I think addressing it, calling it out. Ensuring that Orange County is communicating with those who are entering into their golden years and those who are caring for those in their golden years. That emotional well being is critical. The mental health of a senior citizen is critical. And there are certain hygienic mental hygienic practices that can be implemented to help stave off loneliness and isolation. There are venues that are warm and safe and welcoming to people who are senior citizens and let them know that there's a plan for them, that they are valued and needed in our society.


Well, I think about some of the members of our church and unfortunately their children are not in the home, not as not visiting them as frequently as perhaps the senior citizen would like. And then there are some physical limitations that the senior citizen has or can have, that would hinder them from being able to get out as much as they perhaps would like. So they would perhaps rely on someone coming by to visit them. Is this person going to, you know, care for me, and be honest, and not try to take advantage and perhaps steal items out of my home or steal my identity or, you know, get access to my bank account. And we've heard terrible stories in the past of, you know, senior citizens who have caregivers that have taken advantage of the situation. So that is a real fear. And perhaps if we had some organization that is certified and has background checks that can come in and provide some kind of companionship to that senior citizen on a regular basis, perhaps that might might help.


I think there's a limit of there's a limitation of volunteers. And there's a shortage of volunteers, I should say, from various diverse backgrounds that are able to end desiring to communicate and to be a part of the lives of senior citizens. Some, some cultures value their elders and nurture and care for their elders, in a very significant way. Others don't, and unfortunately, senior citizens, who seem to require time and desire time from people are looking for the most precious commodity that people have. And they younger people have not given a whole lot of time and energy to ensuring that they're spending time with senior citizen.


Are there different experiences for different groups of older adults from different backgrounds,


different experiences, I guess, they're just like we are diverse. In race. There's diverse experiences that will cause someone to light up and get excited and others. Not so much. There's crafting, there's religious practices, there's athletic activities that resonate with different people.


I think that the best way is to devise a plan that is multi prong multifaceted with multilingual aspects to educate and provide safe spaces where seniors can practice good self care, mental health, well being classes and participate in activities that help them to address perhaps some of these other issues that can surface in their lives if they are applicable.


Now I can. You said Please describe how accessible is the and that's where I lost.


Okay, can you please describe how assessable geriatric care and Orange County


Well, um, I have very little knowledge around geriatric care in Orange County other than I have seen nursing homes and adult daycare centers throughout Santa Anna and and Orange County, but my limited knowledge is it's extremely expensive. And not all of them are as clean or staffed with people who are as nurturing as perhaps some would want.


I have no idea what what those are for Orange County.


No, I understand what the long term care is. But I don't know. For instance, in Los Angeles County where I grew up, right, I know of long term care facilities that that are near my mom. Right. But I don't know, of long term care facilities in Orange County, because I just haven't had a need. Nor have I been exposed to those places. I am familiar with one only because some of the deacons at our church visited on a regular basis. But I can't speak to anything about that facility other than I know our deacons visited and visit people in that facility.


That's an interesting question. Um, so I am aware of mental health services being being offered in Orange County, but the waiting list is extremely long. I also am familiar with the Be Well organization where there are services available for people who have no insurance and people who do have insurance on a sliding scale. The challenge that I have observed is that it's very light on diverse counselors, meaning if someone is struggling with mental health issues, and from the black community and looking for a black counselor, they will be waiting for a very long time to get served by a counselor of the same race. Also, people who speak various languages like Vietnamese, or Mandarin, people who speak Farsi. We don't have very many diverse counselors available to the general public. On the flip side. I am also aware of many, many people in the black community not being aware of services available through Be Well, or other organizations like sift where there's a sliding scale. And so therefore, they go without getting mental health services, thinking that it's just none available or the waiting list is so long that they'll just figure it out on their own or go to their church or go to a friend and try to explore other alternative solutions.


I don't. I think that human services and what what was the other one social services and social services. I think human services are available. Identifying where to go is a challenge. I know that we have online tools that are readily available, but they are very convoluted and require are training on how to navigate to get what you're looking for, in those tools, social services, I think that there are many, there's a plethora of social services available. But communicating those sorts of those events and social services to senior citizens who may or may not be on the internet, and may or may not know where to go to find them is the challenge.


The biggest challenge that older adults will face in the next 10 years.


Well, if they're a minority, I think incomes going to be a big challenge for them.


Financial financial security and in stability will be huge, because prices are going up so quickly. You know, when when your needs change from a pharmaceutical perspective, and from a physical perspective, on top of transportation costs, etc. and financial stability is going to be a huge challenge in 10 years.


Gosh, that's tough. I think that the government would do our senior citizens a service a good service by providing quality information in language in writing, perhaps by mail, in addition to digital on what what services are available and support around how to engage those services. So that they are not overwhelmed and the the pathway to to access those services is a smooth and efficient process. Make things easy for them.


Thinking about all the older adults resident in Orange County who is getting the least amount of attention.


I think the those who are refugees, and undocumented individuals are getting the least amount of attention.


Thinking about all the issues facing older adults in Orange County, what issues is being overlooked.


I would say taking a stab at it because I haven't really given it much thought before today, I would say it's transportation. Because oftentimes, when I see public transportation, there's, you know, sitting outside on a bus stop, and then they have to step up, and then they're in close proximity to strangers. And just navigating that whole experience, especially during the pandemic can be dangerous. If someone is on in a wheelchair or has, you know, a cane, that that could be dangerous for that senior citizen and they don't, if they don't have anybody to help them, then that might be a daunting experience for them to be able to get to the doctor or the grocery store or wherever, you know, they they need to go during the day or the night. So that's why I say transportation perhaps is the biggest issue that's overlooked.


Any organization that you think that we should talk to that serve older adults


I think let me think about that. I think you're already talking to Abrazar


hey, thank you. So this concludes our interview. Thank you so much for your time, you have been incredibly helpful for our research, you find out, you have more to share, please feel free to reach out to us. So you know, my contact and contact information is also on our website. You can leave a voicemail, or or on our telephone anytime as well. When I stop recording now. Thank you so much.


You're welcome. I got tongue tied there for a minute. I'm like


no worry. I'm gonna read it from the service scream. Five times still got tongue tie. You know, really good. Very insightful. So thank you for sharing your perspective.


My pleasure. My pleasure. I'm just so glad that you all are doing this. And any way I can help, please don't hesitate to let me know because it's critical. I'm Yeah, actually in the senior citizen club. And


well, you know, think of thinking about my you know, what I'm going to encounter in 10 years. It's kind of daunting, but you did ask some questions that made me think okay, maybe I need to look at long term care because I don't have children. Yeah, so my husband does but they all live in Michigan. So I don't think I went to Michigan though.


Not after you've been in Orange County already.


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 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 the list and let me know when you're ready to begin. I will share that list now.


Okay, so feel free to take a few minutes to review that and let me know when you're ready.


Sure. So my name is Yosef, followed by truly, I'm the executive director and co founder of CIELO and we serve budding entrepreneurs, particularly those from immigrant bipoc lower income neighborhoods throughout Orange County. And it's within that context that I do, we do interact with folks above 60.


And then personally, I have a mother who's


above 60, and, you know, aging parents, as well as my own lived experiences of being a caregiver of my grandfather, before he passed away, several years ago, so I think direct, professional and then personal experience. Thank you. Thinking about Orange County and looking at the list of common issues and concerns impacting older adults.


I think these are pretty broad categories that


I think anything that I would have brought, I could bring up sort of feel like they fall into one of these. So


That's something that I definitely know and experienced, is a big issue is that our elders are being inundated with mailings with calls with not as much emails and texts, because that's not their mode of communication, but through snail mail, and phone calls,


constantly inundated with like, you know, fraudulent opportunities, who you know, to win money or to support someone in some other country. And so yeah, I think they fall prey to that type of those type of activities.


Yeah, go ahead. I was just gonna say to clarify, is that is what I bring up included in any of these categories issue. Not that I can see. Okay, okay. Cool.


Okay, thank you. So other news on the list, including the one you just suggested, Please rank the top three that you feel are most important


I think that's easier for me to wrap my head around.


I guess it might fall under emotional well being but like, loneliness, depression, feeling of not belonging.


So I feel like that's, that's a big one. And then


Um, you know, didn't enroll in Social Security or sorry, like, didn't have pensions or 401, K's or retirement plans, which a lot of our immigrants fall into, you know, there's not that safety net. And so it's, it's a


it's a demand on like the family household. And so, you know, that's why a lot of our older generation lives with their children as part of the economic model.


Yeah, I guess economic security, emotional well being.


And I guess it's related to maybe what I just mentioned, but like, I think housing is a big issue of like,


Thank you. So the next few questions will be going through each of these topics that you have brought up.


Hmm. I think in particular, because as their partners, you know, age can pass if they are widowed. Certainly having a life partner, um, move on is, is challenging and common.


