Governments cities counties got to do more. They need to do more they need to develop so many programs you know they need to develop so many programs geared towards older adults. Yeah.


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


Yeah, it is accessible to to operate this way is accessible to to people. But I will tell you most of the time is when they are in the in the in the manic or when they are in the lets say now, I have high blood pressures than older adults, you know I have a prescription let's I hope everything is okay. I determine if I take it. I'm talking about me who has all those insurance what have some other older adults does that have doesn't have anything they use I know I know in Orange County has no county hospital but they're still you use yeah and everything. They're using all these public hospitals to get few weeks of their medication where they are in either in their manic or in their active or where they are in the uncontrollable. Let's say you Oh, I saw someone who fell over there. I call 911 They're measuring his blood pressure. Their blood pressure is like 140 over 200 that that came to UCI. Oh, that. He goes to UCI, the doctor was run labs and everything. He has this attack. Maybe he's homeless, okay. They took care of stabilize him. Okay. Now he said they're not looking How can we let him to this to the communities certain programs where they can get medication Their goal is to, or how many people did I discharge. If the case manager didn't discharge them, they go to their wherever stand up, they do every month. We got to find a way to get them out, get them out to where we can get him out to get him out, he's gonna come back because there is no, there is no continuity in the society for them. Yeah, there is no way to get whatever you give them in the hospital, they can get it you send them home with one week or two weeks worth of their medication. Because of because they have private care doctor, maybe you link them up to a doctor while he's still in the hospital. When this member or when this guy goes home. He's that doctor is not going to follow him up any longer. Yeah, no way. Because as I'm still saying there is no continuity in the society to help this older adults is not actually, sometimes it's not. It's not all government folks. Some of the older adults have their own blame, because they don't want to, they get used to the street, you know, they don't see life worth living. They just whatever comes out of there comes out of there. They don't care what you tell them. Tell them don't don't drink, you're wasting your time that drink. That's only where the the the thing that drinking or using drugs is the only way to get out of their mental mental health or behavioral problem. So they keep drinking there. It's not happening even in even as rich as Orange Counties. Let's talk about that. Well, LA is quite different problem, you know. You see now you see how the homelessness population is exploding all over the county. He's not just happened. And because those elderly people that becomes homeless. Just tell me where somebody can get an apartment in Orange County for less than $1,000. There's no place. Some of them don't get 1000, maybe $1,200 a month for Social Security.


Yeah. Older adults, okay, you know, long term care is still using most of the long term care programs are medical benefits. You know, let's start with long term care, like going into a nursing home is not a Medicare benefits is a medical benefits. And most of all, the adults might not qualify for Medi cal. The because of they have homes. They live, they live in their houses. So if they have any reason to go to a nursing home, they better be out of pocket, or no nursing home. I mean, if they're going to stay there for a long time, but if it's like a quick visit, like scaled made, yeah, the insurance or Medicare will cover it once it turns into cost. So there are services in a nursing home like states classifies it. Level A, B and subacute. Once at once somebody's care turns into that and you don't have medical, you're not going to get it there's been no there'll be no nursing home that will admit you then if you think you're okay. You should have private Long Term Care Insurance. How many people 100 People have it's not a lot because it's a very expensive insurance. So you see this na are moving away from the people in the lower part of the society financially to them middle, middle, middle, late colleague working class or the adults that is retiring, because they have property or whatever they have, they do not. They are not qualified for Medicare. If you don't qualify for Medicare, you don't have a lot you don't have if you have any need for staying in a nursing home for long time, staying in LTC facility for long term, because you don't have Medicare, so you don't have medical, you don't have that benefit. You shouldn't have, you should have private long term care insurance, which is expensive, you know, you see these groups in between being poor and rich, that's where it's affecting them. But the people with made the people with medical, which is the people were talking all along the middle, I mean, the lower class level financially, they're qualified to qualify for Medi Cal because they do not have enough income, or they don't have any property nothing. So those people, they have access to long term care services that has been approved by Medicare, they have access to that. But um, I don't know is how they is how the health insurance works. You know, how the Medicare medical, you know, combination, you know, so, I've seen people I've seen some, some older adults, who was they were discharged from a nursing home because they do not have medical and they cannot get medical because of the financial status maybe because they go to county to apply. The county looks the county around the record, they might be seen houses or home there's okay with them the matter them okay, we give you medic car. That's what they call Sheriff costs. Yeah, if you give us 2000 a month, we give you medical maybe the person do not have 2000 A month maybe the house the county sin is where they live.


Michael to but we have around a six more questions. extra time


to I think we use a lot. You know, I can be I can be I can be a resource for you anytime. But


he's not. He's a lot of problems. If I start talking I don't mean for six hours will be enough for me.


Yeah. Do you have a little, maybe 15 more minutes so we can. Thank you.


Pretty much the same for older adults is the same. There is no much education there to convince them that they need it. Yeah, yeah. Because you're not telling them you know that they've been living like that for many years or whatever. I tell them, Oh, you're depressed or you have an alcoholic problem or, or you have anxiety or you have memory loss, forget forgetfulness. They don't even believe what you're saying. Because they've been living like that for such a long time. Yeah, it's accessible. They need more education. They need more people out there. They need interaction with social workers, nurses, you know, yeah.


Upper East different, you know, to compare with, say, I'm comparing Orange County with other counties is different in Orange County, you know, they have access to that. Yeah. Is this you know, given maybe 49 50%.


They go forward. Government. Oh, the goal for government should be enough to be improving access to care. You know, trying to try to make it accessible. I'm trying to I'm trying to get more often services out there education, trying to make sure that there's a continuity in services. If you have a program, that program needs to be followed up, you know, if if older adult goes to the hospital, there has to be a program that link them up. I know there is but you see the being done is not going to send somebody in the street, you don't want to live in a county that their nursing home can discharge an order to a motel for seven days, with a voucher, after seven days, it becomes homeless. Because there is no continuity, there is no you know, there's no checks and balances. Yeah, so government should do more in providing care and making sure those cares, there is continuity of care, which is apt to be honest with you, there is none. Everybody, Non non, there is some there, but most of the establishment is practicing what's called defensive, whatever they are doing, they want to defend themselves from lawsuits. So they do the minimum, the basic thing they have to do not to get involved in any legal action, you know, so the continuity is more kind of zero, you know, so got to do more.


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


Yeah. However you want to take this question


the difference is not racial, there's no racial limits, I will take it by the list people getting exposed, or people that are people that are educated. What I mean, education is people that get in surveys, that the people that actually know how to follow up, people that actually understand the system, they know the system very well what to do. When most of the older adults, some of them don't have the knowledge of what is out there. Because they don't know nobody has told them. Yeah, so we got to get in, we got to engage community we live in, we got to gauge community services, you know, churches, whatever it is, those steps to educate, to provide the service the government should get involved in. So that we they're going to be a way to send the information out so that people will understand. We have this program. So if you have something that you don't know, what you don't know, is greater than what you see, if you don't know that you can get this you cannot get it because there's no education. And it's not your fault that you don't know because nobody told you. Yeah, you're not exposed that I can get. Maybe there is a social group I can go to, to to take care of my drinking problem. As a social group out there, I can go to take care of my drug or there's some social services I can have that will talk about my depression, my anxiety, you know, can recommend, Doctor Who are going to give me a medication for my depression. So that my moods I will be happy most of the time. People don't know that there is some there. When they end up in the hospital, they're going to get maybe 20, 20 pills of antidepressant, antidepressant to go home. Even if it's up to 20 they go home and they finish it. They are back to zero. There is no continuity.


Think about all the issues facing older adults in Orange County.


Yeah, financial need. Yeah. On their behavioral health, you know, he's been overlooked.


So, I want to dig a little deeper in the economic economic security that you mentioned earlier. That is that is working and not working for older adults in Orange County when it comes to economic security.


I think economic wise actually is not what state is now what's that alone can do another been adjustment in their social security payment and those what I think that can walk more is for the state county and non for profit and people that has money to develop more, more ways to put To help us financially, yeah, more ways to develop some programs, people, people, you know, donate some stuff, donates, whatever they can donate to make sure that the society is gaining from it in less a lot of foundations to get towards providing services, you know, employing social workers, employee nurses employing whoever they can get out there that can provide education to homeless let's get to the I mean, they can provide education to elderly adults. Let's get out there and let's get to the society let's get to the homeless, let's get to the churches. Let's go to the communities. Let's put up tents everywhere you see how do you see Do you see what we did to to make COVID vaccine available to people you know, put in tent will come here get vaccine. Let's put let's make other programs like that. Let's be more aggressive. Yeah, yeah. Not only when they have a pandemic, like you know, they want them to get vaccine that's when you go to homeless camps and set up a temp of camps for them to come give us in no let's go there and educate them let's put some social workers out there. Let's put some nurses out there to take care of their chronic problem. You put them in a dress and you slap a dress and then you let him up with a doctor who are going to follow up with it. That's what we should be doing for them.


