus those who know a little bit to get by and those who are monolingual. So and with that is why it might be hard to make the appointment or even being scared of going. In every all I feel like all older adults or people in general, they just have different perceptions of going to the doctor. So they might be fearful or may not trust them or trust them a lot more. So. Yeah, those are all the different experiences I would feel.


Again, I think it starts with education on health insurance, a lot of older adults, well, all the old orders will fall into the under the Medicare medical, but I guess, how to navigate it. In making sure to, like translate all that information and make it understandable, and kind of explaining why certain checkups are needed and why it's important in a lot of the awareness with transportation to to make it like whether it's through other CBOs or just like county grants, like being able to have that transportation for them specifically for getting them to like the certain health appointments, making it easier for older adults to get there.


Yeah. Yeah, thank you for sharing. So that is it for the list. There are a couple more questions, but I will stop sharing. Okay. So the next question goes through a list of different care services.


Yeah, I think it's, it's pretty, it's pretty accessible. It's just in Orange County, it's just the matter of finding it. And I think in Orange County, we're really lucky to have a lot of organizations that are based on culture and based on certain needs, but I think the difficult part is seeing as part of the older adults to find those services, the ones that when when they find them, or when they're able to refer to each other, then yeah.


I don't have too much knowledge. I will say that


feel like there's never enough with mental health. And especially for older adults. I, you know, like, I do know that there are services, but again, or not again, but like that, there's the problem is that the older adults aren't using them, or maybe they don't find a need. And so then, therefore, I think there could be more. Yeah.


I think there's a decent amount in Orange County. Yeah.


I feel that. I know the 10 years is like really big change. But I think that there will definitely be a need for more of those mental health services. And I feel like a lot of the health care needs will catch up to them. So to me, it's like very important that we know this now, or we tried to. I mean, there's so many issues that could face older adults. For me, it's definitely the health and behavioral health, and trying to pinpoint like patterns that are happening now and maybe seeing the support that those other adults in the future will need. And then the upcoming group of older adults, like, what they'll be facing and being ready to kind of help them with that.


I think the government should definitely kind of make a better plan a budgeting and seeing who was actually doing like the work with the with the older adult population, and allowing them to because of a lot of the time the ones who are doing the work, have the relationship with our adults and or maybe have a connection. And, you know, it can be just easy to like, throw money somewhere and then open a program and saying that we ran a program, but it's way different than actually making the effort to have older adults come to the program, and actually falling through the like, did that even work, because a lot of time, it's just like we do things, but we don't really see the result or are able to know that it helps like that's the best we can do. I think it'd be helpful for the county to kind of just let the ones who kind of have the expertise and the knowledge, run these programs and be there for the older adults.


So I think, to answer that I'll say like, the most is a lot of the older adults and the kids. So right in the middle kind of like the gray area of people who kind of need support, but maybe they don't fall under certain criteria. So I would say like, middle to old adult, and then the young youth adult population.


Thank you. And thinking about all the issues facing older adults in Orange County, what issue is being overlooked


It's hard to pick. But if I would have to say I think the issue being overlooked is older adults who are being left alone, and then that could that kind of is as simple as like the neglect and and with that, like the ones who are living alone, there seem to like be to do things on their own. But that's not always the case. And so like, therefore, I think that they also need just as much support as other older adults who maybe have more economic status, or they have family around them like that. Those are the ones that are being overlooked.


Thank you. And so in addition to what we've already talked about, let's dive a little deeper into your, your area of expertise. So we have HOPE for protection from poverty and hunger.


Um, yeah, at least one of them. But the thing is seniors Yeah.


Yeah. So one of our programs that one of our main programs that really aid with this is our monthly distribution program, and we make sure what's working for is that it's cultural competence. So we have like Asian dry food groceries that we package per month. And right now we have about 125 to 130 packages that we distribute every month and older adults who want to sign up. They sign up as needed they can come with any month and we kind of track them for data through. We give them like a card name card. And that's been working so So far in terms of what we're able to pass out, and, you know, we have, we've had good feedback. But obviously, I think what we need is more of a bigger capacity, because right now we're being held by one, one program manager in charge of that program, and volunteers. But we kind of only do to the extent of our capacity, and with every month, we kind of do bigger. And so that is tackling the hunger part. And we also allow, like, anyone who's homeless also come in as well. What's we what we can work on. And of course, it's like with, if we have, if we could build a capacity, we need to work on building capacity, and also figuring out a way to kind of solve far unreached people, right now we kind of have a radius of just our surroundings, or whoever is able to come. But if we were able to provide a transportation system, or offer those services, that would be even more beneficial to the community members who utilize our service.


Yeah. Yeah. Um, I feel that, um, in terms of for policies that I feel need to kind of be revised is probably.