I think having to transition into like different housing dynamics, whether it's with from family member to family member, or from home to some group


support care dynamic, I feel like there's,


a lack of community at times, to feel a sense of belonging. So


No, we'll go back to the second one after. Okay.


Thank you. So the second part of this is what barriers exist to see improvement in this area.


forces us to have to work. And so instead of having, you know, family around to


be a part of their aging experience, are we're having to work and make ends meet. And so that leaves, you know, I think the elders at home if they're living at home with family.


I also think, like I mentioned earlier, a cause is that, as you age  your friends and your peers and your partner's


pass. And so that that becomes a very challenging


experience. And they're no longer working necessarily, right. So they don't have that work, community


Yeah, I guess one of the upsides of, of our immigrant, you know, people of communities of color, is that you tend to live multi generations together.


Sometimes that's economic or not, sometimes, oftentimes, that's cultural, but that also has like economic impact. And so I think, with that being the case,


the sense of loneliness might be lesser than those who might have means and just can't afford to


put their father or grandfather or mother or grandmother into facility. And I think there's a sense of like, discernment or disconnection from family when that happens. And I think that's, that's probably more common with people's means.


Oh, man, mary. Okay, you're getting in there


Yeah, I mean, obviously the issues, I mean, obviously a solution would be that


financially, families can afford. Our families aren't,


are, it's not so demanding on on family members to be working so that they're, you know, there's a sense of connection with family if they're living at home. I think the same could be said about those who are living in a facility and like, having their family or friends be accessible or visit often, I think,


you know, the increase in like, family engagement


is certainly a solution. But I think, how do you do that is another is another question. I think that's where, like, our economy has a lot to do with


the availability of family members and friends to be present and engaged.


And I'll go straight to that. And I think


a lot of our older population who are immigrants


who didn't have access to, you know, the benefits of retirement and savings programs, are now left in that baby boomer generation, but don't have the financial stability that


that that's a big one. And I think the cost of like, of support, so whether it's in home


in home care, or, you know, facilities, those are expensive. And so I think that creates a challenge


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


So for folks that don't have the appropriate documentation to work in this country, it puts them in a situation where they can't enroll in 401k. Right, they can't benefit from some of these, some of the infrastructure that exists for our seniors. And so that makes it extremely challenging for, again, that that particular population, I'd say, those who are,


you know, have the ability to work here legally.


Having access to 401k, 403b, some sort of retirement programs, in all sectors. And I know that more recently in the nonprofit sector, it's been orange sorry, in the small business arena, it's been something that's more


it's been more it's been required more. And there's, I think,


legislation that's, that's supported that. So I think that is, is one


and I think the ability to still earn money generate income at later ages. So for what we do, we find that a lot of people are coming to us who are above 60, who are at this point in life where they want to follow their passion or their dream and want to open up a business. So I think that's, that's a key ingredient. It's also like a form of dignity and purpose and value that and belonging right to the community. So I think entrepreneurship Small Business Ownership could be a


have multiple benefits for that this population.


Thank you. And I know you already touched on the next one.


and I obviously, I'm biased, but like that part of the reason why CIELO exists is to extend that ecosystem to the underserved populations


to become entrepreneurs and small business owners. So I think the ability for the small business entrepreneurship ecosystem to be intentional, and accommodating of that of that population is is one avenue.


And then as it relates to folks who can,


And it's, it's kind of a daunting task, if you don't have the support system to help you figure out sort of housing for your neck for your silver phase of life.


For housing, yeah, I think I feel like I might be repeating myself, but I think you know, with


basically families of color, I think they tend to


keep multi generations in one home. Because a sense of belonging, connection, community.


versus I think, are less, you know, maybe are whiter, more affluent, folks tend to have access to facilities that are, you know, well regarded. And, oh, that's the other thing. Like there's, there's a very, it's very, there's a spectrum of these types of, of


facilities, right in terms of quality. And so, certainly when you're not as wealthy, or you don't have as many resources or the means, you can find your put your self in facilities that are very substandard. And lack, I think the


the warmth, and connection and the services and customer services


from the lower and to the higher end of of facilities.


I mean, one of the things I'm seeing is like the building of ad use,


or which are accessory dwelling units, right, I think they historically would be called the in laws. And so


and that's, I think it's with that purpose of like, how do you create more housing stock in a dense place like Orange County or Southern California, and that's one way as you can build these adu issues where family or elder or your aging parents could live with you but still have a sense of independence.


Obviously, that that's more towards those who have the resources and the means to you know, even have the power


cash to, you know, develop something like that. So I think that's, that's key for folks with resources, I think, a key for folks that you know, more of our families of color.


Because they're so busy, I think having like, accessible in home care, I feel like that's still something that isn't adopted as a normal practice for families of color, because it might even be a pride thing. Like, why do we have to hire someone if we're family, and we're close, and we take care of each other. But I think both can be true, you could still


love and care for your elders and, but have to work and also want to make sure that they are cared for while you're not there. And so


I think that's an opportunity is to socialize to create more access to in home care for our lower income.


We have a few more questions, but I will stop screen sharing.


Yep. And if you would like to even elaborate on if it's, I don't think I can elaborate. Yeah. I mean, I'll just give a because I don't know, to be honest, and I don't have like a


strong sense. But I would say, access to geriatric care In Orange County


Generally, right, obviously, as I mentioned before,


not good for a population of folks that,


you know, a large population of folks, but I think the


I say that's a big, big challenge and opportunity for


I think it's a cultural challenge, right. And you don't address cultural issues with necessarily like big policies, I think a lot of it has to do with


socialization and education and awareness.


And I think it affects them in many different ways. But I think we even though meant it's mental health awareness month, and there's a lot of like, better help, and, you know, apps and different things. I still think it's not as accessible. Or there's not enough awareness and education and engagement with the population. I know, I mentioned.


Yeah, I think I see a couple of different things happening in our in our neighborhoods of color, that are that this area that that that arena of services is strong, and that is that


they meet them where they're at, right. So in many cases, with our government and with our different types of services, including small business services, the approach is largely build it and they will come.


Whereas I think human and social services and health services have evolved to understand that for this particular target population, again, lower income immigrant bipoc neighborhoods


to meet them where they're at. And that's not just theoretical, that's like geographically physically, like, meet them where they're at. And so, in neighborhoods you see, like family resource centers, you see


these beacons of sort of trust that are built in these neighborhoods through the pro mythos model, right, like the health promoters in the train. The trainers, like these are incredible.


that exist and channels that exist, that have helped, I think, engage this target population, and particularly around health and human services, than health services. I feel like they're really good about being intentional about reaching and meeting people where they're at.


I am thinking personally, because I'm in this situation where my, my parents are aging. And so in the next 10 years, they're going from like, your late 60s to late 70s, maybe early 80s.


And so I think it's going to require a lot of physical movements, I think, in in Orange County, there's a lot of, of our workforce that are transplants. And I think, where as their parents age, a lot of them are going to have to go back to where they come from, and sort of leave.


Leave where they are working and playing right.


yeah, I'll stick with that. I think that's obviously there's a lot of different common things. But I think that's an interest. Because I'm experiencing that myself personally, with folks in a family like moving back to where they came from to care for, or, or bringing your elderly parent to you. So like, potentially, you can find, I think these folks that have come to California as young professionals, right, over the next 10 years are building a community here and a family potentially here in a life here. And I can see them taking their mom from Ohio, or their dad from New Jersey, and bring them here to be their part of their support. I think that's more of a, you know, the population who's coming here and has means because they're here for biotech, or they're here for Silicon Beach. And so they're going to have means and they're going to be able to bring their, their their aging parents here.


I'm feeling like I'm, I'm, I'm actually more insightful on this topic than maybe I thought coming in.


It's very, it's very odd. Mary, as I mentioned, at the very beginning that like, because you preface this by saying that you're neutral, and you're not going to have any emotion. It's like, I'm speaking, and this is no fault of yours. Cuz, you know, we're used to like getting some some form of affirmation or pushback, and, you know, it's not a dialogue. So anyways, just wanted to


note the dynamic here. Go ahead. Yeah. Thank you.


Hmm. Well, first of all, I think our most vulnerable aging population


needs the government the most, right. And so


as we talked about, like maybe legislation around older adults who are here and don't and are immigrants and don't have like, documentation, there's a whole lot that's a


if you think about all of the immigrants that have come here in the 70s 80s, right, and now we're here


here being here, they're now at that age of aging, and they don't have all of those benefits. And so there they are almost a drain on the family's income of their kids, because they just like another dependent. And so I think that's a big challenge that we need to figure out how to tackle.


And thinking about all the older adult residents in Orange County, who do you who is getting the least amount of attention.


Those that I just talked about, I think the


immigrant low income, families of color or individuals of color.