He's I don't know. I say okay. If this man is diabetic, whatever you're doing in the simple dressing you're doing is not going to happen you need to control his diabetes for the wound to heal. Yeah, so the out there they're gonna there are some you know, those small small societies I think their name is mental health of Orange County or I don't know what they're that they are in some we're in Santa Ana is one of the groups you can you know, if you get towards all the adults that are homeless, that's a good that's a good agency there to talk to. Yeah.


So thank you. And this concludes our interview. And if you have anything more to share, please feel free to reach out to me or anybody at events will say I'm gonna stop the recording. All right.


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, take it into consideration of the older adults, caregiver, family and their community. I'm going to share my screen so you can see a list of common issues and concerning impacting older adults, please take a few minutes to read through this list and let me know when you are ready. And when you want me to scroll, just let me know your long list


Okay, so this will be our last item. Okay. Yes.


Sure. My role here with the city's Community Services Department is Community Services Manager. Prior to that, I was solely the Senior Program Coordinator. And so we interact with the seniors here at the community center on a daily basis Monday through Friday.


Scroll down. Scroll down again. One more. I just want to make sure. Yes. No, you have you have you have it on there. I must have missed that one. So yes, everything's there.


up their needs on the list, including those that you have suggested. Rank the top three that you feel are the most important.


Okay, so the top three for our city. How three would be housing, economic security, and transportation.


When you think of housing, how or why older adults struggling with this issue.


Um, you know, there just probably isn't enough affordable housing, as most cities have, we have a few affordable apartments that are in our city. But you know, the availability of apartments is small. So if we had to, to comment on that, it would be just the lack of affordable housing for seniors.


Um, I imagine it's all about development. I will say this, though, that it is going to our city is improving. We are actually just going under a really very unique program with jamboree housing for a substantive housing project. So that will be another apartment complex available. So that is I think the biggest barrier is property and, you know, available develop developers coming in and being able to develop that land for affordable housing.


Are there different experiences for different group of older adults from different backgrounds. Oh, yeah, I


imagine. So I mean, we see that every city has a population of seniors that are wealthier and don't have the same struggles. But over the years, we've seen many seniors that have come to our center, indicating that they are being asked to leave their current housing complex. Next, and you know, they're worried and afraid that they're going to have to live in their car. These are seniors that are, you know, older and from 70 to 80. So, for us, yes. So you can definitely see a difference in affordability and those that have money and can afford their homes and stay in their homes, as opposed to those that that can't and what some of these apartment complexes do raise their rents. And when that occurs, if that's annually or biannually, that really has a significant impact on those that are living in those complexes.


Oh, goodness, that's a very good question. I would imagine maybe a little more oversight with these apartment developments, you know, where perhaps there's a nonprofit or the government is having some oversight in how maybe a little more rent control for for their apartments, and they are all on fixed incomes. And that's why they're in those apartment complexes. So I think a little bit more oversight would be a solution and or rent control.


When you think about economic security, how or why older adults struggling with this issue,


um, probably for the very same reason that, you know, when they get an increase in their social social security, oftentimes, it's not significant enough of an increase and or they get an increase, but then they get dropped, if they if they have social security and SSI. Oftentimes, if social security goes up, then they'll receive a letter that says, because that went up. They're reducing the amount that they receive in SSI. So I would say that they're just not we're not they're not able to keep up with the growth. And with recessionary times,


Boy, again, I think it all goes back to if they're solely reliant on Social Security. And they they have they don't have a pension. They have no investments. It's those folks that need additional assistance.


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


Well, that would be a difficult one. I mean, I would hate to I would hate to think that there are differences. But there I know they exist. So yes, I mean, you probably have many seniors who had careers, or were executives. And so their experience is different than someone who had a blue collar position and not as highly educated and didn't have a savings over time, and they don't have investments and or a pension to rely on.


Both back to again, you know, having perhaps more additional programs that are available to them to provide maybe a little bit more of an increase in Social Security or food food programs, you know, utility programs, utility costs continue to go up. And while our utilities do have some low income programs available to them, I think that would would help as well. And you just have to It's not any one answer. I think this is a multi prong approach that would be necessary.


I think, you know, as our seniors age, they losing their ability to drive is difficult. And while Orange County does have you know, transportation programs that and even our center we we take part in the octa senior mobility program. But oftentimes that you know, there's there's not Have enough, or there might be limits to transportation, there is Octa access. But again, maybe there are not enough options for seniors. Perhaps, you know, the taxi service or something like Uber, but Uber for seniors some something that's easier for them to be able to use. I have heard, I actually just heard a report recently that Uber is going to a call system whereby I think they're modeling it, or they're targeting probably teens. But really, it could be used for seniors to where much easier for our seniors to call a phone number to schedule, transportation and a ride than it is to get into some type of an app that they're not, you know, not all of our seniors are, are tech savvy. So I think that would be helpful. So those are the issues that we're experiencing is they want the freedom to be able to go grocery shopping whenever they want, or to go to the mall and whatnot. And unless they're an access member, or they qualify for the access program, they are still somewhat limited. Even in our grant program that we have. It doesn't, it doesn't take them out of our city. Our grant keeps them within our city boundaries.


Mm. I am very interested to hear about tranportation services that you have at your city. Sure,


sure. So what we offer here we have the octa senior mobility grant. And we then contract out for AGEWELL Senior Services to provide our transportation needs. However, it is limited to just serving the boundaries in San Juan Capistrano. So our program provides free transportation from their home, they can go grocery shopping a few times a week, we, we limit the number of stores that they're able to go to. And then we also provide service here to the community centers so they can arrange for transportation to come to the center for programs, like our meal program, or legal aid, tax program exercise classes. So right now, that's what it's limited to here. If they have a doctor's appointment in another city, then they have to rely on either access or age wells, their own program, which is for non emergency medical transportation. And a lot of the times they think the seniors too, it's like you can't a lot of them require advance notice, as do we, and sometimes seniors, you know, don't have that ability. And sure, like same day service would be helpful for some as well. We've heard those comments over the years.


What the area is just to see improvement in transportation,


goodness gracious, for that would probably, you know, really funding funding sources and transportation companies like who, you know, what other businesses or companies are out there competing with Octa or, you know, California Yellow Cab for instance. So, I think that is a barrier, that there may not be enough options for seniors for transportation,


are there different experiences for different group of older adults who have different backgrounds.


I don't think so. I think you know, Octa and AGEWELL have done a great job with all seniors from all backgrounds, you know, and all ethnicities, so I don't really see that as much as an issue.


Probably, again, having meetings or interviews like what we're doing today is helpful and going back to Octa or organizations similar and discussing the needs of each community and how it how services can be expanded. is a good start.


You know, I think, I think the county does a very good job. Of and and and as do cities, local cities and senior centers, providing as many services and resources, leisure activities that engage the seniors and keep them healthy and vital. So I think, I think they're doing a great job with with in general terms, I think they're doing a great job.


Now, long term care is an interesting topic too, for the mere fact that again, it kind of goes back to a senior who may not have had a big career, and they didn't invest in long term care. So they don't have that available to them. And then, if they don't, and something occurs that requires long term care, families are being asked to step in. And oftentimes, I've heard over the years as well, that a lot of our seniors, they don't want to be reliant on their loved ones for their long term care. You know, it is a big financial burden. So honestly, that that, for me is is an issue.


Not, yes, not the public, in general. So for seniors, I would imagine this has been an area where there hasn't been as much not research, but availability, or talk to the senior community, making sure that they understand that there are services available, however, I think, or I can only can speak to our city, in trying to encourage programs that will support them through things like grief support, or art for healing. That happens to be a program that we have that does touch on mental health, but in such a way that it's done through art. Programs like that programs that are really cutting edge are great, because there's such a stigma, I think still attached to mental health with seniors. Right, not wanting to think that there's something wrong with them, or being fearful to ask for assistance. You know, they some are and but many more aren't. So I think, yes, there could be a little bit more done in that area.


Well, I know that they're, you know, I think some of our local hospitals. I know that let's see your St. Josephs in Mission Viejo. I learned recently that they they have a program and I don't know that it's necessarily targeted for older adults. I think it's just broad in general. But those are the only ones that the only one that I'm aware of. Most recently. I'm not aware of any others.


You know, I think human i think it's accessible I think also having social services, especially in Orange County, right. So there was only one office that folks could go to or call and that was in Santa Ana. However now for the South Orange County area, there is a another office in Laguna Hills. So I think having some satellite offices spread around that are closer and easier for seniors to get to. It is great.


I still believe that housing is going to be a challenge In economic security, not knowing within the next few years if there if we are looking at recessionary times. I think, also long, long term care or in the home caregiving, you know, having a husband and wife where one is ill, or has Alzheimer's or dementia, and the spouse is staying in the home, and they're their primary caregiver, I think that is a problem. And I don't know that that will be getting better anytime soon.


