you know, the American College of Emergency Physicians, they have their own accreditation that we went through six years ago, and we've renewed since then, as well, what's called the geriatric emergency department accreditation, they really help build guidelines and show you how to put policies and procedures into place and in emergency departments to help care for geriatric populations. And especially at risk, geriatric populations, like our lower socio economic cohort. There, they have a lot of great resources. We also partner with a organization called Alzheimer's OC, and they've come in and they've done specialized training for our nurses and our physicians on how to care for a patient that has advanced dementia because it's a whole unique care process compared to older adults or other patient, you know, an older adult that has advanced dementia in an acute care setting like emergency department requires a lot of specialized care and training on the staff part. I know we're doing that out of our own pocket. It's not a requirement by EMS, or by the state or by the county. We're doing it because it's the best thing for our patient population. We do see an older population than most hospitals in Orange County because of our location and Laguna Woods. So I think that's a great organization, Alzheimer's, OC, they help us with a lot of our Age Friendly Care.


And the first one you mentioned is American College of Geriatric emergency. I think I'm missing a war.


Oh, sorry. No, it's the acronyms ACEP or ACEP. It's American College of Emergency Physicians. So ACEP


ACEP. Okay, thank you. Physicians. Thank you. So this concludes our interview. If you think of anything that you'd like to mention, you can always reach out to me and reach out to us. I'm gonna stop the recording now. Thank you so much for your time, and I'm learning so much today.


Yeah, I just really like during the interview, I cannot really say anything that would encourage any kind of response. So I have to keep it pretty monotone. Like they'll be really touched my heart when I know that, you know, the senior doesn't I mean, they don't have transportation late at night or like caregiving. So that's something I'm going to take no up and hopefully we'll put that in the report.


Yeah, that one's definitely the most challenging and the most upsetting on our end to when we have a patient that's, you know, 85 years old and we have to arrange an Uber at one in the morning. Just to get back


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


Hello, Katie, I can only read down to Okay, perfect. Economic No, okay, perfect. Okay,


One more, maybe just like up to the Okay, got it. Okay, that's good. All right. And then you're asking me to rank the top three.


Okay, so my name is Carol Dupee. I am a Senior Advocate. I actually have a long history of working with older adults in the Orange County area and a wide wide variety of ways. Everything from elder abuse, to fall risk to caregivers. Certainly, to mental health concerns, that's a passion of mine grief. Honestly, just a lot of different ways, including telehealth and health care access. Telecommunications with older adults, etc, etc. I currently am a member of the Orange County Behavioral Health Advisory Board and I chair, the Orange County older adult Behavioral Health Advisory Council. And we have developed a wide variety of different resources for older adults, including a mental health training program that we developed for community members who may encounter older adults such as emergency responders, shelter workers, etc, etc. As well as a mental health resource guide for older adults. And, and even more, but that's enough for now.


Yeah, you got it. Okay, so for the next question, thinking of Orange County and looking at the list of common issues and concern impacting older adults.


No I don't think so. I don't think anything is missing.


Thank you up the links on the list, Please rank the top three that you feel are the most important.


So that's so just because these are the top three doesn't mean that there aren't other ones that are pretty close, easily the top three, that just about everybody is going to say first one is going to be housing. The second one is going to be healthcare access or transportation in general. And then the third one very likely may be caregiving and or caregivers. Caregiving in some in one way or another whether they need it or whether they're doing it.


Okay, so to clarify, so first will be housing and second is


health care access, how can access and about transportation,


and transportation, and third will be caregiving. There's so when you, when you think about housing, how or why older adults struggling with this issue,


for a number of reasons, one has to do with affordability. That's many, many, many older adults are living on their social security. And just so that, you know, and Katie, maybe you know this, but the average Social Security check is between 15 and $1,800 a month, who can possibly live on that, and, and pay rent at the same time. So, older adults, but they don't just need affordable housing, they probably also need ADA approved housing. So it's not just affordable, but it's also ADA approved. And there's very little of that period, in Orange County, very, very, very little of that.


What barriers are assessed to see improvement in this area.


But there's a lot of housing that is going up everywhere you look at your I'm sure you see lots and lots of housing going up. And mostly these are apartments, condos, that sort of thing. Or some and some of them there, we have a lot of assisted living facilities, residential housing for older adults, that that's going up, but it's not affordable. That's the problem. That's a barrier having it be affordable. For older adults, that's that's a huge problem. And the other one has to do that, as I say with the ADA piece. Not all older adults need ADA, but so many of them either do or they will need something that and ADA is going to be so larger doorways so that wheelchairs can go into and showers that are called roll in showers so that they can roll into their whether it is with a walker, whether it is with their wheelchair into the shower, but not just that lower kitchen cabinet, kitchen cabinets, and kitchen counters. But I mean, there's a wide variety of of those types of ADA requirements. Again, I think there'll be a question and I'm not sure that I'm answering it.


Yeah, I think those are actually very insightful.


Of course, of course, there are, of course there are. So that's one of the that's one of the dilemmas too, with older adults. And Katie, if I get off track, you're just gonna have to pull me back on. And I really mean that because I may easily get off track. So older adults, oftentimes, oftentimes got to get lumped into one big ball. And they're there. They're older adults are you and I, they're everybody. So it's not just different ethnicities. It's not just different physical needs, but it's it's also community. That is to say, and then, and then this is this is typically an overlooked group of older adults that has to do with gender preferences, that is to say, many older adults have not chosen to identify their own sexual orientation. That's something that we really need to be addressing. But as far as housing is concerned, that's the community piece. Many older adults would, they would really prefer to be with other individuals who are like bind it in as, as they are, whether that has to do with language, or whether that has to do with ethnicity. Sometimes it has to do with, with religion, truthfully. And not that everybody has to be we don't. That's just a consideration. We just put it that way. That's just a consideration that we need to keep in mind. One last thing that happens with older adults is all older adults get lumped in together whether they are 62, or whether they are 92. And that's also not cool, because there that's a 30 year age, difference and many interests and values and preferences They're not the same within that 30 year age group. And all and older adults typically get all lumped in to one mass bundle. And honestly, it doesn't make sense. But that's that's oftentimes what happens.


Well, first of all, I think we, we need to, there truly just needs to be more affordability, that's the first piece, that's the most important piece is that it has to be affordable, even if it's not ADA. But that's the, that's the most important piece, it needs to be affordable. But then the second piece is we need to truly focus on on the ADA, housing, because if we don't, in many ways, we're we're asking for trouble because people, if it's if it is neither affordable, then they can't have it. And then then we just have all kinds of other problems at this group, this age group is just growing. By leaps and bounds, it's not going to that's only going to become more apparent as time goes by. But then the second piece is, if we don't look at the ABA piece, we're going to have a lot more injuries. And then there's more hospitalizations, and more problems with healthcare in general. Because when older adults try to reach counters, cabinets that they can't, that they can't reach. We're gonna have more falls. And that's, that's also just that's not okay, we're gonna have more deaths, because older adults die when they have hip replaced when they have hip fractures that time of course, but that's, that's often one of the things that happens. Infection sets sets in there all kinds of other problems anyway.


So when you think of access to health care, how or why older adults struggling with this issue,


so for a couple of reasons. One has to do with having personal transportation. So it I don't know how old you are, Katie, but I can just tell you that they're there two times in an individual who lives in California. And I mean, in California, I don't mean in Kansas, we're not talking about Michigan, I don't mean Arizona, I mean, California, there are two times in an individual's life that are absolutely life changing. Life changing. First one is, when you get your driver's license, Katie, oh, my goodness, it changes your life, it changes your life. Because here in California, our public transportation system is not very good. We just, it's really pretty bad. And part of the reason that it's pretty bad, it has to do with the fact that because we are so independent, here in California, we like to be able to go wherever we want to. So the transportation, public transportation, they're kind of like ham strung because they don't have the money because people don't use their their services that much. So then they end up having to be cut their services end up getting cut back and cut back and cut back. But so transportation, that's the first most important milestone for any anybody, for almost all individuals is when you get your driver's license. The second one is when you take it away, completely changes your life, life changing life changing days, when you get it, and when you lose it. And if you win, you lose your your driver's license. That means you have to depend on other people. And nobody likes to do that. Yet, I am having surgery on Thursday, and I'm not going to be able to drive for a week or 10 days. The doctor is telling me a month but my point is I'm resistant to taking a month because I don't want to have to depend on other people. But a few seconds before I got on this call. I was making arrangements for some doctor's appointments for next week after my surgery, and I don't want to have to do that. No, no, I've got a perfectly good car. I'm a good driver. And and I don't want to have to depend on other people. That's what happens when people don't have their their either their own transportation or when they don't have a driver's license. So that's one thing. The second thing it has to do with finances, because let's say, let's say that they do have their own car. And they can drive, because a lot of older adults can and do. But it's expensive. And they, they are already counting out every penny, and having to come up with the, the maintenance that is involved with a car, whether it's gas, or insurance or whatever, that's another big expense for older adults. Let's say they don't have transportation, and there they are using OC access. That's not a whole lot. Okay. Unless, unless you have and that's but that's $5 to the doctor's office, and then that's $5, back from the doctor's office, and it's actually I think it's $6. But my point is, that's 12 bucks. If you go to your doctor's office, I don't know where your doctor's offices and it doesn't matter, it's not going to cost you that much. And what if you have to go to the doctor's office, let's say half a dozen times a month, and that doesn't count how many times that you also need to go to the grocery store, or employee number of other places, it really adds up for older adults. And that's, that's a problem.