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


Well, I'll just say it because it wasn't on that list, and I think it's indicative of where it's at on people's radar. But this predatory


scams and fraud, active fraudulent activity is not only economically


like, you end up getting into these, what he call run arounds, like trying to solve for all of these issues of fraud and like, it's such a complicated system that you kind of just give up. And so I think, you know, extorting money to getting people's hopes like preying on people's emotions, right, their hopes and feelings because they're lonely, and they want connection. Like, that's a huge deal. And I just like cybersecurity, obviously, is a huge deal. I think we're over looking that there's still some old school fraud and security issues that are, are not being addressed.


So from like, predatory loans to like, fake


What do they call it back in the day, like sweepstakes, like, you know, those, those kind of things. So, I think that's a big one that's being overlooked.


In addition to what we already talked about, we can dive a little bit deeper into your area of expertise,


I think that what's working is that, at least, with us, we're seeing the


both social emotional and economic benefits of entrepreneurship.


You know, these a lot of folks have been working in in the same industry or whatnot, because that's just how things had been done. And so there's a sense of like, one's own deep


aspirations and dreams and hopes that had been squelched.


oppressed in a way because they had to show up as the nine to five like, I'm, you know, I get my, get my Social Security and my, my, you know, retirement plan and all that stuff, like on the, but they lack sort of that creative, inspirational part of their life that has been so sedentary for so long. And so I think that is a, an incredible experience that we're observing a lot with older folks as they're transitioning from either retiring or


Yeah, retiring and then shifting to this path of like, entrepreneurship.


Thank you, and what new or revised policies are needed


like I said, like a retirement savings type of options for folks that don't have access to that.


education advocacy around mental health support


for four individuals in that target and my target.


Target community and yes, we are talking about finance


job security. But what we found is, in order for


an entrepreneur to create the best business possible, they need to become the best version of themselves. And so if they're not, if we're not looking at the whole person, then we're not really


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


Again, by I'm biased, but CIELO, I think is well positioned to target that the target population we're talking about, and use the tack, like, tactics that are necessary for this population, where you're building relationships building, trust


me and making the instruction in accessible. So it's not like going over people's heads, like, you can't take, I think, necessarily a retiree who's or let's say an aging immigrant, who may not have may not may have only gotten like a sixth eighth grade


level of education, and then take them through like, the UCI incubator program, right, or the accelerated program is just, or even the small business development centers, like programming.


We're kind of not meeting people, this population where they're at. So I think that's where CIELO is unique.


I'm gonna be focused on this this context, I think, looking at our aging population, and understanding like, once they get to that retirement age 63, 65.


And they don't, they aren't on like, part of


a retirement program, right with, with the corporation or company.


Or they are their programs are there they have to lean on their family, as I projected.


So yeah, unpacking specifically, that that population of immigrant, undocumented.


proposing an opposing or creating an opposing view of, of where I'm coming from, like, I could be very wrong, right. And my assumptions based on these anecdotes, and so like, I would love to know if that's at all accurate, and what is happening specifically with that aging population.


I don't have anyone in like anyone in particular. But I do think that these


family, these family resource centers, which is part of like the fact FFA are fact, at the county level, they run the different


family resource centers. And I think that the directors of those centers, a director of those centers, right, because they're embedded in these neighborhoods that we're, I'm talking about with the lower income immigrant communities, and I'm sure they have a lot of


anecdotal information around this population as it relates to


age or aging, folks. So that's, that's one that comes to mind. Another is like, folks that are promo Thoris, like, part of Latino health access, for instance, that they're the ones that really the Pioneer


And so I know now HOAG has a problem with Toto model. And others have applied that that approach. And so I don't think they Latino health access invented it, but they certainly have made it


popularized it, I think in Orange County.


No, I'm done with this process, and I'm just kidding. Yeah, absolutely.


Okay. Great. Thank you. So this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. If you find that you have more to share, feel free to reach out to us. Our contact information is available on our website. That's www.advanceoc.com. And you can also leave an anonymous voicemail on our telephone line at any time.


Quick this. So the primary goal today is to identify what needs you think are 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 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. Now, I'd like you to take a few minutes, as much as tight as much time as you need to read through this and this list. And let me know when you're ready to begin. Thank you.


And let me know if I to move it. This is the entire page we're trying to fit down to one page. But let me know if you need me to move it down or enlarge it or shrink it down even more.


So these are listed, just so some clarify questions. So these are listed as issues and concerns with examples of what what might occur in these areas. We're asking before us. Go ahead. Go ahead, Tammy.


It's not an exhaustive list. And I'll be asking you about that. But just would like for you to take a look at the list. And again, these are just some of the examples. I'm sure there are others that are not listed here.


So I think for me some of the two things to the top things that stand out are the need for elder transportation. Access and transportation go hand in hand. I think for me, looking at the county that's important.


I just want to show I want I would like for you to take a few minutes.


And I want to scroll down that would be good that I think the list ends here on the screen.


Yeah, it's this is yet on in the unintended. That was that's one


thing. Okay, go ahead with your questions. I will not get out of here.


So I serve in the community both as a private owner of a community of a companion homecare business and also as a medical management services business we manage other physician practices. And we also do physician staff recruiting of nurse practitioners, physicians, nurses and allied professionals throughout Southern California. I also the volunteer incoming chairman of the board for Meals on Wheels Orange County, and I frequently speak on topics related to care and access for older adults, those with Alzheimer's and dementia cognitive impairment, brain injury and the need for companion level care and respite services for both the client as well as caregiver family member


Yeah, thinking about Orange County and looking at the list of this the common issues and concern as we have in front of in front of us and you know in the concerns impacting older adults, is there anything missing from this list


I would say let's let's let's change that to state I don't see it here so I'm gonna make sure I'm not duplicating it isolation loneliness still looking


right respite for the family caregiver. That's what I have as additions.


Okay, now, often often needs on those lists, including those that you had just mentioned. Please rank the top three that you feel are the most important.


loneliness and isolation which I mentioned would be number two.


Now I'm going to ask you a set of questions for each of the three that you identify. So we're going back to the first one transportation and mobility that you just mentioned. So how, or why are older adults struggling with this issue.


So as it relates to transportation and mobility, it has to do with their lack of ability to drive their their lack of access to owning a vehicle, their geographic location, with their home from where they need to go for basic resources, I think are the primary drivers for that particular question.


Public transportation is very poorly designed in the county of Orange. The cost and limitations to


Disability Access Services for transportation have been reduced and limited throughout the county.


And are there different experiences for different groups of older adults from different backgrounds, for example, where they live, their disability status, income, education level, etc.


I think their income level and their education, education specifically about the resources available, varies by geographic location with throughout the county. And I also think there is a cultural barrier as it relates to access for those who have specific cultural needs and desires. Because there's limited resources based on on ethnicity, and and based on location and clustering of those ethnic groups throughout the county.


That's a huge, that's a huge question, Tammy. I don't know that I have the answer for that. I do believe that our taxpayer dollars should go more towards identifying public transportation for those with disabilities or limitations or older adults, beyond just typical busing services. That also needs to include more than just a curb to curb service. It needs to be door to door service in some instances.


And we're going to issue number two that you identify which is loneliness and isolation.


While there is a network of assisted livings and a network of community, local community, city based civic centers, there needs to be more of a network of senior activities, and geographic places of gathering that don't exist at a, I think a strong geographic level. I think it's limited based on city. And I think the county could play a role in weaving together a better roadmap for gathering places for seniors to have access. And the reason I state that we're talking specifically about those who are dealing with loneliness, and isolation, is being able to bring them together in areas where they can have, you know, common experiences. The other issue that I think significantly drives this is that it ties back to transportation if somebody can't get out of the house, but even have has the financial means they might or may not know how to access the resources. So I do believe enhancing programs like Meals on Wheels, programs, and sabich Excuse me, and homecare companions, being able to go out and do wellness checks and companion visits. To check on the elderly who live alone, who have limited access would be some things I would add.


I think the biggest barrier is cost. While I am suggesting opportunities for these services, I think cost is a huge driver. I think there's limited tax taxpayer resources to do this. And so is there a way to model both and increase In taxpayer dollars, but also a, a pay a paid program, or both the individual pays a portion. Because I believe that, you know, if you get something for free, you're not always apt to use it. So if we build these resources, and they're free, they're not always going to be out to be used. So maybe there's some type of copay, or, you know, minimum payment requirement for participation in the services. So the value is, is increased to the individual.


Absolutely, I think there is, you know, safe communities and unsafe communities, which makes these individuals more apprehensive and the unsafe communities to seek access, or to get out and seek access. So I think, you know, safety and security is typically what an older adult is looking for. So there are some barriers that do to do play into that. I also think that their living environments can limit their ability if they have poor mobility, or are disabled. And so I think those are some of the things that would reduce their participation or access.