A, you know, I think just offering more programs designed for health, I mean, seniors are living our society as a whole. You know, we're living longer lives. And I think, you know, there needs to be more work done in making sure that we can also meet those needs, and we can treat the senior as a whole, as you said earlier, just not only their physical well being their mental well being in a caregiving to, to help them go through those golden years.


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


Okay, Orange County. Now, this is a tough one too, because our the economic makeup of our city, obviously, I would then tend to say, and I'm just looking at our city alone, we're different from, let's say, Westminster, who might have a diverse resident population, we are we do have a large contingency of Latin community. So for for that community. That's, that's tough. We've been working very diligently at programs and services and going into the community and informing that community what programs and services are available at our, our Senior Center. So yes, there there is definitely a difference they're


You know, I, I don't know that there really is an issue at the moment that is being overlooked. I mean, honestly, the basics are obviously what, what the most important, the most critical need is, and looks like from the list that we've been discussing. You know, we we have that completely. So it'd be hard for me to say if we're, if we're missing something, if I do think of something, and that may just happen. I definitely want to follow up with you on that.


I would like to dig a little deeper in your area of expertise of providing a community space on all ages, including older adults, right.


Or you're talking about our facility and what we have available to the seniors.


You can draw from that expertise. But I think just in general, in the capacity that you've providing a community space that all people could come but including, you know, the older adults too,


right. Right. Okay, so for us, I think our program has grown over the years. And since we happen to be a community center, combination, senior center space is definitely an issue for us. So it would be so nice to be able to have either a standalone Senior Center, or more space that we would allow us to broaden programs here in San Juan. Exercise happens to be one of the highlighted programs that many of the seniors enjoy, so possibly having an area of space for them to have a have gym equipment or more socializing space within our center would be beneficial. And and that's what we're we're kind of lacking at the moment.


You know, I do. I would imagine. So since I touched a little bit about our Latino population, there are several organizations within our city that that work with the Latino population, but as a whole, so everyone from youth teens and and seniors, so yes, if I had to say that you probably would want to engage organizations like Creer, or even Unidos. Those are two nonprofit organizations in San Juan, I think that would have a voice and the Latino population as it relates to senior issues.


R. E. E. R. Okay. Thank you. Yeah, thank you so much. You're welcome. That concludes our interview. I'm gonna stop sharing and stop the recording now. All right.


Good afternoon. So my name is Tohron Barnes and I'm a part of the research team at Advance OC. And we're a local nonprofit, conducting, excuse me the county. Older Adults needs assessment. Thank you for your willingness to take part in this interview. And the purpose is to identify the needs of older adults, and to gather insights from your expertise and experience. So the information you provide will be used for the development of Orange County Master Plan for aging. This interview will last approximately an hour. And with your permission, our discussion will be recorded for transcription for transcription and note taking purposes. After transcription, the recording will be deleted. If you do not feel comfortable being recorded, turn off your camera and quote and change your name attached to your picture. Your responses are confidential, meaning that we will remove identifying information in the report. Please note that your participation is also voluntary. And you may also choose to answer any question in part full or not at all. You may also withdraw from the interview at any time. If you're unfamiliar with any terms I use, please let me know and I'll provide an explanation or examples.


Thank you. Nope. Okay. So again, the primary goal of today's assignment to identify the needs of older adults and to for you to let us know what is most important to older adults. And those that again, those are folks 60 and older. And we want you to think as broadly as possible, taking into consideration the older adult, their caregivers, families and the community. So I'm going to share my screen so you can see a list of common issues impacting older adults.


The whole list, okay. So let me know when you're ready to move forward.


Let me just go through these really quick.


No, not at all. We just put them in alphabetical order, not any order of, you know, rank or anything like that.


Sure. So my name is TJ McGovern. I'm a deputy chief of emergency op your operations Bureau for Orange County Fire Authority. And right now, as far as emergency responses, I typically don't respond to older adults right now in the emergency scene. But I did spend many, many years coming up to the firefighter ranks being a paramedic and ng captain. And going on a lot of these calls throughout my career. The engagement I have now is basically when we see him at community events or council meetings are kind of out in public. And they obviously come up and we have conversations about that, but not really an emergency scene anymore. But I do oversee, and I am responsible for all the crews that do go out on those.


, no, you kind of hit it, because one of the biggest things that I've seen through my career is when when some of these older adults don't have family to look after them, and we, and either their spouse or themselves or medical alert company calls us and we go out there, and we get a sense that they struggled or take care of themselves, we can see that with the home status that their their home is in cluttered. No food in the house, kind of just dishoveled if you will, and you know just not able to take care of themselves. And most of the time when we go in these situations, it's a godsend that we do because we're the ones that will reach out and start getting some help for them. Our first question we normally ask is, you know, do you have any family we can call and and when we see houses and some of the status we see um, if the answer is usually no. So I would say out of all these big ones is where they need help is kind of just their well being in their day to day operations of living,


Absolutely, yeah, that's that really, you know, I don't want to say, a hoarding conditions, but their opportunity to take care of themselves has been significantly diminished by what we experienced and visualize in their dwelling, whether it's a residential house they've owned for many, many years, or an apartment that they live in.


Okay. So these needs listed. Now, I'd like you to rank the top three that you feel that are most important for older adults in Orange County.


would 3 do you see as the most important


economic security would definitely be one that kind of ties into that


you did connote personal care management that's on the list here for highest


I would say, Yeah, I'm just kind of going down. Absolutely. Personal Care Management is definitely probably the top of when we respond and we reach out to where we need some additional assistance. I'm at so yeah, personal care management. You know, economic security and medical, now, if we're talking just medical conditions, and they're, they're well off their family, are you looking for kind of medical conditions to because of medical conditions, we'll go on cardiac events, shortness of breath, that sort of stuff. But we go on those quite frequently, I would say the biggest ones, but they don't need help. But obviously, they need advanced life support carries cardiac and breathing problems, as far as that goes.


Okay, so I'll add that to your list. Because I don't see that here.


Yeah, cuz we typically get a lot of our calls for cardiac related and difficulty breathing, which includes, I thought I did see like asthma like respiratory conditions is in there. He literally Add Card cardiac events. And, you know, a lot of mechanical falls, whether it's being they got dizzy and fell, or they tripped over something because of their mobility. piece of carpet or something, their their mobility is hampered later on in life.


Okay. So now, when you think about the top three, that you Whoa, I don't have your third one from this list. I'm sorry, I need one more from this list.


So let's go economic security. Yep. Personal Care Management. And then use the other one, I would say by cardiac and respiratory conditions. Kind of ongoing, or to summarize those out use ongoing medical conditions.


Okay. And so would that's the one that I added to where it's not on the list. Because related to that,


I would say that's probably the third one. Okay.


All right. Well, so you do I'm looking at the list, you do have heart disease and stroke. So that is on there. That's a cardiac event. So you can scratch cardiac because I do see heart disease and stroke. That's a very, very common 911 Call we go to, you also have respiratory conditions or another very common emergency response that we go to also, so actually a four up there, so. Okay. And, you know, the economics of security. It's, you know, we have, we're not one city so we have a lot of different diversity in a lot of our cities that we do, you know, we have 23 cities and two unincorporated area. So we're, we're kind of all over the spectrum,


Yep. So now when you think about all the lists economic security Personal Care Management, you know, your heart disease and cardiovascular, you know, your respiratory conditions and you said shortness of breath, and then also the mechanical falls.


You develop heart disease, your lungs don't work as well as they used to. So it's kind of just a deterioration of your whole health. It's just part of life. growing older, the mechanical Falls is, you know, that could be part of dementia, coming into play, and those sorts of things.


Now, what barriers exist to improving in any of these areas, this is the medical area of the mind intentional injuries.


Yeah, so the medical areas that's, you know, proper health care, having a proper designated physician, routine checkups by their health care providers, making sure they have enough and the proper medication at their houses, is something else we do see is they might get a medical or a prescription, and whether maybe they don't have the means to get to the store to get those prescription prescriptions filled. Or they don't have the means to pay for them to get them filled, when they might have to choose between food or medication, those sorts of things. And then also, family. When we get older in life, you have to have family support your kids, as you're getting older, you need that support to help you get through those sorts of things.


Yeah, absolutely. In more, in a more fluent, I guess, are fiscally stability cities that we do serve, you know, you're probably going to see some more health care, they get to their doctor's appointments more, they were able to be under a physician's care, they don't have to worry about the finance piece for prescriptions getting those filled. And then some of the other lower lower fiscal areas. You might not see that not all of them, but you probably have more tendency to see that and, and some of the areas I've worked throughout my 29 years in the fire service, you can kind of tell when you arrive to their house or something that isn't maintained. And that's kind of something we can notice pretty quick on that.


Now, what do you suggest, so I'm gonna go one by one, what do you suggests is the best way to address issues surrounding the medical


you know, okay, I spoke to those, it's just under, under doctor's care, routine appointments, routine checkups, making sure that they have their prescriptions on hand, and making sure that active staying active is accused of very acute thing that, you know, we definitely need to get them out walking social events really helps them get out of their residence, and interacting with the public or their friends or public services that they have, you know, getting active and you know, exercise, those are definitely going to help all the medical conditions that are associated with getting older in life.