So yeah, what barrier exists to see improvement in this area.


Honestly, I would say a couple of different things. So obviously, there are and by the way, there are some very excellent transportation programs out there for older adults in the cities, the cities themselves have a number, not all but there are a number of cities in Orange County, who have developed great programs for older adults that involve that involve offering transportation within city limits to various locations, whether it is the Senior Center, or whether it is to shopping on like, every Wednesday and Friday, there are a number there are a number of different options that that are currently available out there, to some extent to some extent, but there's some good options out there. But here's the second thing that I would love. And that is I would love to see older adults have access to like golf carts or to or other transportation, really local kinds of transportation options that many older adults just they just need to go someplace close by. And if they had those kinds of options that would free them up to do to feel more independent and would alleviate probably a lot of different problems, including that maybe they need scooters. But there there are other things that that we can do to make older adults both more independent, as well as healthier too.


what cities are doing a good job at providing those kinds of local transportation for older adults.


But the cities so Brea is doing a really good job. Irvine is doing a good job. Let's see. Newport Corona del Mar is doing a good job. Newport Beach is doing a good job. Let's see. There's some there's some other North Orange County cities too that are doing a good job. Orange is doing a good job.


Anaheim is doing a good job. There I honestly I'd have to think about it. But there are there are a number of cities that are currently I think doing a good job. There's another one that is Oh, Fullerton, Fullerton is also doing a good job. Oh,


Of course, there are lots of different experiences for older adults. And thank you for asking that question. Because that would be one area that I would want to shine a spotlight on is that there are different different groups of older adults. Again, whether we're talking about different ages, whether we're talking about different ethnicities, whether we're talking about different language groups, whether we're talking about different religious groups, there are lots of please, let's take those differences into account. When we talk about older adults, please take those into account.


Yes. So one of the things the so I worked at St. Jude for about 15 years, with older adults. And one of the things that we started doing at St. Jude, probably, at least, and I can't take any credit for this. This was my boss, Barry Ross. But one of the things that that Barry Ross, I'm saying his name again, because I want it to be recorded. One of the things that he initiated, oh, probably in the 90s is, or maybe it maybe it was in the 2000s, early 2000s. But there was long before anybody was doing anything like this had to do with transportation for older adults. And he offered, he developed a transportation program for health care where we would offer transportation to seniors who needed transportation to any appointment at St. Jude, whether it had to do with occupational therapy, or whether it had to do with a grief group or whether it had to do with a visit to their primary care physician. He offered transportation, the transportation was I'm trying to remember how much it was, oh, I shouldn't say that. I know how much it was $2 a ride. And if you couldn't afford the two $2, we waived the $2. It's not like $2 was going to pay for the transportation anyway. It was just a no nominal amount. And he offered that long before anybody anywhere was offering transportation. That's one of the things so now insurance companies do offer transportation options, typically a limited number. It's usually around between 10 and 16. rides per year, which by the way is not enough. But it's something and it certainly is helpful. So that I think health care systems, whether we're talking about insurance, or whether we're talking about health care groups, like Memorial care, Hoag, Providence, where I come from, if those if those programs would offer transportation options to older adults, that would be that would be huge. And it's it's not easy. It's it's, I should rephrase that, that it's hard that I because I worked with the program. I'm pretty familiar with some of the barriers, the problems with that program, but I can tell you, it's also very successful, which is why insurances has started offering it, they just piggybacking right off of my boss, Barry Ross, and doing what he suggested he was very innovative. He came up with a ton of great ideas in general, not just for older adults, but in general who's great. Sorry. Didn't mean to get off on that.


Lots a ton of reasons, there's no one reason. So if they need caregiving, it's hard to find dependable caregiving. Like I say, I'm going to have I'm having surgery on Thursday. And so and the type of surgery that I'm going to have, it's pretty major and, and I have been told that I'm going to need to have somebody with me absolutely. For the first few days after after my surgery. We're gonna have to go someplace. I'm gonna have to either be out of my home or have somebody come into my home to help me well, I'm fortunate that my son and his wife have said, of course Mom, come and stay with us. No worries. But that's not how it is for everybody. So finding somebody or even being willing to be dependent on somebody else, that's really huge. But let's, let's turn it around. Let's say that that I'm married, and my husband needs a caregiver. Well, you know what that's going to be me. Like, regardless of what my health is, I am going to be the one who's going to be responsible for him, you, you very well may know that when a partner is the caregiver for their partner, more often than not the person who is the caregiver, they're the one who they're the ones who end up in the hospital, and they end up in the hospital because nobody's taking care of them. The person that they're taking care of, they're okay, because somebody's looking after them. But the caregiver gets worn down, they actually literally lose their life, they become invisible. And because it's not about them, it's about the other person. And they all have their needs become secondary. And that's, that's unfortunate too


what barrier exists in seeing improvement in this area.


So here in Orange County, again, we're very fortunate because we do have resources. There are quite a number of resources available, including the Caregiver Resource Center, but Alzheimer's, Orange County, as well as the Alzheimer's Family Center, as well as Alzheimer's. Foundation, of course, they, they, they also offer caregiving kinds of assistances. But one of the things that we need more is we need more respite. for caregivers. We need opportunities for caregivers to be able to have a break, they just need to have a break, whatever, whatever we can give to them is not enough. Currently, if you are on if you're Medi-Medi, you're likely. Alright. Jack, thank you. Thank you. Okay, pumpkin. Sorry. I'm having my street paved out friend, and they're just all kinds of things happening out front of the house here. He's very interested in this. So I was saying What did I say respite, but caregivers need. I got sidetracked. One of the things that caregivers need is they need training. So oftentimes, let's say that I was having to be caregiver for my husband, and I was until he died. He may need to be transferred from the bed to a wheelchair. Well, if I don't know how, what the proper techniques are, for transfers, I could injure both myself and him easily. So there are fall risk training, there are all kinds of trainings that caregivers could benefit from having who are family caregivers, but they could Oh, I would say that they could qualify if there are Medi-Medi they can they can qualify for IN HOME supportive care, IHSS services, and they could get a caregiver. And and that can be also very helpful. But oftentimes, they will have to pay a share of cost for that caregiver. And that can be for them to even if they qualify for Medi-Medi, they very well may have to pay a share of cost. And that that's just one more, even if they need it. Badly. That can just be one more burden.


Yes. So one of the one of the differences. Katie has to do with tradition. So in in, so I'm Caucasian. And so I think I've said that. I have two two, I have two children. And they're both they just step right up. And if I need whatever it is that I need, I'm going to stay with my son and his wife. My daughter is going to be transporting me to and from doctor's visits. That's great. That said, the I'm Caucasian and the tradition in many white families is that absolutely let's let's do these things for you, mom, but are you thinking of coming to live with us Mom, I'm not so sure that we're we're We set up for that, or how long are you going to be here with us. That's, that's not something that in my ethnicity that we do quite as easily. But there are many other ethnicities, both of the Latinx communities, both as well as the API, the Asian Pacific Islander communities, they're much more likely to say, mom come and live with us, or I will come and live with you. They take it very seriously. And I don't mean to suggest that it's not taken seriously. Within the Caucasian. European background, but there's differences. That's really what I'm getting at here are different. And, and the responsibilities are seen in different ways, too.


Thanks. Thank you. So what do you suggest is the best way to address this issue


And don't just look at it from one angle, because that's not going to work.