I don't know if this would be under but like, just how kind of the support in terms of food and nutrition like food stamps, or like the EBT cards, like, how or and then like, the whole, like, CalFresh Cal benefits, like applying for that. I think making it a little easier for older adults to understand there are some that are still like, Hey, can I use this for this, and like, they don't really know. So I guess, like making sure that the language is easy to understand and also translated, and maybe making sure that they kind of have an idea of where they could go in, or making sure that the places they can go are culturally competent to their palate, and what they're what they're kind of familiar with. And then also, I guess, like, more. Having better accountability for the places that do provide maybe free food services or packages, that there are more places that have different culture, like variety, our, or if a place offers it, like kind of having a check on like, like, is this familiar to them and more like explaining, like, explaining, if it's new foods, like explaining, like, Hey, this is we're changing it up, because you know, this is healthier. And this is how you can make this or try this food, because it might not be different, but it's still nutritious. So like, really making sure that we're not just giving older adults, or people food, just extra food, or like, hey, here, food is food. I think that that's good. But the next step that I would like to see is like, Okay, some sort of quality or some sort of meaning to it, because I feel like everyone should have good food to eat.


Yeah, and who or what entity is best suited to address this issue.


I'm, of course the county to, you know, for more money for, you know, existing food pantries. And also see, kind of like so so the county to, for that to help the food deserts and food pantries. And then pantries are like people who distribute food or like marketplaces to kind of collaborate more with other organizations so that way, so that the ones who are producing it, who are able to have the resources can kind of speak with community members and then vice versa, like community organizations, I would refer out to different places.


What's helpful is in terms of the programs we have is tracking like where they're from, like zip codes, all the time. And even from from the census data, like if we were able to see those those would have been helpful in and also data in terms of like their housing or where they're located is helpful. And also in seeing where, if they're available markets or like restaurants around them, like that's also would be good to know. And another thing with the housing is maybe like household size, and like some of that some of that information will be helpful.


Yeah. I would say if not already. A SCSC Abrazar they work a lot with seniors for poverty and hunger. Anyone who is involved with food, and also probably like housing, so there's Meals on Wheels. Hope through housing. Those are just some examples and and definitely any senior citizen or older adult organizations. Yeah.


Thank you. So, this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. And if we find if you find that you have more to share, feel free to reach out to us our contact information is available on our website, and that's WWW dot advanced oc.com or you can leave an anonymous voicemail on our telephone line at any time. So I will stop the recording now.


So the primary goal of today is to identify what needs you think are most important to the older adult populations you serve. That's defined as those who are 60 and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to begin. So I will share my screen now.


Yes. Okay. Great. So please take a few minutes to review and let me know when you are ready.


Yes, so my name is Alejandra Lupercio. I'm the Vice President for social services for Meals on Wheels, Orange County. And the way we serve the current population is that we currently have different programs. One is a congregate meal program that we serve just about 23 sites, congregate meals for all our senior centers in the northern and central County, Orange County.


the center, so we have a partake in that as well. And then lastly,


I don't have a direct oversight. But I know we do interact with the adult daycare centers that we have really three across the county as well that we're currently serving.


Thank you. And thinking about Orange County and looking at the list of common issues and concerns affecting older adults.


The The only thing that I would be the only other area that I would that I would see and this was related when I was in nursing home administrators probably legal counsel, you know, those that are able to provide some type of aid for kind of directions on how to provide resources probably end of life planning. Yeah, and just just more. The way that I will see is that is that how is it that they're able to get these resources


in time, right, as opposed to wait to the last moment.


Three that you feel are most important and that includes the ones that you just mentioned as well


I'll say that and that's what makes it a bit a bit difficult because you know they can be kind of interchange depending on the person so.


and also behavioral and mental health. Thank you.


Thank you. So the next set of questions will be going through each of the three that you just mentioned.


Sure. So thinking about emotional well being how or why are older adults struggling with this issue.


The way that they're struggling with this issue is is also something two different factors, I would say trust is number one, trust is, is an arena that I would say that when we interact with individuals at a certain point in their life, right when sometimes, you know, and again, I probably based on nursing home experience, and also experiences that I've had in centers as well is that these individuals already have a life, and they've gone through other experiences in life, and we're just trying to get, you know, have a sense to kind of understand where they're coming from, because we don't have much time with them. So in that sense, creating that trust with them and being able to, to understand what their what what they've experienced in life, what the current family situation is, how the community is how they interact with others is, is, is is very, it's very different for each one.