Now, what would you suggest is the best way to address the issues surrounding improvements with personal care.


So that's where we need help. We need help there. They need help from county services. Reaching out making sure they have an avenue and they're aware of the avenue that they can call or reach out to to get those services and assistance. It should be very easy. They all know everyone knows if you have a accident medical emergency, there's a 911 number that you can call and we will come we We definitely need to get to the point where maybe it's like a two on one call, that they can call and just ask for help, because they are unable to sustain or they're in assistance, that maybe not isn't a medical, a life threatening situation, but they just need that day to day assistance, giving them direction of where they can go to find those essential needs to sustain, you know, their life.


What do you suggest is the best way to address issues surrounding economic security,


kind of the same thing, having an avenue in a venue for these older adult communities, to have somewhere where they can reach out to, you know, the technology gets more difficult for them, it's moving so quick. So having something easy to go to, and kind of a one stop shop, of who they can call who they can reach out to, to assist them in directions to find these essential services. As we're all going to need when we get older, that's not readily available to us today. How do we get there. But as you grow older, technology moves so quick, it's hard for even myself, keeping up with the technology. So it has to be easy to find those essential functions that they could use.


You know that that really goes back to help from the county health. That is back to doctor's care. Having support these people are going to need support. Because when you get in that Alzheimer's and dementia, you don't know where to go, you're scared, you're probably by your self, if you're not at a assisted nursing facility or assisted living facility. It's all about those essential services that they need help for. Once you have Alzheimer's and dementia, you need that support mechanism. And that's where we got to get for these people. That is very, very large right now, when they get in that Alzheimer's dementia phase is they need assistance because they are no longer to sustain by themselves. And without family or friends or children. They need someone where they can go to to assist.


Okay, now could you please describe how accessible and adequate the following care services are in Orange County and I for services, one geriatric care to long term care, three mental health, behavioral health and substance use treatment and for human and social services. So with one geriatric care how accessible and adequate is that service in in Orange County.


So on all those services, um, you know, through all our big health care providers here, I know that we do have those services available. But in order to get those services, you have to be proactive to reach out to get those services and to keep going to those services. But if there's older community is unaware of how to reach out to those services, that hence the problem, they cannot access those us as 911 providers, we have routinely back when I was in the field as a paramedic, firefighter, and even a fire captain, we knew that we can contact Social Services with name info, and that's where we would reach out to them to provide because when some of these older adults when, you know, they don't have Alzheimer's or dementia, and we recommend it, we're not sure that they're going to follow up because it's hard when when you need to reach out to these services, mental health, that sort of stuff. It's a tough conversation. Because you know, you're kind of addressing that, you know, you have a need, and it's hard to come in there and admit to that, at times, not everyone can just say that I have a mental health problem I need, I need help. So what really helps is having clinicians kind of aware and kind of reaching out to them as well.


Now the you know, of any services or programs in Orange County that you know, specifically some provide support for older adults on any of these services.


Offhand, no I could I could, I'm able to research through the internet I could. But what we typically would do, we'd reach out to Orange County Public not public health I just said, social services agency social services. Yeah, we would reach out to them make contact, advise them of the situation we found, and then kind of let them take over. But I don't know like what hospitals have what but I would be able to research it online and, and I think in this county, we do have all those services available, but it's about getting that message out and making it readily available for them. And that can be done, you know, through there, they're able to go get routine checkups. Maybe there's something that all the doctor's offices, the hospitals that clinics they go to, for the elderly community with brochures or something just so they can, you know, you give them one or they're able to take one and bring it home and maybe read it at a later later time. But at least it's it's it's another resource that's available to them.


You know, that was hard for me to understand, because I've never had to use those. I would assume not knowing in depth, it would be like a doctor's appointment, I know, I go see a cardiologist, I'm gonna go I'm gonna tell him my signs and symptoms, what I'm experiencing, and that cardiologists would say, run some tests on me, give me some medications, have a follow up appointment, get some routine schedule is going, but I don't know, the depth of what those services provide the you know, mental health, I know, we do have a couple of facilities where, you know, private and public where they can go get those help. So they can be admitted, depending on the nature of that. But as far as in depth, I'm not sure I know. My dad had Alzheimer's dementia as I went through that. So it's just kind of a waiting game. Those are tough, there's no answer for those. So it's kind of a, it's a long drawn out very painful situation for for not only my dad that I went through, for the family, too. So that brings me to the next point. When these older adults are going through these, I think the family, you know, it's part of the family, their caretakers need some assistance to what to expect and kind of closing the loop with the family members that are going through this too.


Well, you always gotta put fiscal responsibility or fiscal elements into this, because you know, with inflation, everything's getting more expensive. Healthcare is getting more expensive, prescriptions are getting more expensive. And typically, most of them are on a fixed income income. So, you know, the health care system, hopefully, it just doesn't run past them with the inflation of health care with prescriptions and costs going in there. That's one of the biggest things that I see, I think medical treatment, they're learning every day with all the research that they do. So you know, we're making huge strides in cancer prevention awareness treatments, so we're definitely moving forward with that. As far as that goes.


I think that has to be a priority, because it's not, you know, we're gonna get to a point where we don't have any more older adults. This is an ongoing continuous concern that we all need to have. And we need to be proactive, and have services and plans for these older adults for perpetuity. It's not going away. Everyone's getting older, day by day, minute by minute. So we definitely need to be proactive and look for new innovative ways to make sure that the older community is is a priority for us moving forward.


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


I would say people who are unable or unwilling to reach out and ask for help. I don't know but I would say probably the people with lower income They probably, you know, they have priorities or priorities put food on their table and shelter over them first. There, some of these individuals are just in survival mode. And there might be a mindset where if I'm reaching out, and it's gonna cost me 20 3040 $50 To go to the clinic, I'm gonna stay here, save that money and hopefully wait it out, in some situations, waiting it out, cost them their lives or deteriorate their lifestyle. Moving forward also.


offhand maybe a substance abuse, mental health, those would probably be and the third ones are so maybe substance abuse, you know, alcoholism, I'm sure they're not doing recreational drugs. Maybe they've been alcoholic for their entire life, and it's definitely waning on them. What asked me that question one more time,


I would say that is probably the big one.


Right. After all the questions and you know, thinking about what I'm asking you only thing


now that the ones you know, I've been doing this a long time. And the ones that really are bothersome, if you will, is going to a residence going to an whether it's a house or apartment, and they're not able to care for themselves. Typically, it's no family is there and they're just they're surviving trying to survive day by day. And having services to come in and help them. That's that's probably the toughest one to go through. You know, they spent their whole life getting through and now they're just struggling because maybe they have some early signs of dementia going on, and they don't know what to do. They're afraid they're alone. So I think the bolstering of services for these individuals would be a key.


Well, this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. And if you find that you have anything else to share, please feel free to contact me. You can also contact with us through our website events, or c.com. Or you can also call our anom our anonymous voicemail at 949-415-6898 at any time. Okay. Well, thanks again, she. And yeah, I'll be in touch or, you know, information about the about the next further stages of the project. And also, I'll just keep doing a loop of like where we're at. Perfect. I


I'm sure we're going to be collaborating on the events to outreach to the seniors themselves, because we need to know from them, you know what their needs are. All right, that means a lot. Alright, thanks again. Take care


Those who are 60 and older. We want this thing as broadly as possible taken into the consideration of the older adults caregiver, family and their community. I'm going to share my screen so you can see a list of common issue concern impacting older adults.


Please take a few minutes to read through this lesson. Let me know when you are ready to begin.


Yes, my name is Griselda. And I work for Orange County Parks. And I am a park division manager. And I oversee 1/3 of the open space


which includes an outdoor space including


like programming to keep, like older adults engaged, for example, opportunities for interpretive programs where adults can go on


can learn about local history through our OC Park has several historical sites have we actually provide tours of our historical sites, and we actually provide


information about our local history. I don't see anything that


I don't see any of these categories where where


maybe it will fall under mental health or mental well being.


I don't know what it would fall into, but more like education or like long,


long life education, anything that has to do with like, older adults either taking courses in classes, that kind of things. I don't see that in this list. And we can dive a little deeper into that later on. Thank you for sharing that. So of the list that you saw, including the one that you suggest that can you bring the top three that you feel are the most important or the most important in my role as working with parks. Yes, of course. I would say the top one would be diet, fitness and nutrition.


Also behavioral and mental health by using by older adults using outdoor space or or visiting parks, or as park users, that would probably be a good thing for mental health that would be two.


And also emotional well being would be one as well. I think those three would be my top three. Thank you.


So when you think of diet, fitness and nutrition,


Of safe places to exercise, being able to, to find a place close by where they live, where they can either go for a walk or exercise


That may be a challenge for some people, the older they get, they may not have transportation, or have anything close to their homes.


Yes, like I said, perhaps you live in an area where they don't have the open space and outdoor space available to them so they cannot enjoy the outdoors.