Thank you for sharing. Can you please describe how assessable and adequate the following care or services are in Orange County geriatric care


it's just, it's really too broad that's too broad of a of a term, just so that, you know, for one thing, so I really don't even know what that means. Because that could that might have to do with food insecurity, or maybe that has to do with transportation, maybe that has to do with loneliness, maybe that health care. So let me just also say that the term geriatric is currently it is typically only used that term is typically only used in healthcare settings. It's an old term old. The more invoke term would be to say, older adults, or seniors, geriatric or elderly. That is not, that is not a current term. And it's not a term that older adults like to hear. They don't like to hear elderly, and they don't like to hear geriatric.


Okay, so two different those are two different questions. Accessible, there is. It's pretty accessible, truthfully. If you need but you have to be it's accessible. It's it is available. But whether or not I can access Long Term Care financially, there is it is accessible is there but whether or not I can access it. That's another story. There are any number of adequate long term care facilities, whether we're talking about a residential care facility or or skilled nursing facility. They exist. Not that doesn't that's not true in every area of the state of the United States. But that's is absolutely the case here in Orange County. Whether or not older adults can actually use it. That's another story. That's not always as easily to access. And as far as the out of adequate is concerned. Again, it really depends on what we're talking about. In terms of the financial situation. There's everything from really, you would absolutely it may be considered adequate. But it's really like a you know, if you're grading it on a on a scale of ABC, it's really a D. You would certainly not put your own flesh and blood in one of those facilities even though they are licensed and accessible financially. And then there are other ones that are that are okay and they are also accessible financially. And then there then there is the third tier, which is no, these are beautiful facilities, and you'd be happy to stay there yourself and when you move in, but so there's kind of the whole, the whole spectrum here in Orange County, which is not the case. Nationwide or even statewide.


Yeah, I think they have quite insightful. Yeah. So thank you for sharing.


No. Yeah, can easily I'm jumping in before you even finish because there are, oh, my goodness, don't even get me started on the mental health piece. Because there there's very little here in Orange County for older adults having to do with mental health. Very, very, very little. And that's a huge bugaboo of mine. So counseling, preventive, preventive services, there's almost nothing nothing. Katy scan offers some, some in home counseling, and they will do that for free St. Jude offered in home counseling also for free. And Council on Aging does some does some things. But having said that, it's still incredibly limited. The Orange County health care agency, HCA they work with they offer services, they certainly offer services to older adults who have what are called severe and persistent mental illness, such as bipolar disorders such as schizophrenia, schizoaffective disorder, that type of thing. But you have to be MediCal. And then you also have to, you have to qualify in other ways as well. And it's just incredibly limited. Beyond Belief limited. That is not how it is. Certainly, that's not how it is for children and youth. And by the way, that's fabulous. I love that children and youth services are available. I love that, in my private practice, I see a ton of kids. So I'm certainly not, you know, upset about what we offer to families and children. And youth. Certainly not upset about that. But we don't offer that for older adults. And there aren't preventive services out there either. We need a ton more outreach and engagement workers a ton. So we we probably have I don't know. I don't know how many. But you can call you can I can I could give you a number that it's like a double digit number of outreach engagement workers for older adults. And that number would be probably, I'm sure it's way less than 30, 30 Isn't generous, or there aren't 30, there's probably maybe they're maybe they're 12, or 15. We have so there is one RFP in Orange County, there were technically there are two because there's Council on Aging, because in the end, they have a couple of programs for older adults, and I'd love Council on Aging. So they do a terrific work. It's just incredibly limited, so unbelievably limited. And then there is oasis. That's one RFP that works with older adults. And And again, there's a very, there's a small group of older adults who again have to meet certain certain criteria before they can qualify for the program. And believe me Oasis stretches that criteria, because they because they want to serve as many people as possible. But there's one program and that's Oasis, and council on aging. And so I'm not. I'm not forgetting about them. And then there are other smaller, smaller programs and Mecca has some programs. And then there there's a US VETS program that is currently working with older adults who so it's not like there's nothing very, very, very little, very little. If you're looking at what but Children and Family Services has. There's there's no comparison, because I don't think you can even count how many services are out there for children and families. And again, it should be but there's There's one in orange in Orange County, and that's a waste. Smaller, they're small programs that other agencies have. But there's one but there's only one RFP. That's it. Not kidding. I'm not kidding. That's not an exaggeration. There's one. Oasis. That's it. Wow.


Well, it's just not there's not much to be accessible to. It's certainly not adequate is certainly not adequate. And again, one of the things that that we're there's the biggest deficit has to do not only with mental health, and substance use, which is that's the combination of behavioral health services that are available for older adults, but also the prevention the p&i, the p&i that's not available either. And that's, that's huge, that there aren't those kinds of services, there are some services like, as an example, the cities work hard to do a very admirable job with the senior centers. And the seniors provide a wonderful service for many different kinds of for older adults, everything, again, from nutrition, to transportation, to just just the sense of community that is available. But if you look at the number of people who actually attend those services, who are truly engaged in the senior services, it's not very high in comparison number of older adults in any given city. So again, I'm not knocking any of the senior centers or any of their services, because they do a terrific job. And they work really, really hard. What I would love to see are more local, localized services. So that is to say, I would love to see services that come to senior housing. Apartment, yeah, complexes, so that the service has come to them, whether that has to do with something like a grief group, or whether that has something like an exercise group that comes to that senior housing facility. Things like that. Or I'll meet you meet at a at a local park. Though, to me, those are preventive prevention services that, that I'd love to see offered to, to seniors, but they need to be more localized because seniors, particularly Katie, I'm sorry, I just keep going off on tangents. But one of the things that happened during COVID was we said to older adults stay home. Don't go out while people got used to that. And now getting them off of their couches. Not that easy. Wow.


I keep saying they I'm a senior I'm 73. So it's not but So technology is a huge barrier for my age group. For for us as seniors I've been next door neighbor who is a year younger than I am. And he has a cell phone. He never texts. He doesn't he doesn't know how to text he doesn't. And he he does a lot of other things. But you certainly never looked anything up on on Google or YouTube or anything never. It wouldn't even occur to him to do something like that. And those are the kinds of things many older adults either don't have. So you already know this. I'm sure I'm not saying something that you don't already know. So here's the these are there are three main issues with technology. First of all, older adults need to have they need to have the device so they need to have whatever device they need to have a device, but that that's not enough. They don't just need training, they need training, but they need ongoing training or access to somebody who can help them change their password or whatever. But then the other thing that they need Wi Fi so it doesn't matter if they don't if they don't have Wi Fi if they don't have access to the to the internet. And, and they have to be able to pay for that. So then there's a financial considerations. I'm not saying something that you don't know, I'm mostly saying that just to make sure that it gets in into the data. These are known areas of concern. And there, and there are programs that are out there. We did. We certainly did something during St. Jude in terms of offering all of those things. But weren't, we weren't the only one, the county of Orange did some things as well, to offer all three of those problem areas. Council on Aging did some also offered some programs. So it's not like there aren't some programs out there. There's just so much more that needs to be done in terms of identifying older adults who need those services, or persuading them to use them. so that's another another issue.


The role needs, one of the things that I would love to have happen is to be able to identify the older adults who have needs. And then the second thing would be to determine what those kinds of needs are both both things we don't we shouldn't just guess at what the needs might be. We we need to have some clear information, some clear data, demonstrating what the what the needs are. And that's something that the government could do, the local government could do. But we need to identify. And that's where the Outreach and Engagement workers come in, identify those older adults, because like I say, many of them are sitting at home, on their couches. So they're it's not like they're out there. They're they're not, it's not easily easy to find those people we need to go to trailer parks and, and knock on doors. That type of thing. And that there aren't enough. There aren't enough Outreach and Engagement workers currently to do that. By any stretch of the imagination.


Yeah, so we have Yeah, well, we have five minutes that you have to go. So yeah. Okay, I have two more questions. I just want to let you know, so we'll just go through it quickly.


Which ones are Yes. Okay, I think that the Asian Pacific Islanders, those are. We have, I think we also have a number of older adults, who we don't know anything about who are from the Middle East. And we don't know anything about what they may be from Sudan. They may be from Syria. We don't know anything about those individuals. And and we need to identify those, those people and what the what their needs are too, and what the needs of their caregivers are as well. But people whose both are ethnicities, but their language prevents them from really being well integrated into services that may be helpful to them, who aren't aware of the services that are available.