and that and that takes time, which means that if we don't, if we don't reach at a point, then you know, we're losing track, which causes the individual to, to, to decline, you know, not have a sense of willingness to continue with life, not wanting to eat, you know, just the sense of just kind of just wanting to kind of give up. So that, so that is intense, will probably be trust. The second point that that comes across is also having having an understanding of what you know, what is available to them, having that available to them, and having that understanding of what they're able to, to, to get, you know, resources, you know, how they can, how they can interact with others. You know, I think that's a very important portion of what of what also contributes to emotional well being is to get that at an early segment to get them involved in an area to make it easier for them to have that, that, that exposure with others that sense of trust, that sense to kind of expand and that's and that's what I feel, you know, that that makes me


throughout life, and sometimes, you know, individuals outlive their, their actual siblings, you know, and you know, and that's in that,


that kind of comes about. So not not being involved in not having that, that understanding to know what the information is available for them beforehand is very critical. And then by time it happened, and they need someone, either it's normally family member or word of mouth or something that comes out, but it's not really explained to them. So they're trying to get to it as quickly as they can, which was also I mean, if they feel already, in a sense about being empty by not having anyone, this is, you know, this just makes it harder, because then we're, you know, we're having to create, you know, there's forms to fill out, there's, you know, there's a lot of things that, you know, as people get older, they don't want to figure out how to how to fill out all these forms, you know, they, they just want to get the service done, so that way they can benefit themselves and, and if they feel like they don't have that, then you know, then then you start losing, like the quality of life.


For the emotional well being, yes, I think I think a much stronger support effort has to be done to to educate our oncoming population, if we know that our incoming population is going to be over 60, by 2045, where you have I think, I heard it was maybe one in three, or like one in four, especially like in Orange County, that the amount of people that are going to get into that population is going to be coming at us pretty quick. And I That's a, that's a very important factor for us to get a head start for us to teach our younger generations even, you know, even those that are younger, in, in, in schools, you know, just to get the exposure, because they all come in different dynamics, and there's no, there's no one way of, there's no one simple cookie cutter, that that makes it but but but we have to get at all these different components, and involve all age groups, and have that exposure and have a very strong understanding, we have to make that process simpler, we have to make it a lot more reachable, a lot more attainable for them. And, and we have to gain their trust, we have to gain their trust in in some type of effort in order for us to have that interaction that we're able to be able to, to take care of these individuals and, and provide these means to them in a timely fashion. Because if not, it's just it's just a recipe for for increased costs for increased health care costs, you know, and it's just a cycle, that, that unfortunately, a lot of our population, you know, is is getting into, you know, they just go through that cycle where they're going from home to nursing home to, to hospital system rotation that makes it very difficult and very, very difficult for for, for a population to handle, mentally. So, on top of that, I see that we can do better in emotional well being.


Yes, culture, cultures are also very important because they're all different, right. And again, I emphasize back as to being able to help, you know, I've, I've had a lot of families that help language barriers, cultures and food, you know, things that they used to do at home, you know, and, and it gets, and it gets, and it gets very, very frustrating for some of these participants or clients or patients as well, you know, just basically just kind of our population that, that, that once they lose that ability to perform a task, mentally, they, you know, they, they have to overcome it. And it depends on their posture, right, how they grew up, what their culture is, but if we don't have that connection with their culture, in that sense, whether it's food, you know,


just being able to talk someone kind of in your own language, you know, and then, you know, we, we lose that sense of, of ability to again, gain their trust, being able to kind of speak to someone, you know, have a sense of wanting to move forward and just continue with life, you know, that, you know, those are the things that I felt that, that, that that culture has. Food is going to be always a main component. It will make people happy. It will make them frustrated. If they, if they don't if you put something on their food that they don't like, we all, we all kind


of know about it, and we're, we're very vocal about it.


a type of meal. And then we're just kind of moving forward, I feel that we have progressed quite a bit. And I would say from from from our from our goal organization years that I love to be very active and have comment cards and have suggestions and changing up the menus and doing things that are different, and also particularly cater to the, to cultures, you know, and that's something that, you know, that we do introduce is that we have Vietnamese meals that I felt, you know, that we're that we're trying to focus our attention on the Vietnamese population, but also incorporate an Asian meal, changing it up a bit, you know, and just, you know, have that expanded upon, to, to help kind of solidify at least one component of it to help get things kind of moving along.


That's a very good question, I think there has to be a system that we're able to be able to touch each one of our population that's going into we need to have a system in place that is already working with those that are in need, maybe then that is identified maybe in a


in the hospital setting or some type of arena as to how, how the projections of the population is going to be looking like whether we can have an address by by,


Normally nursing homes will be looked at as those that are 60, over 65. And over and more and more and older. Now.


contributes that happen to them, whether it's mental health, behavioral, there's medication, there's change conditions that happen, how they grew up, you know, food and nutrition, you know, they they're all kind of correlated and all,


all at the same point, you know, reaching reaching these individuals, which which are causing, you know, causing harm kind of, to themselves. And now, and now you see that the that the average age of someone coming into a nursing home is younger, it's not, it's not 65. And older, now it's 50 40, I've seen some that are 30 that have made that so there has to be a way for us to, to get a head start have have a good way to to somehow project,