Are there different experiences for different groups of older adults from different backgrounds. When it comes to this issue.


I would think so because depending on on


where people live, there's some areas in the county where there's a many outdoor spaces to exercise. And there's other other places in that in the county where a park may not be or a park or an outdoor space may not be close to their homes. And some people may not have vehicles to to either either get to a local park or maybe even walk to a park. Those probably will be the the things preventing people from accessing a place a safe place to exercise.


one, I would probably let people know that these outdoor spaces are available


provide them with information and locations of the parks and perhaps provide them with information about


transportation, public transportation, they may be able to get a home and vehicle


transportation so they can get to these outdoor spaces.


Okay, thank you for sharing. So moving on to the second


issue or things that you feel that are important that is the behavioral health. When you think of behavioral health how or why older adults are struggling with this issue. Can you go up, I want to kind of see the definition again. Yes.


I guess research has shown that, that having exercise and being outdoors can really help with mental health. We saw it during COVID Where were where people


were stressed with you know, not being able to like see their boundaries or their or go to work. We saw an increase in in attendance and our parks and we've been told that it helps with anxiety and depression. So it's a good way to once people are outside it really helps with mental health, overall mental health.


With barriers I think again is being able to one realize, identify the local outdoor spaces are available public spaces


I don't, I don't really know how to address that. All I can say is the the outdoor spaces that OC parks provide us we, most of our spaces are ad accessible. And a lot of our signage is in different languages. So we try to in parks we try to provide with


all our park users with like, we try to provide them with the same experience when it comes to our outdoor spaces.


What do you think, what do you suggest is the best way to address this behavioral health needs.


Like I said, I'm letting people know that these outdoor spaces are available, and where they can exercise they can go for walks. A lot of our our products provide programming, where you can take a class, you can go on a hike with a park ranger, you just there's a lot of programming opportunities that OC parks provides. I think letting the older community or making them aware that these this that we have these programs is probably probably helped people with anxiety and depression and memory loss issues.


Thank you. So when we think when you think of the last


need that you identify is the emotional well being


how or why are older adults struggling with this issue.


Limits inclusion quite a bit of mindset we can use.


having a place where perhaps you can you can


take a walk with a friend, you can maybe have a picnic with, with family.


perhaps bringing your family or your church to together at a at one of the campgrounds for example, or going on a hike or or like I said just walk. And I think that's that will probably contribute to emotional well being providing spaces where people can meet and bond and and spend time together.


What barriers exist to see improvement in this area.


letting people know that we actually have these outdoor spaces we have


programming that is open to all all park users searching just letting them know that we actually have these resources for them.


Are there any different experiences for different group of older adults from different backgrounds.


Not that I could think of I think I said that it kind of goes back to like where they live and how many parks are are close by. And if if probably the


the biggest barrier would be accessibility like how far these parks are or outdoor spaces are is getting getting them either transportation to these to these these open spaces.


As far as are getting people out to the outdoor space.


improving like public transportation, working with maybe with local public transportation organizations like maybe OCTA maybe


working together with OCTA to provide better routes to the parks and open space. That would probably be


one way to get more people out or perhaps if there's a nonprofit that can provide shuttle service or


older park users that may not be driving anymore, or that they may be limited. They have limited mobility and maybe having heavy shuttles. Or I think I think there's there's ways of getting getting transportation


opportunities for our older communities. Yeah. Thank you for sharing.


And so I don't think I can speak on that. I don't think I can answer that.


arena. So I don't I wouldn't be able to answer that. That's not. That's not what I don't know anything about that. I'm sorry. Yeah, no worries. Yes, I understand. Yeah.


any human shelter services services are accessible and adequate in Orange County.


I wouldn't be able to answer them. Unfortunately. I don't. are not familiar. Yeah.


I would probably have to say the cost of health care.


But I'd think that would be probably the most challenging.


I think the county should be able to provide


both older or older adults can get access.


I think letting letting the older community now that these resources are available, probably key would be really important.


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


Oh, I don't I I don't work with that. Or that group of


I don't know. I don't know that answer. Yeah.


Ah, I don't know of any. No, I don't. Yeah.


So this concludes our interview. Thank you so much for your time. Incredibly helpful. Whatever research, you find out what to share the self okay to reach out to Okay. I will think you have a good one. Thank you.


Okay, great. So the primary goal today is to really identify what needs you think are most important to the older adult populations that you serve. And for our conversation, the definition of an older adult, or those who are 60 years and older, says following California's definition for an older adult, but we want you to think as broadly as possible, taking into consideration the older adult, their families, their caregivers, and the community that serve them, but also the community that


they engage with, right. So, right now I'm going to show you my screen and it has a list of common issues and concerns impacting older adults. Just take your time and read it through. You don't have to memorize it'll stay up for the duration of our interview. And I just want you to just kind of read through it and take it all in, and then I'll ask you some questions about it.


Oh, yeah. You don't have to remember any of them.


I just want you to read them through once. So yes, there. Yeah. So you can reference it Because it's gonna stay on the screen. Oh, wonderful. Wonderful. Okay, that's helpful.


Okay, all right. Sure, my role at WisePlace is the CEO. And the way that my organization and myself interact with older adults is that we provide shelter and basic needs and wraparound services


with the ultimate goal of ending homelessness and helping older adults, secure housing, and then retaining housing.


So actually, I've been I've been leading the organization for five years and believe it or not the first three and a half years, I was almost doing direct service just out of necessity.


And so I'm a bit removed now, but obviously, I know the participants


and very still very involved in the services. Great, thank you. So thinking about Orange County and looking at the list here that's right in front of you. First of all, I'd like to ask is there anything missing from this list


it seemed very comprehensive. Okay, so nothing comes to mind now.


Okay, and you can always add ad it later


if it comes up in conversation. So given all of these issues that you see here, I would love it if you could rank for me just based on your perspective and opinion rank for me the top three issues for older adults in your opinion, okay.


Gosh, these are all very meaningful and important


you know, just from just from our perspective, using our lens, I would say housing


being the number one and I say that because obviously when I meet the older adults, these women are all experiencing homelessness.


And then I would probably pull out health care


I would probably as number three economic


I think those are the three. Kind of very, very


kind of critical that we're seeing at WisePlace. Okay, great. Great. So I'm going to ask you the following questions on those three things, we're going to take them one at a time.


You know, limited income, their market rents, not enough assisted living, not enough affordable housing.


You know, I see it every day, I see women who have sometimes work their whole lives and have a pension, and it's just not enough.


And it's not the right housing, right, going into fair market housing, you need support, you need assistance, you need services. And so housing alone is not enough, isn't even the answer, I would say for older adults or most vulnerable populations, frankly.


So it's just you know, it's a it's a fordable. issue. It's a lack of housing period. I think that's where it starts from, right, because I think there's not enough housing, and then you stack on the affordability of it. And then it's not the right housing period.


I mean, having been through our first affordable housing


I mean, I hate to say it, but it just does seem like a lot of red tape. It also seems like and I think it's tied to bureaucracy that, and I don't think this is specific to California, I think this is federally, but I mean, building


support service type housing, affordable housing, it's, you know, you're paying like $750,000 per unit.


And so it's just, it seems to be just buried in red tape. And that red tape comes with a lot of fees.


Just astronomical prices. The bills, affordable housing are something that older adults so desperately need.


Definitely. And I think that's why, you know, regardless of what type of affordable housing, it should always have services.


I think that would best meet everybody's needs, from health care, to accessibility to socialization that breaks up isolation.


You know, a social worker, case manager health care, I think it's important to have services at everyone's disposal.


I think housing alone without services is not the same. And I think, you know, housing should tailor its services for various populations, just like a restaurant, you know, you wouldn't feed your clients, one thing, you would have an array of services that meet their needs, and includes that. Yeah. Yeah.


it's hard because I've never been in a sector that is swimming in money. It seems like homeless and housing is, you know, you constantly see, and maybe because we're in California, and it's maybe, you know, you see every article saying, you know, and it's with, sometimes with billions of dollars, not even millions of dollars, so, so that's why I tend to think like, gosh, this is still really expensive. And then the bureaucracy all of the holdups and it seems to be that that money is is just going back to bureaucracy.


So that's a shame. So I don't know how you counteract that. I guess you would lobby.


we would get cities and counties the funding that they need so that they could release it. And you I think from a state level, federal level, you have to support cities and counties being able to do this faster.


gears and go to your number two, which is healthcare access and delivery.


So you see it right in front of you all the sub categories there, and all the examples, how and why are older adults struggling with this issue.


I mean, healthcare is just so complicated. And I know myself, you know, I'm, I'm an immigrant from the Middle East, but the rest of my family are refugees from the Middle East. And I know growing up, we didn't have access to services, or if I think of my grandparents, or if I even think of my mom, and my aunts now that are in the older adults category, you know, they need a lot of assistance, they have language barriers, and they need a lot of assistance.


Just navigating healthcare and at WisePlace. I mean, we see so many women who should be, you know, connected to Cal Optima, but they are not.