I don't know that I have an answer for that, Tammy, I think I would pass


it problem. The third one, you, you, you mentioned is the behavior and mental health. Right.


Well, this is typically an 8020 rule, roughly, statistically, what we've seen is somewhere between 18 and 22%, of older adults, have a primary, psychiatric or psyche, psychosocial, behavioral health diagnosis, along with chronic comorbidities. And the problem, I think, is twofold because most older adults also have chronic disease, at least one form of or multiple forms of chronic comorbid disease. And when you're not managing your mental health, well, it is very easy to fail and not manage your clinical health well. So I think that's a double edged sword, both the behavioral health component being a major and mental health issue being a major issue, it also has a secondary impact on your overall physical health.


And what barriers exist, you see improvement in this area,


behavioral health services are incredibly limited. The services are easily disqualified through health plans, because it's a very high cost. The county resources are also very limited, as far back as mental health hospitals being, you know, uncoupled from the federal health system back in the mid 80s, during the Reagan era, and that has really compounded itself over the decades. And I think those are some of the significant restrictions.


Absolutely. We don't have a diverse group of mental health providers. And so it is going to impact those both who have, you know, ethnic, specific needs and beliefs and behaviors, as well as the ability for strong communication in the primary language of their choice. And I think those are definitely some barriers that we see.


Yeah, um, you know, these are, these are big questions that you're asking. And it really, by the way, to me, this is just an aside, these would be good to get to the people you're interviewing a little bit in advance, even though we're experts in our field. These are very contemplative questions. And so I feel like I might be doing a little bit of disservice in this, this kind of quicker q&a, but I will certainly give it a shot. So that's my, just my comment. But I think behavioral health access needs to be integrated between the county and the health systems, not just the county hospital, but with the private hospitals and health systems like Hoag Providence Health System, the Memorial Health Systems, and also the small community based hospitals. There needs to be a coordinated effort that mental health is contained within the county and that dollars are contributed some equal or poor already prorated portion where the health systems take a responsibility to health plans take a responsibility and and the county takes responsibility. And at the same time I do believe the patient has has a qualifying copay needed as well based on financial ability or accessibility to pay for it to make a stronger system for access. But I think mental health issues are are really kind of a cost driven issue. Additionally, we all see we also have a very we have a gap or a lower number of mental health providers available in the community to serve the the number of folks who need it. So I think there needs to be a focus on developing a mental health behavioral health specialists, larger pool of providers throughout the county.


Thanks so much, surely Now, moving on to the next question or set of questions. So we're done with the three that you identify. I'm going to just read off the floor and then we can go back to each one of them or you can just answer them, you know, in the aggregate, however you feel most comfortable. Number one, geriatric care number two, long term care number three mental slash behavioral health slash substance use treatment. Number four human slash social services.


So the accessibility of Geriatric Care. I think that Geriatric Care is a huge issue for this county and quite frankly, every county in the state, because the number of Geriatric trained physicians and allied professionals has the largest disparity in the in the population here in Orange County, we have more geriatric patients to find geriatric patients who need support, and we have far fewer licensed physicians and nurse practitioners, physician assistants, Allied providers to support it. So I think that's a major access issue for us right now. And that's consistent with the theme of what I see in our resource or resource salary surveys across the country that the number one largest disparity and need is for geriatric trained providers. So that's number one.


So we're talking about then redefined, the question is accessibility.


Okay. So Long Term Care has a lot of definitions.


Yes. Well, we figured this is something that folks may ask. So we, I have here long term here is a variety of services, which help meet both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. So much generic. This is Yeah,


so um, so first, we'll start with the skilled nursing access within the county of Orange, there's both the definition of short term skilled nursing and long term skilled nursing. I think we're poorly resourced and under what I would call bedded B E. D, D. D bedded. There's not enough beds in the community to serve long term chronic, skilled nursing needs. As it relates to long term care. I think there is a limited amount of low cost resources to house individuals and to support them with activities of daily living or activities, or independent activities of daily living outside of the lowest cost environment, which is six bed board carers, which are essentially privately owned by citizens who are business people who are running it as a business. There's not really a long term care solution, run or managed by the county. And Ergo that impacts I think, the reason for an increase in geriatric homelessness, which happens to be on the list.


And the third one on mental slash behavior, health slash substance, substance use treatment. I think I think,


yeah, I think I talked a bit about accessibility in in this the earlier questions you were asking me, I think once again, I think there are but too few clinics or access points geographically throughout Orange County, whereby individuals can't get the mental health treatment they need. And more importantly, there's not a follow up system to continue a process for these individuals to be seen on a regular basis to, you know, source, mental health improvement drug therapy improvement. And, you know, that's also coupled with what you mentioned, drug abuse, which mental health and drug abuse don't always go hand in hand. But there's a high proportion of individuals who also abuse medications, both psychotropics that they should be taking regularly, that they either do do not take, or they take them in an abuse situation, along with the illegal or illicit drugs, which usually is fostered in, in the communities where individuals have a mental health needs. So I don't know that I have much more on that.


Well, I know providers, who are independent providers that provide behavioral health services for those who are accessing either medical or who are Medicare, Medicaid patients, I'm not directly familiar with, you know, county based services for mental health. It's an it's an area where I don't have a lot of knowledge or access.


That's fine. And of course, the last one was the human slash social services, including basic needs, food, shelter, housing, things like that. Right.


Absolutely. I, you know, it's interesting, you know, being at having worked with Meals on Wheels, Orange County, knowing that we also run and manage several adult day health care centers, as does age well, as does, you know, Alzheimer's, OC, there are access points for people who to to get services. But again, I think part of it is under resourced, because I know we had Meals on Wheels, Orange County, are limited in the number of people we can serve in those areas. So we're constantly looking to subsidize or fundraise around the already provided county approved dollars that come through, you know, either the office on Aging, or filtered from the older American acts act at the federal level.


Well, I think the county has a very large problem as it relates to the rapid shift in the aging population, the cost of living in our county is only getting higher, and therefore we're not seeing the community by the younger population and people who are aging or aging in place. And so I think the resources are going to grow in a disparate fashion to the number of adults who are aging into the geriatric ages of 65 plus 75 plus 85. And beyond 85 and beyond. I think that's going to be one of the issues is the rapid growth in the the over 65 that we will see in the coming both now and in the coming years.


The government can only do so much. I think it's, you know, I think sometimes we over rely on what government can and cannot do. I do think that the county could provide continued tax incentives for older adults, both local and county taxes could be reduced for those individuals so that their ability to live on a fixed income is is more sustainable. I don't know if it's going to be obviously completely sustainable, but I think it would allow for greater financial resources for the individual to remain independent. I think the county has a opportunity to do a better job educating the community through digital media through really paper and male media. I think one of the things that we are a rapid growing, you know, society and, you know, the mainstream of computer access is important. But ironically, even those who have computer knowledge as they age those skills, soften or they deteriorate and so finding ways To still create basic communications about areas that the gov that the government has created as resources, I think I think needs to be enhanced to kind of the where to go. FAQ type access points would be good for the government to focus on.


You know, I think I think there are still some cultural ethnic divides that cause the older adults to get less access. So I think when you have limited resources in a, in an ethnic population, that are well educated to actually train and educate, I think it reduces it. So I think, you know, I'm concerned about just kind of the ethnic diversity is growing here. But I don't think we're seeing the resource materials specifically to help the Hispanic community, the Asian Pacific Islanders, whether it be Vietnamese Filipina African American is that population, while small in Orange County is still growing. So I think there's limitations based on on culture and ethnicity.


You know, I don't know that one answer is enough, because I think there's I think there's grades of of, you know, things being overlooked. But I think, specifically, the older adults, I, you know, I look at the list, and I think about the digital divide, as I mentioned earlier, I think that's a huge gap for older adults. And I think we have to find ways to create easier accessibility through digital media, because I think as we cognitively decline as just a normal course of aging, our ability to manage a rapidly growing digital age is adults. Because I can hop on in an app and say, okay, hey, good to see my test results, I could never see that, let's say went to the office. But as we move through this, this access point, older adults are not comfortable doing that they're going to have to rely on either, you know, dependents, spouses, older children, grandchildren. And so I think we need to find ways to make accessibility to resources, healthcare resources, healthcare information, more accessible.


Right. Now, in addition to what we have already talked about, let's dig a little deeper into your area of expertise. And by the way, we're almost done. So no problem thinking about thinking about your area, which will leave you have a sign. Let's see, I'm referring to the California master code for ag now. So your particular area of expertise is caregiving. That works so fast. Right, right.