Thinking about all the issue facing older adult in Orange County, what issue is being overlooked.


So I'm going to say issues having to do with I'm going to say mental health, and I'm probably the first thing I'm going to say is loneliness. That's a huge area. And there are that's something that a number of different agencies and organizations here in Orange County, have been kind of focusing on for the last several years is loneliness. But but it's not. We know, in the older adult, agency community, we know that that's a big area of concern, and opens up to so many other problems, whether it has to do with substance use, whether it has to do with suicide, whether it has to do with elder abuse, fall risk, any, any number of UTIs all of those things actually can be synthesized back down to loneliness. When people are lonely. They're much more likely to contract a UTI. One of the one of the things that happens with older adults who are lonely They have many more visits to the ER, many more visits to the ER for again, for what it's too many reasons for me to say in that in the next couple of minutes, but loneliness is a big area that we are overlooking.


Thank you. So this concludes our interview. I'm gonna stop recording now. And I actually I, you know, there you have another time I hope to maybe go further in some of these issues, because then some of the population that you mentioned are some that we actually have a hard time outreaching to you and I really want to get your input on like how we can better


Okay, great. No. Okay, great. So, again, as I mentioned, the primary goal today is to identify what needs you think are most important to older adults. And we want to, we want you to think as broadly as possible, you can rely on your personal experience, but also take into consideration the perspectives of caregivers, right. And they can be family, friends, neighbors, professional caregivers, like doctors and nurses, and also their community. Right.


Wow, a little bit about myself, you know, when you're, I just turned 73. So when you have 73 years, you have like all these different chapters. And I guess, I'm retired, I've been retired about 10 years, I was a flight attendant for Northwest and Delta Airlines for 31 years. And so I've traveled quite a bit. Now that's all gone out to me, I don't want to travel. I like my nest. I live in a community an over 55 community, and I'm quite involved in my community. I just served six years on the HOA, and I'm with the mobile home advisory board for the city of Huntington Beach. And I'm also on the, you know, Huntington Beach mobile home resident coalition. And so we're, you know, I'm, I guess I've become kind of an activist in my last few years. And while I eat sleep and drink housing issues for manufactured homes, and sometimes I'm, you know, you know, how when you're doing any kind of good deed, sometimes it's overwhelming. But then if I think of leaving it, I know I, I can't I know that it's, it's big, and it's important and, and it keeps my mind on something. That seems like it makes me happy, I guess to be of service. So and not like a Mother Teresa or anything like that, but and people like you, and like Ada and like ADA who's who is our president for the HOA. For years. People like that are my news is in my inspirations because it's amazing, the wonderful people that I bumped into in this walk right now. Yeah. And I think that's about enough about me.


Well, thank you so much. So now thinking about Orange County, and I'm going to show you a list of common issues and concerns impacting older adults. So I want you to take your time and review this list. There's a lot of things on this list. And when and when you're ready. Let me know. And then I'll ask you our first question. Okay.


Let me know if it's too small. I'm trying to show the entire page.


No. Yeah, let me yeah. I've got magnifiers on but it's still


kind of, Oh, I know. I know. Don't worry about it. Let me make it bigger. And then I'll scroll. Okay. That perfect. Now. Let me know when you're ready for me to scroll. Okay. I'll keep this list on the screen so you don't don't feel like I have to. Don't feel like you have to memorize it. Okay, you can scroll please.


And just put them while these are really, really good reference points. Heavy stuff you can scroll.


That's it. That's the part one and part two. Okay. So now thinking about Orange County, and looking at this list.


I'd have to ponder that. But this is uh, looks like a pretty complete list to me.


Okay, I'm gonna go back to the top here just to make sure.


Yeah, the economic security I think is pretty important to people. So I was gonna say financial, I had written down earlier. So that's the same thing. So


So please write for me your top three things that you feel are most important.


Well, I would say economic security would be probably number one. Okay. Housing is number two. Okay. I'd say behavior, behavioral and mental health, that would be three. Okay. And they kind of you know, they slide over and just some other columns. Sure. Like caregiving. Yeah, no, well, we'll stay with those three.


With those three. Okay, perfect. So I'm going to ask you the following questions, and we'll take those three items separate. Okay. So the first thing that you listed for me was economic security.


I think part of the problem and where I live, we're over 55. But there's a lot of women. And I think what happens is, as women get older, you know, and they start to retire, they don't have as big of a safety net, as a male would have, obviously, in fact, some of the women that I know in my community were housewives, or they didn't have a very big, a long job history. So they don't have the pensions, they don't have the big social security, they don't have savings sometimes, or their savings, everything went into buying the manufactured home. So oh, man, I, I listened to what they're trying to swim hard against. And I know, the rent, insecurity or the housing insecurity is, is kind of tied into this. So how and why did I tell you the Why yes, yes, yes, yes. Yes.


I mean, you know, we and we can move on. And you can always add later and refer back to it.


And I keep seeing it from the vision of an older woman with barriers. Yeah,


think older adults, there's, there's a few things here. First of all, they're not very social media savvy, a certain age up. And I think sometimes they're too proud to say that they have a problem. And I think that could have been a cultural thing from I know, my mom said to me one time, oh, I wish I had had someone to talk to like you do sometimes. And I'm like, wow, I never occurred to me that her age group would not have someone to talk to like a therapist or a counselor when things get overwhelming. So I think the barrier, the main barrier is not being able to reach out for help. Even when, even when it's right, like when somebody offers it to you. And then, because I've got a neighbor to that, to her mother just passed away who was 94 and they were very close. And I have been giving her so many things to help her get through her loneliness. And then just yesterday, she was telling me again, how lonely she is. No, it's It's I don't know if it's just a habit dying hard or as I said, before, that cultural laying there and and it's hard for them to reach out and you know, say, Oh, I am having troubles. You know, that my brave faces and so underneath so brave. Yeah.


Yes, yes. And I think Caucasians would have, of course, would have a different background and work experience than someone of color, because I've met some people here in my community, in particular, Vietnamese people moving in, and, boy, we've had some good talks, and I realized, we are completely different is so so different. On some levels, some other levels. Of course, we're all struggling together. But I think, say the question again.


Well, I think you answered it, because I asked you if there are different experiences with regards to economic security for different groups,


I think yes, I definitely think culture.


Because I don't think we hang around enough together. You know, we've been talking about having some diversity. And Huntington Beach, you know, is a great example of 99%. Whiteness and anyone and it's I shouldn't it's not 99% for population, but it's like 99%, everything is geared toward Caucasians here in Huntington Beach. And we've been really working on that, because I really would like some diversity. I think it makes such a colorful, wonderful world to have diversity.


Hmm. I think offer respectful. You can't you know, you don't want to be giving advice unless it's asked for. And a lot of times, they'll say, Oh, my God, I can barely make it. So I have a pamphlet, that's all the different opportunities in Orange County with, you know, different places you can call like, the Senior Center and like the Council on Aging, with directions, you can go if you're having challenges, and a lot of times people will say, I didn't know that was available. I think I'm gonna go drop in. So I don't Yeah, I don't want to be. I'm really careful about tromping on someone's you know, like, Oh, you look like you're getting poorer. Yeah. That's a tricky. That's a tricky place to be.


Yeah, yeah. So once again, how are older adults struggling with housing.


And I speaking from my last nine years of living in a 55, and over manufactured house community, and seeing that the rents are, in some places skyrocketing, because, you know, we, we are involved with 17, mobile home parks here in Huntington Beach, some are corporate owned, and they have horribly, terrible rents going in, some have gone up two or $300 a month. And so I think that housing insecurity, not being able to exhale and think about your future being okay, is very, what I want to call it Well, I'm sure you know, affects your behavioral and mental health. Because if you look at the happiest countries in the world, they're taking care of from cradle to grave, then you look at our country. And we seem to everything runs on money. And we might pretend that it's God, but I think it's money. Um, I think I might getting sidetracked. No, you're right. You're right. Yeah. So I think it's the housing insecurity. I think people thinking they might lose their roof. I mean, I think that's getting close to homelessness, for people. And that because you know, you can't buy a house, you're not gonna buy a condo, all those will be priced out of the range. So apartments are pretty darn expensive here, too. So yeah, that that housing insecurity is just, I think, very scary for people, myself included.