And we get them connected to health care, which is really,


you know, really tragic that somebody 60, 70, sometimes 80 is literally lacking health care.


And then I do think the, like, this looks like the last few things you have on here, kind of like specialized care for lack of a better word, you know, nursing home availability, geriatric care for


Gosh, I don't know. But I think in how in home services, I think that would be really important to take services to


is really prohibitive of somebody feeling empowered to take care of themselves.


And when you feel sick, you feel sick today, not four weeks later, when you can get an appointment.


You know, that's what we're seeing a lot when we would get on the phone for women at WisePlace, and really, really advocate and sometimes just show up, you know, we didn't have any fear of like, we're going to show


we're just going to invite ourselves to this doctor's office, we're going to lightly but here we are. And, you know, just it's just hard. It's just


You know, I don't know how you do this, but I think you need to take it into communities.


You know, if he if I feel like that's like a more proactive approach with older adults, if you are,


you know, if our health care system for older adults is reactive, so we call you when someone is not feeling well, or sick. It's almost too late. Right. And so


I don't know how health care systems do that. But they have to find a way to take it into communities.


Because if you if you take, you know, your service into your


Yeah, you know, and then once again, with regards to health care, access and delivery, are there different experiences for different groups of older adults.


Yes, and I mean, for me, I do believe it is separate here. Yes, behavioral mental health. But if you think of health care access, and delivery is also you know, part of your health care is your mental health,


You know, I just think everything has to be specialized.


So I know this is a big question, but how do you suggest what is what do you suggest is the best way to address


I mean, it seems so simplistic and I'm sorry if you know it is simplistic answer, but I do think you have to take it to the people.


Because I think you have to bridge that relationship prior to someone feeling so ill.


And unwell. You know, I think you have to somehow make it a proactive and not reactive


kind of delivery model on a service model. And I think there's


easy ways to do that that are culturally relevant that are sensitive to communities.


You know, but it is a bit, you know, out of the box, right. And so that takes a level of trust. And if you want continuous reliable health care, you know, you do have to kind of build relationships in the community. Don't think you can sit in an office and hope that people are going to, you know, come to you. Yeah, yeah, yeah.


Okay, so now we're going to visit the third thing that you mentioned, which is economic security.


I mean, I think housing is such a big issue for older adults, that the cost of housing is just unbearable.


So you're, you know, often living on a fixed income. And so, by the time you pay your rent, there's usually nothing much left. And so, you know, when you have to pay a little bit for medicine, or whatever it is, your basic needs. Food.


I just think that what we've experienced is older adults, I mean, even when we have women with vouchers, and all the support systems, it's still an issue, it's still very much an issue, until you're really wrapping services around you're saying like, okay, you know, let's make sure you have a, a nutritious food supply, because they're not going to be able to achieve that on their own.


So, you know, unfortunately, we see that a lot.


I mean, for us specifically, we also see, you know, a lot of


debts that, like we come in and help pay off.


And so obviously, that can be just so overwhelming.


I mean, let me think of older adults, specifically.


five to 15, I would say for women 60. And I mean, my first year, we serve somebody who was 92 years old, who was in our shelter, and that just broke my heart that a 92 year old woman was on a cot in a 1950s building, not even a room and a gymnasium. That's where she slept.


Probably 87 is like on average, the kind of most senior, older adult that we're serving. So if I think of 60 to 82, probably the highest bill I have paid for is around 25,000. But I would say if five to 20 in that range for women 60. And up. Yeah. Wow.


No, I would I would definitely say from my lens at wiseplace. Those three


And then once again, you were mentioning for economic security.


It's interesting, because if you're a chronically homeless, older adult woman, then you are eligible for live permits supportive housing, but again, you know,


these, these are still these are still issues


and our phone rings off the hook for older adults.


And I would say you know, people are asking


you know, mental health wellness as well. Yeah, yeah. So I mean, as you know, no two people, no two people are alike.


Yeah, yeah. And then what do you suggest is the best way to address


I mean, I, at least from my lens, and my lens could have, you know, a total skew just because of the service that we provide for the community.


After housing, there is little to no money at all,


even when we have somebody in a subsidized assisted living situation.


So I think that, you know, unfortunately, all of these will be issues to varying degrees if


the housing and the health care is not taken care of.


Great, great. Well, we covered all three things. I don't know if you want to mention anything else. With regards to those three things housing, health care access and delivery and economic security.


I don't think I have anything to add. I mean, everything else is really relevant on this list, too. Yeah.


Yeah. Okay, so now we're done with this.


We're going to now go on to other questions, I wanted to ask you,


the following areas of care, I'm going to ask you for you to judge how accessible and how adequate


the following services of care are. And the first one is geriatric care. And the way we define geriatric care, it is very similar to pediatric care care for children's specifically geriatric care would be care for older adults specifically.


And so the question was, how accessible and adequate and adequate


it is good. But it has been tricky for us to like make the right connections, make sure it's a good fit, help get the person to appointments.


So I think that, at least for us, it's difficult. And that could be just because we're a more grassroots organization. And maybe it's a WisePlace issue, like we don't have enough bandwidth.


But I think once we are able to kind of really help and advocate for the older adult, then usually the connections that we make, then usually they're pretty pleased with their care.


Great, what about long term care, and this is care for older adults as they age. So you know, you may see them at 50, we may see them at 80. Yeah, so I, I would say our organization has kind of only, at least with me, kind of


experienced that for the last five years, so can't really speak to more than five years.


I don't know how to kind of phrase this. But


in the beginning, I would say like the first three years, the older adults that we were serving were overwhelmingly


And usually had were, you know, living with mental illness had a physical disability, and then oftentimes also have we're dealing with recovery in substance. So


for us, that was very difficult. And I find that that is very difficult to find like the proper care for when somebody is kind of checking off all those boxes, if you will.


And I think that if we as an organization are not the proactive ones, their level of care is not great.


Kind of, at least what I've the majority


of what i've experienced the last five years, If our team is not on it,


then older adults are incredibly vulnerable.


Especially when someone is housed. Most people, most organizations will not follow up in the way that we do. Because there's no funding for it.


Which I'm thankful to Cal Optima, they're kind of changing that conversation a bit. So


it's kind of just an interesting place to be because we tend to be one of the smaller organizations.


But maybe, because it's like, I'm still in the weeds that I'm no, go, go check on this person, go check on this person, go check on this person. Right. Yeah. Especially because the majority are not necessarily placed in the ideal assisted living 24/7 care. Right. And so that


You know, that's tough. I would say accessibility is okay. Because there are providers, but I think the quality is not.


You know, unfortunately, it's just been kind of


You know, again, it is very hard to find


a person who can really understand somebody who has experienced homelessness, five to 10 years.


I just haven't been unfortunately, super impressed by the level of care that I have seen firsthand in the last five years, because again, the first three years, I was taking people to appointments myself, because I was trying to figure out what the hell is going on at my organization and in the county. And so I saw it firsthand.


And I don't think it was for ill intent. I think the intent to do good was there. But I just, I don't know, if it's like, you know, providers are overwhelmed.


But there was something missing. There is some there was care missing. And I saw it over and over and over again, unfortunately. Yeah. Yeah.


No, I can't actually I can, you know, like, county have certain. So they're like providers. But


I would imagine that you engage with that quite a bit.


You know, I don't know if my expectations are


I think you know, what I don't like is if you'd like just roll the dice. And you just happen to have a really passionate person on the other end, that really, really cares, then you feel like you've hit the jackpot for, you know, the older adult, but that isn't always the case. Yeah. Right. And so I feel like it's not adequate. It shouldn't be structural, it should be just a value set in the organization. It shouldn't just be like, Oh, because Michelle was there Tuesday, and she's great. But Jim not so great. And so don't make appointments on Wednesday. Like that shouldn't be the case.


There isn't just this like, standard of care. I don't know what to call it. But you know, what have I experienced is accessible. Sure.


and I'm asking you now to think about it in 10 years time, what would you think you say, I would say is the biggest challenge facing older adults.


I would really say it's the three things that we talked about. I can't, I can only imagine it just getting worse, unfortunately. Because you know, there's aging populations and the housing is not getting.


There's been like, even just in the five years I've been in this space, there's been so much good headway. But when I got here in 2018, and I've been in nonprofits for 20 years, but I've never kind of led a shelter. I've never been in this sector.


And in 2018, the county was talking about we are going to build, you know, whatever it was 3500 units of affordable housing.


So that's why I went back to the like, I don't know if it's lobbying, if it's more money, if it's, you know, get rid of some of the red tape make this easier, because you're gonna have so many older adults who are going to, and what we've seen in the last two years,


is that like, we're experiencing women 60 And above who are experiencing homelessness for the very first time.


Because of, you know, mainly the three reasons that we talked about, right, it starts with housing, and then the health care, and then all the other bills start to pile up. And then it snowballs.


Oh, gosh, I really think government needs to lead the way. Because I feel like that's, that's not the only way, right. And I firmly believe in public private partnerships.