So I think there's a variety of different variety of things. I'm in the business and our business is very expensive. So private duty companion caregiving, it creates exclusivity. And and and unfortunately, it divides those who have the means against those who don't have the means. And I think that's one issue. The second issue is developing a well educated companion caregiving workforce. That's a huge challenge in this environment. What we face and this is very ironic. Our caregivers come for for more of the clustered inner city areas, lower socio economic areas of the county. One of the distinct issues not only for my company, but every company that works in Orange County that does companion caregiving. We can't get caregivers to geographically drive into Believe it or not wealthier areas. So where people do have means science Sanclemente are quoted AKAZA caregivers are unwilling to drive that distance, they keep themselves closer because they have unreliable transportation, the cost of transportation fuel, so it drives up the cost, which then passes on the cost. That's an issue for those who have the needs. But the bigger issue is back to the sense of loneliness and companionship. For those who don't have the means we don't have good answers for that. I think organizations who are private, are in the business of making money. So profit is important. But I'm wondering if the county can work with some of our organizations to create some subsidies where we would offer homecare services at a discount, because the family then has a county subsidy to offset them. Now, the beauty of that is, I want to mention this, this is an area where I think things are really going in a good direction. Those who are now working through the Kaleen program, I think that program, which just started here at the beginning of this year, is doing will be doing wonderful things for those who have needs access who are in medical. So I think we are seeing some of those things that I just mentioned taking off, I think we're gonna have to do a better job as a private sector and as a government sector to kind of educate people, but how to get access to, to the CalAim benefits. And, you know, applying for HSS, you know, creating resources. So I think the county is doing a good job, especially with this newly announced you know, Calaim program. And I there's a couple other programs that are going to be launched in June that I'm aware of. So I think we're making some strides there. But I still think that is I still think that is a major gap.


Think I'll just make a general statement there, Tammy, because I don't have a deep knowledge or focus on policies that exist or don't exist. today. I think one of the things we see in the state of California, which I think also applies to the county, is that we're trying to apply policies written 30 years ago, and, and partially adapting them to fit today's needs. I think government resources should be put into policy development, that really re architects policies that meet today's societal needs, and the diversity that is Orange County, versus what it was 30 years ago. And granted, we had a you know, we had a multicultural county 30 years ago, we had nowhere near the amount of integration of our society today in this county, it's it's, you know, 100 times more diverse than it was 30 years ago. And so I think some of the policies should be viewed at what are what are the what are the policies that are trying to be adapted from policies that are aged out and should be started from the beginning.


That's fine. I guess the next question I kind of answered for you.


Well, I always believe that the private sector typically has a greater passion for innovation. And I believe that if the county or government would be more inclusive, and more willing to take risks around innovation, and collaborate with the private sector, I think that we could create solutions that allow us to be more nimble, to create better access and key areas of what we've been talking about. And I think the county is trying to do that. I'm not suggesting they haven't. But I think I think there's a lot there's a long way to go there and in creating that, that that kind of collaborative approach and being able to take calculated risks that maybe an entrepreneur or a good business would take to to you know, advance some of these areas of really great concern.


So on our medical group management side, we access a tremendous amount of both Medicare and Medicaid data or for your medical looking at Patient diagnosis, length of stay in the hospital. medication utilization, specific medications based on on diagnosis. We look at socio economic data as it relates to clusters of populations who might have a higher set of of disease path than another population. Those are those are critical elements for us. We look at geometric mean data as it relates to length of stay people staying in the hospital, people staying in skilled nursing facilities, both short term and long term. And that's probably a big list of the the areas that we that we access and then other business related resources that we access, but but I don't think that would be relevant here.


Well, Tammy, I know you know, a lot of folks that I know. So, you know, hopefully you're talking to some of the great leaders in the industry like a Jim McAleer, and a holly and an esteem warrior. I think those are really key people. Yes, good. I do believe the Chief Executive Officer of Garden Grove Hospital would be an individual that if you're if you haven't targeted him, he has a very unique population he deals with in his in his area, actually, he's the CEO of both guard Grove Hospital and he's the CEO of Huntington Beach or Huntington Memorial Hospital as well. I think he would be a really, really great resource that is Dan Brockman, br o th ma N. I've spent some time with him recently and thinking about the challenges that he has. And you know, they're they're a community based hospital. And I think that's where there's a, I see a gross disparity between community hospitals and those individuals who are at our larger tertiary centers, like the St. Jude's, the St. Joe's the hopes of the world. I would also suggest that you take the opportunity to talk to some researchers, I think about the Alzheimer's Disease Research Institute in UCI where the the director of that program, Dr. Josh grill, GRI LL, is phenomenal. I don't know if he is on your list. And also above him, the Dean of the School of Biological Sciences, that his name is Dr. Frank laferla, la fer LA. They are studying Alzheimer's disease and related dementias, both locally, nationally and internationally. And they're dealing with a large cross section of our population with dementia at all socio economic levels. So I think those would be a couple of individuals I would recommend.


Yeah, I'm honored that you asked. And again, you know, I feel like I did an okay job, I think I could have done a better job had I had some chances to think about these questions. And I know you've got a process in place. I'm not suggesting it's bad. It's actually Tammy did a beautiful job. But there's some very, very heavy topics here that I will step away from and think more about now that we've spent this time together. And I applaud you all for doing this. I applaud the county for reaching out. Just the fact that this is, you know, looking at the master plan on aging has been in place, and growing and developing now for several years. So I'm not negative. I think it's actually I think you guys are doing the right things. I think we just have to figure out how do they intersect, I still feel like there's just big pieces that are either flying over or under one another. And we'll get there I think if we continue to do this as as a community. But, you know, I I'm not discouraged. I'm more encouraged about what I think I'm seeing at the government level. And I just think we need to do a little better job kind of mirroring both the private sector in the government sector together to kind of come come to the end of trying to not come to an end, but kind of solve more of these problems. So thanks, Tammy. I really appreciate Oh,


Absolutely. You do that because I'm going to be doing some thinking about this. But the reality is, is you know, we can only dissect it to kind of one section at Time, so be sure to do that. And again, thank you for asking me. I appreciate it. And of course,


of course, you know. Yeah, I'll just conclude the formal part of this interview is I just want to say that so this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research and, and then if you find that you had more to share, please feel free to reach out to us. Our contact information is available on our website www.soc.com. And you can leave anonymous voicemail or not anonymous on our telephone line at any time. And of course, this is off script you can reach out to me anytime, Randy. So let me let me just end the recording for now. Great.


Okay, come on. I know how to do this okay. I apologize.


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


you're going can you just scroll down a little bit


skip it right there. Want to make sure I'm reading through everything Yeah.


I think you're on mute. I can't hear you.


Sure. So my role I work as the health and wellness coordinator at the Newport Mesa YMCA. And my role here aside from overseeing the personal training and health and wellness staff, I also do personal training, I lead health and wellness classes myself so the main classes I lead are active older adults strength and conditioning. And I leave that three days a week and my pride and my target audience for that is all is active older adults so So the vast majority of them are their seniors, they're retired. Quite a few of them have, you know, have have hip pain, simple shoulder injuries, and a lot of them the common you know, wear and tear, older age, older age injuries to major joints. And so I've made it a priority to make sure that at least in my classes, we do a lot of functional functional movement to help build up those joints, especially through the shoulders and hips, work on functional movement through certain muscle groups. So like side like the like the glutes, forearms, grip strength area that tend to slowly deteriorate over time, make sure those areas are strong and functional, as well as I put a really big focus on on the neuro muscular aspect of of strength training. So I tried to make sure that a lot of exercises we do have a have some kind of balance component, or is more of a kind of a different a different exercise style than what they're used to just so that their brain is used to having to having to relearn new movements. You know, just because just because over time, you know, people that are older, they don't need to they don't need to learn new things very often. And it's overtaking more so I try to have my classes take more of an exercise approach to that. You know, so so they're so their body sounds like maybe coordinate a little more of itself while have the right arm lifting and doing something different than the left arm so they're having to put a little more cognitive processing into the movements that they're doing. Balanced coordination instability are another really really big vital parts of the exercises that I do with my with my clients, and as well as as well as with my with my strength training active older adult classes, that I try to remind them as often I can in in the Delta in a delicate way like hey guys, you know, it takes one fall to chain it takes one fall to change your life forever. So we're gonna so we're gonna do we're gonna work we're going to work on on movement patterns and exercises to help you already have a pre programmed response so in the event you do have a forward stumble, we've we've strengthened the right the right joints, specifically through the ankles through the feet through a lower body. And we try to work and we tried to make as many proactive strength training as we can. So in the event someone does have a in maybe a an unexpected stumble forward or backwards that they're advised able to at least respond to it to hopefully minimize the risk of injury so so my active older adults have been having they're having their strength training be focused on on fall prevention is really big, as well as reminding them as well, the value of what what proper strength training does for their independent quality of life. You know, because in the in the past work I've done in seeing in senior livings and assisted livings before most, most seniors are there because their fall risk, their hips are really weak, their legs are really weak. And so my and so my kind of long term goal for every client I see. And then for members who regularly take my class is that they can maintain their independence as they get older, if we reduce their risk of falling, then we're going to increase their total their total independence and their ability to choose to live where they want to live. Because that's my, my, my major role here. But from from an administration perspective, I oversee this I oversee a lot of the group exercise classes I oversee all the group exercise classes and oversee the personal trainers, and then from more of a men also take on that training role myself and leading and conducting my classes.