Well, personally, for what's going on with the mobile home groups here, it has to do with the park owners, and there's such a chasm between us. It's like, we don't understand each other. You know, I, I work. Well, if there's reasons that rent goes up, you know, maintenance and all that, but then when you talk to a park owner, you park owners sound like oh my gosh, if the remt is stopped, we're not going to be able to maintain the place. And that's shown to be not true that other cities with rent stabilization ordinances or some kind of a rent control, they still have rent review boards and they have rental registries. So I think part of it is that there's the groups are against each other and don't want to listen to each other. And I would like to see more communication. And really listening with open with open minds and open ears so we can collaborate even though it's you know, we're on different. We're, but our endgame is still we still want to have a community that works. And we don't want people you know, on the streets, and I don't think the park owners want people on the streets either. No. So yeah, I would like to see more collaboration. But I don't know how that would. I don't know how that because I've been speaking at city council meetings here in Huntington Beach. And collaboration is one of my favorite words. And I don't see collaboration coming back. frustrating.


Right. And, and now and I know you mentioned diversity earlier, but in thinking about other groups to like people with disabilities, right, or, depending on you know, maybe not so much in Huntington Beach, but maybe in different cities. Do you find that housing is different for different groups of people, and in particular, you know, people with disability or in other cities other than Huntington Beach are different.


I don't I guess I can't speak to other cities than Huntington Beach. I, I have done some field trips at manufactured homes, and other cities like Anaheim, San Juan Capistrano, Oceanside, and it's so much it's so similar, that I almost can't find. I can't find what's different. And yeah, the diversity thing is a problem with almost every community I go to. Yeah. Because I think a lot of different groups cultures have, you know, like, like, the Hispanic people are such wonderful family people. And I think the big house with all family being close to each other is such a beautiful in the past lifestyle. I don't know if that still is existing. Yeah. Yeah.


Wow, that's a heavy question. The best way to address the issue the housing needs of older adults. Hmm. Wow, if I had answers, I'd be I guess, we're trying to have strength in numbers. We're trying to get groups together. We have these open meetings at other manufactured home communities where we have questions and answers. And we listen to what you know, people are saying, as I said, we're so much more alike than different when it comes to our housing. And that's the best way to address the issue. I guess communication, education. I think people need to talk to each other more. I think, and as I said, I'm talking to you mainly from of course, my 55. And older over older community. A lot of times the people here they've retired and they don't want to get involved. They just want to be able to rest and not. But the thing is, you have to be involved, at least the very least you have to know what's going on. Or it's going to sneak up on you here and its not even gonna  sneak up on you. It's gonna hit you. Well, we've told you three times, you know, there was a big new roof put on the clubhouse. I didn't say that. But I thought that and yeah, a I like i said  education, communication. And I think people need to realize that just because you've retired, as I keep saying it's I'm talking to you from the over 55 group. I just because you're retired doesn't mean you're checking out life. You know, there's I think sometimes it surprises them. Yeah, no, like there was a plan that you got a free iPad, if you called a certain number. I think you had to be 60 and over and of course show what you know, a very low income. But the low income was like under $75,000. Like,


really not as retired you would fall into that category.


Yes. Yeah. Even and they even had some classes that came along with the iPad. Yeah. That's a great program. Yeah, yeah. I mentioned it to a few people. They didn't call right away or by the time they call the iPads were all gone. It was like,


Yes, yes, yes, yes. And we're not talking about Section Eight. I'm thinking that some help with buying our communities. So we have somebody called it a horizontal Co Op, but a resident owned community. Yeah. I think the resident own community is a real wave of the future. But now I don't know about California is the only problem. I see it happening nationwide. But California's so flippin expensive that I, but I see that as a real big push. And so then if the local communities or the federal government put in some help, and then everyone, you know, came together and ran the place, you know, with help. I think that that's a real one of the few real good calls for the future.


Good, good, good. Okay. So now we're gonna switch gears and go over to your third item.


Oh, my gosh, I have seen people getting scared. And I mean, they get scared over everything. And of course, the news makes you scared. We had a presentation Tuesday night about mosquitoes. By the time we left. I mean, everybody was so afraid. They were practically hearing voices. I mean, it was like, Yeah, right. I think part of part of it is that traditional memory loss and forgetfulness that I see in your column here. That's true. It's not that the world is always falling in, it's okay, we have a problem. But then let's make a solution or let's talk solutions. And I think we don't get to solutions as as a traditional way of reacting to a problem.


Oh, loneliness is a definite if they're talking about it being an epidemic, it is a lot of isolation. And part of this from the pandemic. People I noticed here, people stopped inviting each other to dinner, stopped having little dinner parties. And now that's like a habit. People are just not socially interacting, like they used to all of our groups seem like they have lower numbers. And so yeah, that loneliness thing, and then people not maybe having families nearby, you know. And, you know, you probably know all this stuff yourself, but but I see it where, you know, like Mother's Day, I talked to have several of my neighbors that were very, very sad, because maybe their kids forgot to call or they called already, but they see that their other neighbors are going into someone's house. And yeah, that loneliness thing, that's going to be huge. I think it's going to get worse too. Because part of it too, is when a seniors, people over a certain age, the age I'm at, you don't have as much. I mean, you're like, I'd like to maybe go country dancing, let's say learn line dancing, but you know, my body's not as willing as it used to be. So that's kind of sobering, that, you know, the flesh is I mean, the spirit is willing, but the flesh is not. So, you know, I'm saying,


I think sometimes peer I think it has to be sometimes your peers that are offering some of the classes. I think I've had some, some, some of the seniors say, Oh, I don't want to take it from that young girl. She's the one that's a great little SilverSneakers teacher. Well, I'd like to see someone my age group teaching senior exercise. That's a good point. And that's an interesting point. Although I don't have a problem with anyone's teaching anything. Hmm. What else would be I think maybe more classes But, uh, you know, I know the senior center does some wonderful classes. But I think sometimes these classes like the sands, which is our, our local classes are kind of expensive. And if we're having economic problems here economic security, you know, a class that cost $125. That's out of the question. That's not on their radar. Yeah.


Yes, yes. I think I mentioned to you earlier, my, my neighbor whose mother just passed away and is 94, she came home from the hospital and was two weeks in hospice. So that was pretty scary. And then she passed away pretty fast, and go fast, fast to her not fast to the rest of us. She's 94. And I can see her grit getting very weak. But now she's very, very lonely. And she just kind of keeps to herself. I keep inviting her social things. So there was a garden tour. She did go with me on that. But that's the only thing she said yes to. And I see where I offer ideas for you know, go to the library, go down, just sit by the beach on a bench and let that ocean speak to you. I mean, that we pay. We pay Huntington Beach prices. Might as well go see the beach once in a while. Yeah. And I see I see her car sitting there sitting there sitting there. She's just not getting out. I even mentioned to her something about a friend told me that her cat had kittens. She's allergic to cats. Stuff cat. I just thought she maybe needs a friend's since now.


I I loved her mother was just the sweetest lady when I moved in nine years ago. So it's, I feel it too. Yeah. And, you know, I think she thinks she's alone. But I keep telling her we're all walking this together. You know, we're all walking each other home. So she's not alone.


Good, good. And then possibly drug and alcohol use among older adults.


Yes, men seems the drug and alcohol addiction. Yeah, I see them. Some of them, not all of them, of course, reaching out for alcohol, and then, you know, making themselves a little embarrassed later in the day, and it's not helping their forgetfulness and their memory loss. So yeah, I and I think to the people that tend to be kind of not as outgoing, or they say they're not as outgoing sometimes I someone will tell me they're, you know that they're not outgoing. And then I think, wow, you're very talkative. Being outgoing. I think sometimes people think they're shy, or they think they're not. Because make say, say several people are talking about college, and maybe that other person in the group didn't go to college. And I can see where that makes them feel like they're not as, as something as the other people, which is not true, because they have amazing life experiences, too. So yeah, wow, this is a heavy this is a heavy column. Yeah. We had be well OC come out night before last too. Now. I was really impressed with the things they cover. Like, you know, if you watch your neighbor, and you notice that their routine has changed a bit, like maybe they're acting a little different, like so maybe it's a they've forgotten to take medicine for diabetes, or I thought what a great thing that you know, you're not calling the police. You're calling be well OC Yeah. And they were saying that they park a few doors away from your house. So it's not like oh, my gosh, attention. Yeah. Yeah, there were much more subtle. Yeah. I was very impressed with the offers, I mean, the services they offer. Definitely, definitely going to Use those those wellness checks that they have. Yeah. Yeah. Great idea.