But it does seem like the counties and the cities and the states and right, they really have the power to say, here's the money, use it for this. And we're gonna get rid of, you know, these three or four things. It took me two years to get through the Historical Commission of Santa Ana, for my housing project, two years.


And then it took another like year and a half to get to construction. Right, which I think that was like, relatively good. But


I don't know. It just it doesn't make sense. And I know, this was my first project. But maybe it's a good thing. It's my first project.


It's just weird. And it does seem like government has, you know, the power. It's not the nonprofit, the nonprofit can't come in and say, Oh, we're not going to pay this permit, or we're not going to go through this commission or this council. Right. So I do think government should be the leader.


Yeah, that's a great question. Because I actually think the population, you know that we get to walk alongside of it. wiseplace is getting a lot of attention. So I actually don't, I don't think this could be naive, but I don't think it's the population that we serve. Actually, I think


that women are experiencing homelessness and older adults experiencing homelessness are getting a lot of attention.


So I'm not sure you know, who else would be


I'm not sure that's a really good question. And I would love to know that.


Well, populations just generally, I'm not sure.


kind of speaking out of both sides of my mouth, but um, but I'll do it.


like health care, and housing. I actually think they are being overlooked even though they have a lot of attention. And I know that that's weird to say, but I


overlooked because there's not real solutions.


And so I think that is why I'm saying those issues are being overlooked. Yeah.


Because there's a lot of like press opportunities and press releases.


You know, the really the disrupting of systems that we know don't work, I think, I think real solutions that have like long lasting impact for deserving, you know, older adults, I think that that is not necessarily happening. Or maybe it's just not happening as fast as someone like me who is impatient for action,


for action. And so that's why I'm saying even though there's a lot of attention, they're still overlooked, because everyone's on autopilot.


Okay, so now I want to dig a little bit deeper into your service in the community, and wiseplace. So we were thinking about, you know, housing and homelessness, especially for vulnerable women in Orange County. That's working really well.


I would say the first even though it's in construction, I think the biggest shift and programming is that we want to add to the affordable housing, with wraparound services in the community.


Because we know that that is like a solution. And I do agree with all the red tape and politics and the cost of units know that I don't control that. Right. So.


But so I would say that, like, that's number one.


We haven't done it in 100 years, we've never done it before. This was our first attempt. Yeah, about near killed me. But you know, we didn't just say, We're gonna stay a safety net shelter. We said, we want to do that. And housing with wraparound services, and we fought really hard with our partner to say no, we will be the wraparound service provider, not you. Even though 100 pound gorilla jamboree housing, right. Because we know that our quality is good. So I think, you know the that really evolving our own organization, and really putting pressure on ourselves to do a $30 million project when we, at the time were like a $600,000 organization.


So I would say that's number one, like we have to add affordable housing units


in the city, and ours specifically will focus on older adults with dual diagnosis disabilities.


So I see that as a solution. And so I think that's something that we are doing well.


And I think once we get one under our belt, then you know, our ability to do more of that


will continue and is the strategic plan. Sure, sure.


Because I was, you know, like I said, you know, my first day, I walked into a 92 year old woman who was sleeping on a cot in a gymnasium.


And that's how we operated. You know, for the last five years, we didn't have an elevator, we didn't have the right infrastructure.


So, although we are going to do that, well, it's one project with 47 units, and it's a start, but it can't be the end. So that's what we need to do better. We need to continue to do more.


And also, you know, I'm really mindful of


Clinical Services, outside of counseling and therapy, I think we do that well. But like the medical clinical services, we don't do that well, and it's not within our wheelhouse. But if we are putting a stake in the ground and saying, we care about older adults, and we want to build affordable housing for older adults,


we have to integrate that into our services. So I'm very mindful of that. I don't have any of the solutions yet. I think the solutions will be through partnership, strategic partnerships.


But you know, like, I can envision like a clinic at another affordable housing, we needed to get one done right.


The $30 million for you know, a now $2 million organization is a huge stretch. So but when I think of creating affordable housing or


senior affordable housing in the future, I do think there has to be a clinic on site.


And so I think that's what we could do better. Okay.


Sounds like you're gonna go into the healthcare business. Oh, gosh.


tell talking. So after we discussed everything we discussed,


all the issues that you brought up, who or what entity, or what kind of entity is best suited to address these issues.


Don't think it's going to be one entity.


I could see the next 10 years and continuing to help solve solutions. I don't want to be the health care provider.


But I want to find a damn good partner, who I know is going to be accountable to the people that we serve. Just like for me for housing and all the other wraparound services, I want to be accountable.


So I don't think and I could be totally wrong. But


it's not like a stain your lane thing. But I think when you try to do all these really big problems and bring solutions to them, it is really hard to do all of that well.


housing partner, like a therapy partner, you know, a health care partner,


transportation partners, you know, economic financial literacy partners, I think all the partners have to break be at the table.


So I think it's going to take multiple partners, because


I just I don't see how it could be done. You know, otherwise.


unnecessary rules, I would say, an unnecessary bureaucracy that stops the building of various types of affordable housing that can be permanent supportive housing, that can be assisted living, that can be mixed use.


But like, this is a crisis now. And in 5,10,15,20 years, it is going to get worse and worse and worse and worse.


So I mean, that's that's the fog, I would wave.


Yeah, I would also, like add accountability to everybody. I


I just don't see accountability in systems.


You know, I think I think it's the funder has ADD accountability. So like, if I get money from somebody, somebody


I mean, Katie, between you and I, like when I first started, we were doing our emergency shelter for the county. I got there and I was like, oh my goodness, this place is on fire. Like literally and figuratively. I was trying to pull data of course, we didn't have any known used computer at wisely, even in 2018. And I was terrified of my first meeting with the county


And I walked away going oh my god. Wow. Easy.


You know, why were they just happy that it was keeping people alive and fed.


and I think the best person to do that as the person who's giving you the money


you don't want to lose that money. You want to keep impacting lives, but it's


you know, I think and obviously, you're the expert in this and I listen, I love talking to Tracy the last couple years because it's like


there's a place for output but there's a bigger place for impact. It's like your heart and your mind meeting.


Um, I think even if you throw away some very unnecessary red tape that I've personally experienced and on the road to building affordable housing for older adults,


there still has to be that accountability piece. Mm hmm. Ya know, for sure, for sure.


It's going to be both. So we have a museum in front


of of the building that is going to be public. We're going to display the community arts and things like that.


But this space is tight. And so that's kind of going to be it.


And so I think we could probably dream a bit bigger for other spaces.


That we have like a little bit more room. Because like so for instance, like my crazy dream of having like a clinic on site, it's not a clinic just for the people that we serve. It would be a public clinic for whatever community we're in. I was talking to like Laval at South County outreach, because I was telling because they're, you know, they're doing a new strategic plan. And I was telling him, you know, this is the weirdest thing. We're serving chronically homeless people, and when they're an emergency shelter,


you know, you feed folks, three nutritious meals a day plus snacks, everything accessible, then you take that same client, you pop them into their own apartment for the first time, and you provide no meals. And folks were like, happy that they would show me their monthly calendar. And once a month, someone would come in and bring fresh fruit. I was talking with Kyle was like,


you're missing an opportunity. Like, you know, go talk to the big gorillas, right mercy house illumination, foundation, Jamboree, housing, National Core, go talk to the counties in the cities, because this is a problem. People are malnutritioned, and permanent supportive housing.


And so anyway, he so he and I were like, well, let's do it with you. And I was like, Okay, well, let's build a pantry.


And so, if and when we're able to do things like that, my hope the goal wouldn't be just for those that we serve, it would be like a public benefit. Yeah. Yeah. Makes sense. Makes sense.


I mean, I'm sure you are talking to, I'm sure, like illumination foundation, I have a lot of respect for them, because they are doing recuperative care. So I think conversation with them, you know, makes a lot of sense. And I'm sure you've already had one or two or five. Conversely, they're so big, but probably lots of people out there. We just spoke to them two days ago. Yeah. Oh, good. Yeah, I think they would have, you know, some really great insight that, you know, we cannot offer at this time, we don't provide the same service. I think that's the only person that comes to mind.


You spoke earlier about older women being were homeless for the first time, you're seeing a lot like an uptick in that


I mean, I just would want the county to know, and I know that they're aware, because I've been to, you know, I think that they're aware.


But I would want them to know that it's a it's a solvable issue now.


But support systems and housing are not in place is going to be


you know, very hard to manage in the future. I think, you know, the, I would hope that the county understands like the time is now, not in five years, not in three years, because what we have seen the last two years is exactly kind of what I described. They they are it's a different profile just to overgeneralize just to make the conversation easier.


You know, it is women who are starting to have health issues, they have no support. They can't keep up


With rent, they have fixed income, healthcare bills are piling up.


It's just, it's just I'm seeing it the last two years, and it's starting to snowball. And I would just hope that the county knows that, you know, let's not make a big problem, an even bigger problem.