a lot, a lot of it see off the off the top of my head a lot of this seems, seems there, I can't think of anything really specific. I mean, I mean, I would say other I would say some of the other concerns and this can probably be in this comprise you put into you know, things like diabetes, obesity, diet, fitness and wellness, I would say a big concern is loss of like loss of leg strength as people get older. And especially with with with women loss of bone density, is because women will typically, you know, be postmenopausal right around the same time they retire. So all sudden, they retire, they have all they have all this new free time, but they're their estrogen levels have dropped pretty significantly, so their bone density gets lower, so there's a much higher risk of things I have osteoporosis and osteopenia. And that's a really big thing I see with a lot of my client with a lot of my clients and a lot of members who were asking me things about that. Yeah, and then and then on top of that, when people have had those issues start to rise up it's gonna affect their emotional well being and sometimes even their sense of respect. But in terms of things that are missing here, I'm not I don't I can't think of anything off the top of my head that would be missing there are some maybe there are some specific things that I would like to see more of but it can be but the specifics I'm looking for again as someone who works in like the strength training side of things and strength training for seniors and I think that can be kind of covered I think that can be covered under the under the diet and the diet and fitness side of things. But here's what we currently have for my for my role here and what I've seen here I think that's fine.


So up the next on the list, including those that you suggested, Please rank the top three that you feel are the most important.


I would say things are the things that have the highest priority would be I'll say number one, probably Community and Family Safety. Let's see diet, fitness and nutrition and then can go scroll down to the second half


then I would say either healthcare, healthcare access and delivery or unintentional injuries, I think those two can kind of go hand in hand because you can have an unintentional injury then you're gonna need a health care access. But I would say probably the probably the health care act Access and delivery, it's hard to say a top three because they all have they, they're all they all are, are very, very important. But I would say those are probably the top three and and if those three are taken care of, then that, you know, self respect and emotional well being are usually taken care of as well with those.


Can you screw up a little bit just saying, yeah.


Yeah, so with Yeah, so the Canadian Family Safety, I mean, yeah, domestic abuse, elder abuse. I mean, there's, there's issues of elder abuse where, where the senior doesn't even know that's happening to them. Because a lot of seniors, they rely a lot on their on either their, you know, that like a live in nurse, whoever their main caregiver is, their kids, their grandkids, and they and they are in a very, they're in a very vulnerable, vulnerable position, especially nowadays, as you know, as, as far as financial security gets more and more sophisticated, there's more technology that is that is included in that. And so I feel like a lot of a lot of seniors from the conversations that I've seen here, you know, they can feel really overwhelmed and having to navigate all that new all this, you know, the independent living in our, in our modern age is getting more and more modernized more and more quickly. So I think Elder abuse is it can can be very, very prevalent. I think that in the exploitation side as well, where they don't even know that this is happening to them. So trying to have maybe some maybe some some safety nets to make sure some safety nets, or some or some resources for seniors who maybe they think they might they might be being taken advantage of by a family member or caregiver, but aren't quite sure about it, you know, having some form resources, or having some kind of resource for them would be valuable there. And then at the wine at the YMCA, you know, we you know, we we make we make safe safety and issuing time, we make safety a priority and make it very inclusive. So we need so so from a personal trainer perspective as a mandated reporter that also extends not just to kids, but to seniors as well. Are they going home to someone to someone that is taking care of them and to something safe. Because then because as they get older, they're not quite, but not as physically strong. They're not mentally as sharp or quick as maybe making as some of the other financial decisions that need to be made. And so it can be it can be easy, it's easy to be to be exploited. And trying to prevent that it's always a priority.


Can you repeat that question one more time,


Um, I would say the, I would say the main barrier for that would be probably just information to the seniors and to try to show them try to show and educate them like here, here here are signs of, of financial abuse of elder abuse, Hear hear this here. Here's some things that you can be you can look out for. Because there's even issues of elder abuse where, where the elder and and the caregiver don't even realize that that elder elder abuse going on. I've seen that in my own family before where you know, where, you know, I've had family members who have, who no longer are capable of living on their own anymore. And their refusal to get help can you know potentially be seen as as, as elder abuse by you know, by the family for not trying to intervene, provide that better quality of life. That's important. A big part of that is just education and then making it and making sure that that senior knows that okay, if I have something going on, then I know that I need to know that I know this is who I can call or talk to in order to get that taken care of.


They're different experiences for different groups of older adults from different backgrounds.


Um, yeah, I imagine so I'm sure there's a big cultural component to it. I mean, Orange County has a has an extremely diverse group of people in it. Many different cultures, nationalities. And while I'm not going to speak to the the cultural differences to maybe an Asian American or Middle Eastern American family, you know, like, because that amount from those parts, I can't I can't speak on that accurately. I'm sure there, I'm sure there is. I'm sure that is quite a difference between I'm sure there's quite a difference between how how different families from different cultures will treat the eldest members of their of their family,


Um, I think the best way just to address that issue is just to provide resources and a sense of security to the senior If so, like, so for. So for a space like here, like if my specific branch of the YMCA, having you know, having a having a staff, that the having a staff that seniors feel supported by and the seniors trust a lot, whether it's their front desk, or their group fitness instructors, having them trust us enough to say, hey, here's what I think may be happening. And many, many personal trainers, you know, get they have very, very close relationships with their clients over time. So it's really common to talk to talk about family members, I had a client this afternoon, who was telling me about how excited they were to see Yeah, ditzy there and to see their grandkids later in the week, grandkids who are older, and like their mid 20s are really excited to see their older grandkids. You know, but but when they say that they also will, you know, occasionally bring up, you know, read, you know, things that could be seen as red flags, or just like to shoot the breeze for a while. Yeah, and so, so do so developing that those community relationships where seniors feel like they have someone that they can tell something to and even in my relatively limited role as a trainer like yeah, sure, my main job is to make sure that you are that you are strong, you're fit, you're healthy, you're balanced, you can walk well, those are those are my main roles, my clients still will have have have adopted the reassurance and the comfort, to tell me you know, the tell me maybe some other other things that are going on, and some little family problems. Thankfully, I haven't had a client tell me anything that would make me need to, you know, call Protective Services, thankfully. But it is always something that I am cognizant of, and it is very, it is nice to know that my, my clients, as well as the other personal trainers hear their clients feel safe enough to tell their trainer. Hey, I trust you enough to tell you, here's what I think may be happening to me at home.


Yeah, the senior are very fortunate to have you guys. Somebody they can talk to. So when you think of diet, fitness and nutrition, how or why older adults struggling with this issue.


Um, I think there's a couple of things for that one, the food is a lot, it's gotten a lot more complicated over the last 50 years, we have, you know, at least at least in the United States, people don't die of hunger anymore. That's not a thing. But we're seeing on the exact opposite side. You know, there's mounting like malnutrition through excessive eating. It has been a really it has been a really big problem with with with hyper processed foods and foods that we can get a lot of calories out of but little new little nutrition out of. So I feel like for last seen for a lot of seniors and this applies to really every age bracket. Anyone who buys their own food experiences this seniors especially though, where you have where you have, yeah, you have so many options. You don't know what is good for you. Why the trans fat bad and why is a saturated fat also bad for me, but some fats are good. Were the good ones were the bad ones. Why it was so complex that this carbohydrate, why is this simple one bad for me and just not having the educational tools to know how to read a food label and how to identify maybe someone like the you know, the grocery store marketing tricks to make a food seem healthier than it is. And I think the other side of it is some folks are you know, you hit 8590 years old. Yeah, you know, I'm older. I've gotten to this stage of my life. I'm going to eat what I want. Because food is an emotional experience for a lot of people. And some seniors want to just lean into that and say, You know what, I'm going to do what I want. It's my body. I've been I'm old enough, I'm retired. I'm allowed to live this way. So We'll just go for it. So I think it's a combination of, or at least the issues with, you know, with with, especially diet, it's a combination of maybe lack lack of a lack of education to the senior of what the right things are to eat, and why it's good to eat these X y&z good things. And Pro, and probably the personal choice of saying, Yeah, I decided that I don't want to put in as much effort anymore. And so I'm just gonna eat whatever feels good to me at the time.