Wow. That's a hard question. We have some groups in our community one is called CAP, which is a community action program. And we have gas cards, we have grocery cards, and we'll take you to some things if you like, we had a man whose wife was in the nursing home, and he needed right rides, and we took him. Yeah. So we try and simple things we try and, you know, get together. So we've got a pretty good amount of money for that, too, we've got quite a few people in the community who have, you know, donated. So we probably have maybe almost $1,000, set aside for grocery cards, gas cards, etc. So I think having community action, and also, we have a big bulletin board with a whole lot of things on it. If but the thing is some of these people, these people, and I don't mean to make it sound like I'm, you know, putting people in boxes, but the some of the people never come out of their home. We have 141 spaces here. And they some people, I've never, ever seen them come out of their home. And I'll ask the manager, and he says, oh, yeah, they're paying the rent. Well, I guess I mean, they're, they can have their own lives. I'm not trying to change their, you know, if it's if they like to watch TV, and whatever it is they do. That's fine with them if that's if that works. But um, we've had actually, we had a SilverSneakers program going on, and another lady and I went door to door, three Saturdays in a row door knocking to try and get people involved. And that was a that was an eye opener. Oh, I did not realize, yeah, I didn't realize how poor some people are in this community. You could, when you go up to the door, and the steps are all broken. And you know, and you're knocking on the door, and then you're telling them about SilverSneakers exercise, and I can see that they're, you know, they're on oxygen. And you know, I almost felt but but but that SilverSneakers older group was anybody could go, you could go, you know, bring your caretaker. And that was great. So that was an eye opener.


That's almost should be like a regular check in. For these seniors.


That's a that's an idea that you're just you just because I was thinking, it's funny. I was thinking like a not a prayer chain, but like a prayer chain, where something happens. So you tell your next three door, your next door neighbor or two or three doors down, then they pass it on, but then I was worried that it'd be might be like telephone, and it might get. And then halfway through the block. We have neighbors that don't like each other who don't speak. So I started thinking, Oh, maybe I'm not thinking this out. I'm thinking, Oh, this is an easy solution. We'll just like wildfire get information out. It's not exactly that easy.


Yeah. Yeah. Yeah. That's great. Okay, so I am done with this list. And unless you want to share any more about any of those three things that you mentioned, economic security, housing and behavioral mental health.


At this time, I don't have anything. Okay. Probably I'll get off the phone in about two hours. I should have said this. Oh,


Yes, you can. And but I have more to ask you. So I'm just I'm just done with the list. Okay, so. So now I want to ask you about health care, and how you access health care. Okay. And do you find that the care is adequate.


I have a scan. I go to Hoag which is Dr. Nancy love. Now who doesn't love a doctor named Dr. Love I know, oh my god. So wonderful. In fact, in the last couple of weeks, I've she encouraged me along with the nurse practitioner to get all caught up on all my tests. So I had my first bone density, which so lucky, I'm okay. Most people bone density is a problem. Right and then, you know, colon tests your mammogram. Mmm, you're all the different tests. Well, she's absolutely fabulous. She gives me like six pages of references of where I'm supposed to go next, and who to call. And I find it. I actually, and I'm not a big organized person, but it's very organized for me. It's on your, you know, they have a thing online. It's called My Chart. Yeah, but I find health care. Absolutely fabulous. I love scan. I can't say enough good things about scan. Neosporin. I'm just like, impressed with that. Yes. That's such a great thing.


No, no. Alright. She hadn't been to the doctor in 10 years. Wow. 94. Yeah, I was shocked. So her health was really poor. Because they're like she had, she had a dislocated shoulder. She didn't even know she dislocated her shoulder it looked like the back of a flamingo or something. And it was, you know, so it shocked me because Because health care seems like. And I'm lucky I don't have diabetes. I don't have any of the stuff that some people have walking here. But I couldn't believe that she hadn't made use of her health care. But her husband had passed away, golly, 20 years ago. And she felt like when he got more medicine, he got worse. Right. So she had a mental thing about health care. And, and actually, when they took her to hoag on the Fire Department took her to hoag. I think she thought it was the end because she was going and could be mental. You know that that could have been a part of her demise. Yeah. So yeah, not everybody looks at it the same.


Right, right. And then earlier, we talked about accessing mental and behavioral behavioral health services.


I when I was a flight attendant, they had something called EAP, which is an employee assistance program. And if you were having a hard time, say there was an accident on board or an altercation with a passenger is something you could call this number and they would refer you to someone in your area. And you could talk it out, which I thought was wonderful. I, I haven't actually needed anything. I'm sure there's an availability. Hmm, yeah, I don't know. No,


yet. No, that's okay. I mean, I think there are a lot of things in the community. We don't know about right. And, and so it's just nice to be able to gauge whether or not people are aware.


Well, I haven't usually needed any of those things. But I've helped other people if it's your neighbor, and I didn't think they were as easy as I had hoped they'd be. Yeah, seems to be like, there's lists of things. But when I called for meals, the Senior Center said, Oh, we're really backed up. We'll call you back. No call back. Yeah. What Yeah, I know, there's food banks, and I've gotten a few people to go to the food banks, you know, Sunday of the month, or whatever. And that seems to be helping some of the folks because a nice bag of fresh produce and some canned goods seems to make them pretty happy. Right makes them feel a little less scared. I think. The ooh Senior Center does have a wonderful ride service though. My friend that's partly blind in this community. Maybe she's on your list by Bobby King Barbara King. She's, um, she uses them fairly frequently and loves it. She thinks they're very helpful. So I'd say that is a two thumbs up two thumbs


up for her. Yeah, yeah. That's great. Oh, boy. So I'm going to ask you to think ahead a little bit into the future.


I think, to be ablre to afford everything,


because if you look at what inflation is doing, what gas is doing what everything is, everything is going up. I pick up something at the store, you know, like, I have a dog, and her treats used to be 199. Now they're 299. So here's another dollar. So I think God 5-10 years from now. I don't see it going down. Yeah, yeah.


That's, that's tough. That's tough. And those things come. They're very unpredictable, too. Yeah. Yeah.


Well, I think hacking on Social Security is not government's role. That because people paid into that. So but I think, rather than fighting among themselves in the millionaire's club, and Congress and Senate, they should be looking at the little people that live and work in the United States that are retiring. Their, you know, it's very iffy. And very, I think there should be more help for people on the road to retirement. It's like $7. How do People live on that. I mean, $15 an hour is pretty disgusting. But seven, and then those guys, they vote on their own salaries, they vote on their own pay raises. So are you going to vote yes, exactly. Yeah. They need to they need to get involved with the real little people. Which they pretend they do every time they get elected.


Yeah, and it's, I suppose you're going further seniors of color. Oh, my golly. Oh, my gosh.


Well, I'm, you know, I've seen some homeless ladies walking around that looked like they're Hispanic. Yeah, that's kind of new. And I did read something that the biggest. Maybe you already know this, but um, the biggest group of homeless is going to be senior women. Yeah. Ah,


Very scary. That is an unsafe I mean, talk about a man being unsafe. No, no, no, no. I don't care how old she is. That's terrible. Just terrible. Yeah. Yeah. No, I've been, I've been noticing senior women of color. And hopefully the navigation center, the Mercy house here in Huntington Beach. You know, but but the thing is, that place has men mainly. Yeah, I think three fourths of them are men. I don't think that women are served there.


There are a few women's shelters, but you're right. I mean, even in shelters where they have men and women women often feel very unsafe at those shelters. Because they can take be taken advantage of in many different ways. And, you know, regardless of how old you are, and in particular, when you are homeless, there's difficulty in just getting by day to day With everything that you need to do just help needing to get by every day from taking a shower to getting your medication to, you know, just everything right. Yeah, so, so thank you for that. We talked a lot about different issues today.


You know, I got this a bit of a thing that I've noticed about people being close minded to new ideas, but I don't know. I don't know if that's something that's overlooked, probably most people. If you talk to seniors, you start realizing, wow, you're kind of set in your ways. Okay. And if it's not, maybe we need some new seeds in that plant field work, whatever. I think being set in your ways to be to be an all of us have it, you know, I like I like my coffee like 630 in the morning, you know, right. I think I more philosophical ideas, versus you know, we want to put the, here's some money, here's some food, go forth, and everything's gonna be fine. Or medicine. I think we need to get up here a bit more. That's a hard one, too, because, you know, we all have different ideas on how to do that. Yeah.