Because if we could even eliminate shelter, if we could get housing and get the women and men like anybody tied to housing, then, you know, the goal should be to avoid shelter period.


Because these are women who have never been in a shelter. And that alone is incredibly traumatizing.


And so I would just hope that the county knows that, like, let's fix the problem. It's already a problem. But if you if you just put 1000s of people in a shelter system, you're making a bigger problem


You know, it's hard because you need both like for me, like, you know, even I think my board was surprised that my recommendation for our next five year strategic plan as we got affordable housing off was not to do a second affordable housing was to make sure that we have one shelter, so that we have affordable housing and shelter, then we'll come back to affordable housing and start to scale. So I'm a fan of shelter, I see the power of shelter.


But I hope that the county appreciates that these women who are these older adults who are experiencing homelessness for the first time that they are different than chronically homeless populations, what they need, generally are different.


like in namesake Yes, I feel like there's a lot more funding for affordable housing for sure.


Um, but I mean, if you even think of like jamboree housing, like, you know, they're our partner, and I was just like, how many units are you doing in Orange County, you know, and they had, you know, four projects in the last six years, 10 years in Orange County. This is a very capable, affordable housing provider.


I think you need the right type of housing. And I think unfortunately, what I'm saying is,


a lot of the cities in the counties, they're taking over industrial spaces, and they're making them into shelters. I don't see how that helps anybody.


I mean, I walked into your shelter, and I like walked right out. It's beautiful. It's from the ground up, there's a beautiful mural. But it's like, you're in an office space.


low ceilings, I mean, you know, and Fountain Valley Westminister garden grove, which is the area I've lived in for almost the last 10 years, they're doing the same thing.


So I don't think you can abandon shelter, because it's a safety net. But it's kind of like if you don't have the pipeline, like I would get a lot of heat my first two or three years because I would have women at the shelter for two or three years.


I can't place them in an unsafe situation. They can't live without services.


Um, so I think you need both. I think you need both. I don't know, it's a little heartbreaking to me.


You know, yeah. It seems to me too, that older adults is a whole nother playbook for them. As homeless. Because oftentimes, you you think somebody's homeless, and maybe it's temporary, or maybe they are chronic. And you can place them in, you know, to get some services or mental health services or whatever, and maybe bring them back to being productive members of society. But if you have an eighty year old or a ninety year old, it's sort of like, No, this is about managing their care. Yeah. Right. Right. Exactly. Which is why, you know, I think your conversation with maybe illumination foundation would be very interesting because I feel like that's kind of what they're doing, or at least that's how I understand it. And that's how we've interacted.


Yeah. Well, they they're doing something really interesting, which is they're starting their own health plan. Oh, my good. Yeah. So that's why I said you're going to be a health care provider. They didn't think they were going to be an insurance plan. But here they are. You're kidding. I had no idea I need to reach out to Jack and have a coffee. It's been a while.


Yeah, it is so difficult to manage. And they're taking an inside outside approach, you know, just being the one stop shop, because they need to be, or at least they need to be knowledgeable. Right. And they can I mean, they are, I mean, it's such an apples and oranges conversation, right.


They're doing by the 1000s. And, you know, we got almost 400, you know, before we had to kind of 400 women a year, before we had to kind of scale things down for the next two years. But yeah, they are impressive. I mean, that's a machine.


You know, that's definitely a machine. I'm very grateful that they're, you know, in the community, because, you know, they do things that you know, we do not.


Well, it's a sad state of affairs, when, you know, we have to have somebody like them scale in the way that they have. Yeah.


Well, it has been such a pleasure, I really enjoyed our conversation. Thank you so much, if you can, if you think of any one else that you think I should talk to, or if you want to come back and say, Oh, my gosh, I totally forgot to tell you this, please feel free to reach out. Okay. And that insightful I think this is


this process, by the way is all year long, it's gonna take us a whole year to do, we're doing 100 stakeholder interviews, probably a lot more at the end of the day with different referrals. And then we're gonna do provider surveys, focus groups, community surveys, we're doing town halls, all of that, culminating into something we hope will be pretty cool and illuminative and then hopefully, move the needle. You know, for me, so. Well, this is great. Yeah, thank you for doing this work and doing the research and pulling data in and helping with the with a, you know, a good plan. I'm hopeful. I'm hopeful. I really am. I shouldn't seem hopeful. But I really


well, I can't wait to see what you guys unveil in two years time. Thank you. Please count us in as allies and supporters. However, we can help amplify the work that you're doing. We would be more than happy to thank you so much. Yeah, I really appreciate the work that you're doing. And you know, Ashley and Tracy, they're, they're good people. So I'm glad that you know you're with them, too. They're both so you're in good company. You're in good company. Yeah, I am. Well enjoy the rest of your day. I hope your husband gets well soon. Yes, an ankle. That's hard. That's hard. Yeah, he broke it in like three places and dislocated it. So it's


gonna get like he's gonna be bionic, he's gonna have the metal plates and all that good stuff. So Oh, boy. Yeah. I hope you I hope you have reinforcement for what's to come in your household.


be fired as a nurse. Oh, my goodness. Thanks again. Oh, yeah, you took it


All right. Thank you. No. Okay, wonderful. All right. So the primary goal today is to identify what needs you think are most important to the older adults population, especially the ones that you serve. And for this interview, we define older adults as those who are 60 or older in years, we want to think we want you to think as broadly as possible, taking into consideration the older adults, but also their caregivers, families and the community at large. I'm going to share my screen so you can see a list of common issues and concerns that impact older adults. Please take a few minutes to read through this list. And let me know when you're ready to begin.


Sir, so to clarify, and I know that you'll be speaking with January Johnson at the Orange County Housing Authority. But our main program to residents is rental assistance. So in that we know about their their housing needs. Don't serve seniors as just a population. So I'm not going to be as familiar. I'm clearly going to be familiar with their their housing and homeless needs, because that's the programs we run. But I'm not, you know, I would just be guessing whether caregiving exceeds their economic security versus their emotional wellbeing concerns.


It's perfectly fine if this is within your scope. And yeah, what you feel based on the work that you do are important factors.


Yeah. So housing is an important factor and being able to age in place. So on our rental assistance, the Housing Choice Voucher Program, or what people call the section eight Rental Assistance Program. The individuals have been out the the rental assistance, or we have affordable housing developments that are built, right. And so the rent is not as high because it's already subsidized. And then we also build permanent supportive housing. And that supportive housing does have built in supportive services for chronically homeless individuals. That, you know, basically, to assure that they can remain housed. The biggest thing in rental assistance, general rental assistance, and general affordable housing is the older adults needs as they increase, right. So their rent is taken care of that, should they need assistance with daily living activities. That's not part of you know, necessarily that's another component that has to be subsidized if this is a lower income senior so I know that there are a lot more resources out there especially with cow up to my health. But I think for the the older adult, definitely they have a static income. Generally, you know, SSI SSDI. Rental Assistance is key, or affordable housing is key for that, that population that finds them finds themselves to be low income in the county. So if you are looking at


So issues and concerns representative list of common issues impacting homeless homelessness housing. I think you've got personal care management, which I guess is daily living activities would that be


And I'm guessing that housing and homelessness is up there.


Yeah. No, I mean, that's, you're talking to this. So yeah, we know that that's a critical need of this population. And I just put the other one as aging in place. And that could be a variety of these issues. It for it, because I'm essentially talking about low income, that's the population that we target all of our funding is for low income individuals. So when I'm talking about seniors, I'm talking about low income seniors. Right. Right. Got it. Okay.


So when you think about housing, homelessness, aging in place, you know, I will start to ask you questions, the following questions about each of those specific things that you've listed. And I just, I'll just go in order based on the order that you had named, and we're going to ask you specific questions about the same set of questions, but specific questions about each of those. Right. So thinking about housing, specifically, how and why are older adults struggling with


Oh, there, we don't have enough affordable housing in the county. There's not


I'm not making a general assumption that older adults, you know, can work, just generally. There's not much income growth. Alright, so what's more, you're living on a fixed income, there's not enough affordable housing,


in Orange County, and what barriers exists to seeing improvements in this area.


So we have housing funding strategy for development of permanent supportive housing, so financial resources, if you're going to develop that kind of housing, you need the financial resources, for the Aging in Place piece, you need services that are paid for, that can accompany that housing, so that when the individual needs a higher level of care, they can access it, because they can't afford it. Otherwise, if they're a low income individual, senior, older adults. So I mean, the barriers to housing our land, available land, financial resources, zoning, not in my backyard. I mean, it's it's a thesis statement on, you know, the potential barriers to housing and it's general it's not just for closure. In fact, senior housing often affordable housing is sometimes easier to build from, from a community perspective, because people don't feel as threatened by older adults, or, or that grandma and grandpa need a place to live as opposed to, oh, that homeless individual, right. It's like veterans, veterans are also easier to everybody wants to, you know, house veterans and has a place for that. So. So it's just, I'm giving you the general background on barriers to, you know, you know, developing the housing. Yeah.