So I look at that in two different ways. You know, because I gave two answers there. And I think the easier one to answer is you have the barrier for why people want to just eat what they want all the time. I think that if I think that if we were able to do a better job of explaining, okay, let's, you know, here's why what you eat matters a lot. Because if you eat if you eat really poorly, your quality of life, cognitive, pretty poor, as well, if you eat really well, that's going to help you have a better quality of life. And so, you know, so I think part of that is trying to help people, maybe separate the emotional response and the emotional age relationship to food and have it be more had them observe food, and what they eat is more of a here's fuel that I need. For my body, I'm eating, I'm eating this thing so that my body feels good. And I bike thanks. And you by performing well, and by then by living, you know, in a less painful way. And I think the other and then I think the other, I think the other barrier to entry there, you know, is with with the educational resources is there's just not enough educational resources, or at least not not as many affordable ones. And that's something to work through. So the YMCA over the summer, we're starting off in piloting a, a nutrition plan where we partnered with a with a registered dietitian, who's going to be actually, you know, writing out nutrition programs for individual members that sign up for it, we're still definitely in the pilot stages. So we're not doing anything. It's not super widespread or really being marketed out out yet. But that is something we're doing because we've had members who have asked us, you know, for quite a while now, hey, you know, what, what do I eat, I need to get my diet under control. I feel like I don't have control. I feel like I lose all sense of reason. When I see certain foods, I just need help managing that, what can I do so we're actively trying to provide the new nutritional resources. Again, that's still it's still a couple months away from from really, from really hitting our members. But that is something that that we are doing. So we're actively trying to eliminate, we're trying to eliminate that barrier to entry by providing educational resources, and providing someone who can actually walk with a member in their in their journey to have a more structured diet with less chaos in it.


Yeah, you know, a lot of people now, kind of like what the previous with the previous question about community safety, different, different cultures will have a different have a different kind of priority towards certain foods or a different or different bias towards certain foods or against another, you know, there's, you know, like, you know, like, like, like seniors who maybe have some more more Greek and Mediterranean roots, they're gonna be all in on a med train diet a lot, a lot, a lot of veggies, a lot of veggies, lamb fish that's been really, really big for them. You know, and then you have some Hispanic, Hispanic families really big, really big on on beans, carne asada, rice, and a lot of, you know, a lot of meals like that. And not to say that not to say that one, one cultural diet is better than the other. That's not no, it's, it's a little challenging to say that because we all processed foods, there's general rules, but every person processes food a little bit differently, and there's that major genetic component, that that that's part of that so, you know, so So the culture differences, it's really, really it's really hard to say, but I would, I would, I would say I'll say by and large from a cultural perspective, each culture can agree to maybe take a step back away from fried and processed foods that will be okay. I have noticed I've noticed as well though, that the you know, there are a lot that you know, selling some of the some of the days the Asian families Around here, as well as all Hispanic families, yeah, they like to they cook in house a lot, which is good, you know, they go for more of a more of a home cooked meal, which is always which is always always desired. That's almost a lot of times what we better for you than most things that you get out from the the cultural differences with with food are going to be very, very fast.


Um, I think the YMCA is on the right path to addressing that issue by providing a in house nutritionist I say okay, this, this is a person that is going to be leading our big diet in it, I'm being nutrition initiative. So providing so providing the resource, the resources, and resources well, as well as the options then that the seniors have to feel like okay, to feel like, okay, you know, maybe maybe this isn't out of control, and there is something I can actually do about this, you know, because every time because every time you you know, if you just go on the internet, and just, you know, go you know, go to Google or any search engine and look up what are good things to have, you know, you're gonna have some consistent things you'll find and then you're gonna have a lose 10 pounds in a week program, and is there gonna be some really quick flush diet and so seniors going through the seniors who can easily get trapped, or, or get easily pulled into the into like the flesh diet fad, it's gonna be really hard for them to bounce back from it because they're naturally older and little more frail. So, yeah, so that's saying, okay, you know, everyone's gonna do things a little bit differently, but you for sure, should not do these types of diet plans will be would be ideal.


Yeah, um, you know, with the, with, with the cost of medicine and health insurance, a lot of seniors are there on their on a, a fixed income. So, so for them, it's, you know, what is what is worth me spending my limited income on. I mean, I don't know if I can find a for a copay to go into to go to go get my health care for this right now. Maybe I'll just put it off, you know, but with but with law seniors, you know, with seniors have, especially an injury, or maybe some something internally wrong, you know, the more than put it off, the more expensive is going to be and then they really can't afford it at that point. Yeah, and then on our side said, that is, you know, do do seniors feel like they have, they have have a doctor or a place of medicine, they can go to where they do feel like they're being, you know, respected and treated well and actually treated like, like a person and not just like a baby, I feel like I feel like a lot. I feel like a lot of people have a tendency where, you know, as, as seniors get older and older, we kind of like regress in our talking and always talk to them, like their toddlers, you know, instead of fully functioning adults. So having access to having healthcare professionals who are capable of an cognizant of talking to their seniors, as adults and not just like grown babies would be a good step in the right direction.


Yeah, I'll say the barrier there is going to be probably I would say maybe cost would be would be a big one. You know, you know, while my role here in the YMCA doesn't Yeah, we don't transport people to the hospital or do it or do anything in actual in actual medicine in a traditional sense so it's hard so it's hard for me to say in my in my role here you know, but there but we do take take an element of Jerry of Geriatric Care. And then trying to provide for that population just through, you know, through, through through structured exercise that is specific for that for that group or for that type of population. But one of the barriers to that is having is is is laying seniors know that there are that there are options to them, you know, good telehealth care access and delivery. sure a lot of people are going to consider that, you know, your your trip to urgent care to hold the pharmacy, and those are definitely really, really big parts of health care. Yeah, because of her ex, like, because time spent in exercise is less money spent in the emergency room, typically. So just so just having having, having seniors be, oh, be aware of what are other ways that they can other ways that they can invest in their health care, that would be more it would be just as if not more cost effective than actual, then actually just going to the doctor all the time, because you can only you can only medicate yourself so much like, yeah, that's a that you're just you're just buying time at that point. It's not, it's not quite, it's not quite quite as quite as valuable is actually yeah, encouraging encouraging seniors and getting seniors to actually exercise themselves with with a trusted professional


attire, different experiences for different group of older adults from different backgrounds.


I imagine I imagine there are, I've noticed that. And again, this is in my in the scope that I've noticed here, I've noticed that our I noticed that seniors, seniors have an Asian background, they tend to be very, very on top of their exercise program. Yeah, this is not uncommon to have to have seen you to have, you know, seniors in our bootcamp classes and our biochem classes in itself are kind of higher intensity classes, you know, it's it's these, these all of these older, these or Asian, Asian Americans who are trying to who are there, they look, it seems to me, like they're enjoying the physical investment in their health, through through strength training, whereas a lot, whereas a lot of a lot older, maybe all the older, Caucasian seniors here they will be, you know, they'll work out, they'll work out the stuff, they will still make that that investment and that investment in their physical well being but the kind of like dragging their feet doing it and not quite as like, excited about it. Yes, yeah. So so so culturally, yeah, it's gonna definitely, this can definitely change a lot. And that also is probably more dependent on the location, I am at the border of my locations at the border of Newport Beach, Costa Mesa. So it makes sense is going to be you know, there's not going to be quite as many Hispanics in this area. Whereas maybe like the Fullerton YMCA, it will be a much different group of people over there or in Huntington Beach, much different group over there. So it's hard to say exactly when with respect to eat to each branch of the organization. But But yeah, yeah, I've noticed that culturally speaking, there is a definitely a different a different kind of Geriatric outlook on on your on your healthcare access, and some and some seniors just have a built in distrust of, of going to Doctor sometimes that says, yeah, that's, that's, yeah, that's how it is.


Um, yeah, so aside from kind of a back into why just answered I was saying the obviously their thing is trying to maybe maybe, like, maybe D stigmatize some of them, some of them in the medical profession. You know, because I I've had I've had a lot like, like older grandparents who, yeah, who, again, they look like me, you know, some older white guys who are just not who, you know, naturally out, I'll kind of trust doctors, they're in it for the money. They're today's kind of a very, yeah, they're very apprehensive and distrusting of certain professions. hire new doctors are one of them. So trying so trying to provide resources and say, Okay, well, you know, I get You know, maybe not, maybe you don't trust doctors as a whole, but here, but here are some some really well, so really highly regarded, you know, medical professionals in our local area that would serve, there was certainly well, as well. And I think the other part would be also educating seniors on you know, just because you need to go the doctor doesn't mean, you also need to shell out 1000s of dollars for a medicine, you know, maybe, maybe, maybe try try, try our best to equip seniors ahead of time and say, okay, you know, here's, here's kind of like, yeah, sure, here, here's the pain you're feeling or the discomfort you're feeling. And you won't get checked out what you're scared to. Here's, here's a list of questions that you should ask, and try to provide, and try to provide some kind of a rubric of here's how to make here's how to make the doctor's office less scary, and more informative, by by asking these, by asking these questions, specifically about your health.