Yeah. So earlier, we when we talked about housing, which is how I know you and how I know, your work and advocacy.


Oh, well, I think it rent needs to be fair and equitable. I think there needs to be a rent Review Board. So the rent Review Board would look at rents and see, does this landlord really need to jack up the rent that much. And also have since it's a rent Review Board, you'd have both sides. So you'd have the renter there, and you'd have the landlord there. I would, I would love love, love to see something fair and equitable come down as a policy from our city. Ah, I don't know if you know how Huntington Beach is right now. But we're very, very, can I say very conservative, all of a sudden, we just had four new people go in. They're horrible. They're just horrible. It's all about the money all about not in my backyard, all about not helping. And so that's not a very nice way for the city to portray itself as a good place to live. They say we're a great place to live. And it is a beautiful place to live. But underneath, it's not a very nice place to live, especially if you don't have heaps of you know, millionaire houses. So I would love to see the city. Be a little more proactive and get out there. Now. I don't know if you know about our city council and all this. Like now little


bit. Yeah, I know. Moser is Yeah, yeah, I know, Natalie Moser.


She's wonderful. Oh, my gosh. She's had some really because she had like a diversity Fair last year at the park, Central Park. That's a pretty cool idea. She does a community cafe once a month. It's a library. Yeah. What's great about


So I love these community cafes because it's a police. You know, the chief of police will be there, the chief for the firefighters, and we're all talking. Just normal stuff. It's just great. That's why I'd like to see more of that but I don't think Natalie is going to be Natalie's really getting pushed to the back. And I watched City Council on Tuesday night. And poor Natalie. She's trying but yeah, the four that have come in and I call them the nefarious four they're against everything. That's, that's for the little people. It's all for the rich people here.


Yeah. Well speaking of that, do you feel that older adults are respected.


No, I think we've become invisible. Yeah, no, no, I think. No, I don't think so. I mean, and it's weird, because since we're just talking about this, here, we have two people that could possibly running the running for president. And there's so much older. And I don't understand. It's like we're not, you know, older people are not very much listened to, I feel. And in here they have, we have some people that are the head in the country that are so old, and not that I have anything against anybody. But we just need some freshness in there. You know, I think their ideas are old sometimes. And like, I don't care how old you are, if you if you're paying attention to what's going on, and you're maybe coming up with some fresh ideas. Yay. Yeah, I think I think seniors, as a as a group are much, much more invisible, when they retire, and when they're out. And


Wow. Or the Oh, yeah. Because Hello, we got a nest of us. Wow. Hmm. I think maybe more community cafes where we have intergenerational groups together. I, I miss sometimes, because I live in over 55 community, the sound of a child or a teenager going by on a skateboard or something, you know, I take my two dogs to the park. So at least I get a little bit out. But anybody else who's sitting at home watching TV, they think the news is what's going on in the world, which better get out there and see if there's a lot more world than that. Yeah. Yeah. Yeah. I think, you know, some in here earlier, I said, I'd like to see more. The age group is, you know, the teachers being a little older. But I like the intergenerational thing, too. So I'm kind of going back on what I said earlier.


No, just you're saying maybe more events where we have more diversity and ages as well. Yes. Yes. Yeah. Yeah.


Well, that was my last question. So thank you so very much.


I know, I know. We made it in time. So But if, at any time, if you want to reach out about something else, oh, I forgot to mention this, just either send me an email or give me a call. And, and we can talk some more. But I am reaching out to Ada to see if we could do a town hall with you guys. Yeah, I love that idea. Yeah, we'll bring some resources, we'll bring some goodies. And hopefully, we can make kind of an event out of it. And then we can talk more about these issues. And what I would like to do is, raise your profile so that people understand what your needs are, make sure that you're a priority. For you know, all these programs to make sure they come around to see you and to check up on all your neighbors as well. And make sure that all of you have all the information and all the programs that quite frankly, you're paying for and taxpayers, as taxpayers that you really should be aware of and make use of right because they're really there to support all of you. So I'm gonna reach out and see what dates we could do a town hall with you guys and I would love to come out and see you guys in person.


We have another lady named Terry Olsen. She's head of the HOA now the president. Yeah. And I would encourage you to reach out to her as well. I will. No, no, I


have a list of all of your email. Oh, yeah, I haven't I have you guys all on my shortlist.


Wonderful, wonderful. Ada. Ada did ask me to ask you. I say yes.


He was always she's always working she said And I love that. She's unbelievable. She is well, yeah na sees well my heart's in the right place but she's really she's an organized person. I wish I could be half as organized so


well, such a pleasure to spend time with you. I'll be in touch with it and we will get cooking.


primary goal today is to identify what needs you think are most important for the older adult population you so those who are 60 and older, we want you to think as broadly as possible take it into consideration the older adult caregiver, family and their community. Okay, I'm going to share my screen so you can see a list of common issue concerning impact. Older adults. Please take a few minutes to read this lesson. Let me know when you are ready to begin. Okay, I'm going to share my screen


and when you want me to scroll up and down, just let me know.


Sure. So I am the Regional Administrator for Orange County Silverado hospice. Currently, in my role, I oversee the entire operations of our Orange County office along with our expansion area out in the Riverside San Bernardino area. My interactions are more so with the team that is visiting patients and overseeing each department. So I have a social worker, Director, Clinical Directors, sales and so forth. So I don't typically have at least now in my role that I'm currently in, I don't have day to day interactions, but I do spend time reaching out to families and or patients via phone when they come on to service to check in and see how things are going making sure when they do come on to hospice services that the team has reached out to them, they've gotten all of the equipment, medications, things like that, that they need, if there's any additional education that they may need from the clinical team, things along those lines. And other than that, it's really just managing the budget to make sure that we're falling in line with the parameters that have been set for the year.


And then do you mind scrolling down just so I can see the other just to make sure. Okay, um, I would say where we're lacking would be a personal care management in the sense of older adults having the funding available, or when they are declining. I know that that's tough for a lot of families that we see where they can't afford to have those caregivers come in and help provide the additional support they need in the home. It would be great if that was something covered under insurance or Medicare benefit. Hopefully one day but that would definitely be a top one that I see a lot of mental health, I think in general is a big one as well. And then let me just the third one would probably be to mind Scrolling back up again. Yes, thank you Sorry. Gosh, oh, I guess that would have been caregiving. Haha. So maybe caregiving and personal hygiene kind of go hand in hand. Those are probably the three big ones that I see the most struggles with.


When you think about personal care management, how a lot I older adults struggling with this issue.


I think just with their overall decline in health, it becomes a lot harder for them to be able to do that, especially if you have someone maybe with Alzheimer's or dementia. And if they don't have the support system or the funding to bring that in, we see that there's a decline in that area. Which is unfortunate. So


I would love to see caregiving covered under insurance, whether it's Medicare, or commercial. I know typically, with older adults, they're on Medicare. But a lot of times it comes down to funding and it's not covered under insurance. So they can't, they can't afford it.


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


I'm not necessarily a kind of see it a wide range of people who have that, whether it's funding or they don't have the family support to come in and help them. So I know that Oh, go ahead.


I was just gonna say on some of the extreme ends. With hospice, we're obviously mandated reporters. So there's even been times where we have to report APS just because they're not getting the care that they need, and it's a safety risk.


From the county standpoint, and the government, I would say, more people advocating for it to be a covered service under their insurance benefits. I don't think they have enough people advocating for them.


I think sometimes it starts early on. But I also think if they don't have the care that they need, they may not be getting the appropriate medications. To help with some of that. I see it more so with patients who are in facilities who don't have family members or a support system. And what's really unfortunate, I see it more on the hospice side. So when we get patients who are admitted into the hospital and need hospice, and there's mental health and behavior issues, a lot of facilities won't accept them. So they have nowhere to go. And nobody caring for them, it only ends up getting worse.


What barrier assists to see improvement in this area.


Outside of more fundings, I think if there were more facilities and places for them to go, specific to mental health, that would benefit them a lot of times, there's just facilities don't specialize that in that. And they are fearful of how they could potentially endanger other residents, patients, so they just don't take them.


Are there different experiences or different group of older adult from different backgrounds.


Not necessarily we've just seen, you know, unfortunate situations where patients with behavior and mental health issues they're, you know, being strapped to beds, and it's just a it's a very sad situation, because there's not a lot of people out there who know how to manage them appropriately.


Wow, I didn't know that before. That's very, that's heartbreaking.