I would say it depends on your income bracket. So if you're, and, yeah, that may sound a little vague, because that can apply in a lot of different areas. You know, if you have more income, you have more accessibility and to different things. You know, they're, you know, for them every time they get sick, there's a major fear component of, am I going to am I going to, cannot do I know, I cannot afford to go to the doctor for something that may be life threatening. And so there is that. So there there is there is that risk there. So I would say the accessibility part of it for at least and this is in the mind, in the mind of seniors, I don't have the data. I don't have the data in front of me to to accurately say if this is, you know, generally for sure applied, but I think in the mind of seniors. You know, can I afford health care whether or not I absolutely need it, and ask me health care both with you know, both internal medicine and even like dental care as a part of that as well. You know, because we're having getting getting a new a new a new top bridge. That's $20,000. Right there. That's a big ask for a lot of seniors to commit to. Yeah, so. Yeah, so yeah. So trying to trying to make things more affordable would definitely be would definitely be good. And if you're older, sure. If you're I mean, if you're well, if you're wealthier come from a wealthier family, maybe you're tired with more more in your bank than most people did. Then yeah, those things are accessible for you. Great. I will say that I will say the inaccessibility gets dramatically bigger as we get to like, kind of the lower middle class and below that is when the accessibility becomes really really limited. From there and then the accessibility you do kit do get is not particularly high quality.


I would say it is. Maybe maybe a little, maybe a little bit below average. A lot. A lot of it depends on where you're going to see. I think a lot is gonna depend on where you seek that care from. Yeah, okay. So yeah, so because most seniors who are on your medical or Medicare there, they have some kind of health insurance you know, in the in their insurance covers a YMCA membership which is great. So that can so that that's really great long term care for them just so that they just they know they had they have a place they can go exercise and put some effort into their physical health and wellness, which is great, wonderful. But but from a from a medic, a medicine perspective. Yeah, it's harder. It's harder. For me to say exactly what exactly how how good that would be, but I do know that. But from my experience here, I know we have a lot of numbers. And I have most of my clients who they are putting their who they're putting their, their time in the gym and in their classes as weights as a way to invest in their long term care, because they're saying, okay, you know, I just retired, I'm 65 years old, I want to be able to run around with my grandkids and my great grandkids later. So I have so I have older clients, I have clients in my, in their 70s and 80s, who are still looking 10 or 15 years in the future of saying, I'm investing in my health, I'm investing in my long term care here. So that I can, you know, still have that still have that time later. Yeah, so as far as Orange County, Orange County as a whole, there's probably probably some work probably definitely some work to be done for the long term care of things. But remember, but for members that come the members that I see here, they they make it they make it a big personal commitment to invest in their in their long term care.


Yeah, so I feel like with, I feel like the the mental health, the mental health conversation is, it's relatively new, especially for seniors. 20 30 years ago, that just didn't happen. And so and so I think a lot right now is is, is helping seniors to identify what what that what the mental what mental health even is, and what that looks like, you know, because because it's not as simple as, it's not as simple as you know, someone in their early 20s, who just wants to have who just wants to like sleep in a little bit on a Wednesday when they shouldn't be at work. And then like from at the office, it's a little more as a little more intricate, and little more complex than that. And so trying to trying to break down the stigma between mental health and trying to make sure that make sure there is an understanding of Yeah, your mental health is, is really valuable. It's really important. It's going to it's going to be it's going to be the difference between, you know, and wanting to wake up in the morning versus hoping to stay asleep. To try and try and just to correct some of the some of the misconceptions about what, what, what mental health is and how to actually invest in it.


Um, yeah, it's gonna vary depending on where you live because orange with Orange County is why why it is it is going to have really well we're really wealthy areas like Laguna Beach and Newport Beach. And that's going to have really large, maybe lower income populations like Santa Ana says, uh, so it's, it's hard. I would say I would say in the I would say, south of Costa Mesa is going to be pretty good. Yeah, we're looking we're looking at Irvine, Aliso Viejo Mission Viejo Laguna Laguna Woods, especially those areas, you know, they're gonna they're gonna be great. And then I will say for Costa Mesa, maybe about half of Costa Mesa, going up towards maybe the back end maybe the Santa Ana slash test inside of Santa Ana. That area, you know, and then extending out to like Garden Grove Fountain Valley, maybe maybe this May the social and human services aren't they're not they're not gonna be as great over there can. Yeah, that area is known for being maybe a little bit lower income, maybe having a little more issues with a little more issues with, you know, with fluent language with with death and gang related stuff out there. So it's not so it's not quite as, as, as great of a place for you know, for for an older population for seniors that feel somewhat vulnerable. So it sounds so when you're taking Yeah, we're we're taking Orange County, and you're, and you're kind of had to split it in half like that, you know, half of the half the county is doing pretty well. Maybe 25% is doing medium to well, and then the other 25% has definitely, definitely some work to be done less so work towards less successful and less and less acceptable.


Um, I think that depends on what your definition of the word challenge is. Given given my my my background in health and wellness, and especially one educate people, the purpose of exercise, my opinion, is that the biggest is that the biggest problem is going to in facing seniors in the next 10 years, is going to be a lack of straightaway to phrase this. People not investing in their, in their, in their own health, that that's the biggest one, I am a big big proponent in being proactive about our health because there's a lot of times I'll see people who they'll have, you know, they go to the doctor, and they get a major health scare where the doctor says, Okay, you're, you're pre you're pre diabetic, you have osteopenia, yeah, your your mental health is starting to deteriorate, go access, people who will start who will begin a geriatric exercise program because their doctor, more or less scare them into feeling like they need to do it. I take more I take and I encourage everyone else, you know them around, to take a proactive approach to say, Okay, I'm gonna start, I'm gonna start doing exercise program, and I'm gonna start trying to clean up my diet and eat better early to prevent that, to prevent that health scare to make sure that I will still live longer, because there's a lot of times because because medical science has gone a very, very long way. And you can keep someone alive for a long time with a terrible quality of life. Like he missed a lot of lives. easy part. Yeah, we have, we have no technology to do that. But making sure that someone has a has a high quality of life and enjoys, and enjoys the life that they have left. That's a whole nother story. So and then so in the next in the next 10 In the next 10 years. We know how, you know, things are pretty good things are fairly convenient for a lot of seniors, you know, I would say I would say, the next 10 years, they're going to start to unintentionally lose a lot of a lot of their independence because they're not going to they're just going to kind of forget about you know what happens when you get when you get older. Let's say I say after him just in short, next 10 years, I would say an individual's physical health will be their biggest challenge in the next 10 years and then the maintaining of that physical health


Um I think that I think the government's role should be not financial assistance in the way of just giving a lump sum of money to seniors, but providing providing more more affordable affordable resources. And would that be a okay yeah, here's a here's a here's a a affordable government sponsored exercise program and nutrition plan for seniors maybe hard to say off top my head but Neva maybe that maybe that could be a good resource for the seniors or but they're always they're always scared and worried about money slash their remaining amount of money to live off of and their health. Probably not. But at the very least, I think it's the government's responsibility to give resources and say hey, here's here is what we have for you or here's some organizations that we partner with, that can help to address these things. They can help to address these these concerns for you. Because if someone 70 80 years old, and they feel financially comfortable. And they feel like they are strong enough to independently move, move themselves around and not feel like a fiscal burden to others, then they're going to be doing great. So yeah, so yeah, I think I think the government does have, you know, it plays a role or at least has some kind of obligation to, again, we don't want to force seniors to work, but provide them with, you know, but provide them with resort with a poor resource take care of themselves. And maybe even, you know, you may even some higher quality senior volunteer work. Yeah, because as as seniors get older, they're retired, you know, they left their career they're in for 30 or 40 years. What am I How am I contributing to society at large, because seniors feel a very, a very, you know, what I think is a noble a noble sense of, I want to contribute to, I want to contribute to what is going on, they want to be involved in, in society and in their communities. So, so the government having Kevin made me some, some more volunteer programs will be great. Like, yeah, like, like, as for a little example, you know, at Fairview Park in Costa Mesa, every like second, every, like, second or third weekend of the month. You know, there's this little train track for children, and it's 100% volunteer community runs, always seniors, always, always, always a few, a few grandfathers out there, just, you know, you know, conducting a train with all these little kids on it is, is really great volunteer service that we get to see. And you know, kids love it. And you know, and the seniors that are out there running it, and the volunteers that are running it, for them, they're like, yeah, yeah, this is great. Look, we're happy these kids are, you know, sure, I may not be, I may not be in my professional career anymore. But I'm doing something that that brings, that brings me joy, because bringing joy to others in this area. Seniors, they love they love community, and they love community involvement, and belonging. And they take a real sense of pride and wherever it is they in wherever it is they volunteer, grew up and just kind of live in.


So just want to be my full time. I only have two more questions to the interview. Yes.