Um, I would think continuing to advocate for, you know, government funding, especially because a lot of times we see it with a very low income residents in the area.


I'm gonna I know you mentioned a little bit on the caregiving already, but I want to just go through it again. Okay.


Well, with the finance piece, that's a big thing. But lack of caregiving leads to additional health care costs, whether having falls in the home and ending up in and out of the hospital. You know, a lot of times when they're older, and they have a fall and you know, they maybe break a bone, you see a severe decline in their overall health too. Whereas I think some of that could have been prevented.


I think the same as before, just you know, having that coverage, I think would be really helpful under their insurance and their benefits. So that we could, they could have more of that one on one support when they are declining.


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


Now, we obviously see it more with low income because they can't afford it. But other than that, no.


I think the continued advocating and petitioning especially, you know, to the government, because it is, you know, mostly Medicare age, population.


I think there's a lot of great companies out there a lot of resources. I think it's important to I think there's a lot of great companies. And I think there's some that don't always do it the best way, and are looking at it more from a financial standpoint, and how they can make money. And that's where you really see them cutting corners, or maybe they don't send caregivers out enough. Or maybe the caseloads are too high. And that's where we tend to run into problems. I see at least with hospice, where there's transfers, because they'll bring patients on and then they won't go out and see them for days upon end. And it's not really benefiting them. But they're billing Medicare for it and making money off it. So it's really sad. I was happy to see that they put a stop to any additional hospice licenses this next year, because there are so many companies out there, but there are a lot of good ones. And there's a lot of good caregiving resources that are very readily available if people have the funding to cover it. But again, it can be expensive. So unless you have long term health insurance, or you were a veteran or married to a veteran, those are really the only two avenues you can go where it's covered, without paying out of pocket.


Um, I think it's accessible. I don't think a lot of people have it, though. paid into it. And unfortunately, when you get to a certain age, it's very expensive to get it at that point.


Um, I don't think there's a lot of it. I think that's why people end up going to the hospital more often than not, but then they, you know, don't keep them there for very long, and then will discharge them. And it's just one of those vicious cycles if they don't have the proper care, so I don't think there's a lot.


Um, that, um, you know, I'm not really sure. I only experienced it in the hospice industry, being you know, we have social workers that are in place. So as soon as they come on to services, they have that support system wherever they may need that extra help, but outside of hospice, I don't know is, I don't know as much in that industry in that arena.


Oh, gosh, I don't know how much it will necessarily change. I think a lot of it is similar to what it is now. I'm having the funding and the coverage under their insurance to be able to properly care for them. Because healthcare is very expensive. So I only see that going up in cost, unfortunately, so there's probably some financial risk to cover their health conditions.


I think allocating more funding to their health care.


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


probably the low income people who are living in skilled nursing facilities, because they only have medical the care that they get is very minimal.


I think caregiving is overlooked. I don't think obviously, it's not covered. So I don't think they government necessarily sees the value as much. And I'm hoping that over the next, you know, decade, that's something that becomes a coverage point, because I do think it would actually in turn save a lot of money from hospitalizations, and readmissions.


Yeah. Yes. Um, I think it just makes us a little more self aware of where we are lacking because we do have a lot of patients in skilled nursing facilities or who are very low income. And hospice is one of those few benefits that is covered at 100% under their Medicare benefit. So we're able to come in and really provide some supplemental care. But unfortunately, it is supplemental, so we're not, you know, typically around the clock, we are available 24/7. But that's really where we pull in on our social workers to help find any possible resources for families who may not have that the financial piece to be able to cover the additional costs


Um, gosh, I'm trying to think I know the Alzheimer's Association is a big one. They're big advocates. They would be a great organization to talk to you as well.


Thank you. So this concludes our interview. Thank you for your time. If you have any more to share, you can always reach out to us and our information is available on our website, and you can leave a voicemail on my telephone. So I will stop the recording now.


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


I'm still learning a little bit more about advance oc and the goals here. Yeah. So


yeah. So so thank you for having me, Katie, and honored to be part of advance oc and what you guys are trying to do. And hopefully I can share some some ideas on how we can help older adults, I think we all have the same goal. I think a lot of people that work in the healthcare and senior industry, have a heart for seniors and want to do the right thing and be a resource and advocate for them. So I think our our goals and mission align. And so, you know, my background is, is 20 years in assisted living and living. So I, you know, did marketing some operations, I did new development, where I built new communities, in multiple states, primarily in California, and I did a lot of acquisitions. And so I was a VP for numerous companies. And, you know, our, our goal was to take care of seniors in these assisted living communities. And so being an assisted living, I got to learn about a lot of different parts of senior living. And and, you know, and how they're operated, how they're managed, you know, some of the different partners that we worked with, to provide great care for the seniors who live there. And then now, I transitioned into a new role about a year ago, where I'm a VP of Business Development for Senior doc. It's formerly known as Geiss Med. We do on site primary care. So basically, we have doctors and nurse practitioners and physician assistants, that go into seniors homes, in the convenience of their own home or assisted living community. And we provide primary care. So it's kind of that old school where the doctor comes to you and you know, we go to the homes and provides we're physician group that provides care in their home. So we do a lot of other things. But that's our primary core business today we're at, we see about 2500 patients a month, we're in about 380 Assist different assisted living communities in three states, primarily in California, we're based out of orange in the city of orange and in Orange County. So we're central with with your your, you know, market that you're serving in Orange County, I personally grew up in Yorba Linda and Fullerton and Garden Grove and so I have a lot of connections here and you know, have a huge heart for for this county that we're serving and in our offices here. So I'm really passionate about this and glad to be able to read through this and hopefully share some some ideas here.


sure. So, um, you know, let's start with the top, Alzheimer's and dementia is, you know, in the in the folks that are part of this, the very first one is Alzheimer's and dementia, dementia, you know, and I'm not here to educate you and I'm not pretending to be a physician because I'm not. But it's, you know, dementia is an umbrella term, there's many forms of dementia, there's some that are more challenging like Lewy Body vascular and Huntington's disease. It's even more challenging than Alzheimer's, which is the most common. A lot of the memory care communities you know, do have a secured or assisted living communities do have a secured neighborhood for folks with memory loss. And I think they do a great job at engaging them and making sure they feel active and they're as independent as they can be. But there's just a huge challenge. There's a stigma still of moving into senior living communities, or even needing one on one home care in the private comfort of their own home and it's very expensive to bring In homecare, so there's great organizations out there that help people with Alzheimer's and dementia like Alzheimer's OC, there's Alzheimer's Association. So there's some great groups out there. And there's lots of support groups, which there's a stigma even attending those. You know, in a lot of it's untreated, it's undiagnosed. People don't want they know they're becoming forgetful, their short term memory loss, and they don't want to get diagnosed with that disease. And they don't go and see their doctor, you know, and I think what people joke about is, hey, hey, Katie, if I'm joking with you saying, you know, I have dementia, because I misplace my keys, that's different than me, that's different than me driving home from Ralph's, which is down the street that I've been driving home from from the last 20 years. And I get lost. And it's just down the street, and it's somewhere I've gone, you know, forever. And I get lost. That's, that's different than me misplacing my keys. And so I think people don't really understand the difference between dementia and in Alzheimer's. And I think one other important part is seniors oftentimes, self isolate, as they get older, many times they lose a spouse, their friends and neighbors move on and pass on their, you know, that they're retired, and they need a purpose, they need a reason to get up and get dressed to go down for breakfast, and they don't like to cook for themselves anymore. You know, a lot of their social groups are getting smaller. And we all need eight meaningful conversations a day, I think that's a great message and takeaway out of this whole message here with advance oc is to say, the seniors need eight meaningful conversations. And so, you know, everyone knows we need to eat healthy, we need to exercise we need to, you know, manage our medications correctly. But the eight meaningful conversations, we need a purpose. And so I, you know, finding in to prevent dementia, we need to not just work a pseudocode every day or not, you know, do the same thing over and over, we need to use different parts of our brain. So the experts will say, you know, learn a new language, even though we're seventy years old, you know, explore and go to different places, try new things, join the Senior Center, there's lots of opportunities out there, especially with the internet, to engage different parts of your brain so we can get to those eight meaningful conversations today is our goal. So diet, nutrition, fitness, I think that solves a lot of problems. You know, I think, you know, there's so much opportunity out there just through internet through, through, you know, telehealth options, through podcasts, through, you know, books, whether it's books, where it's reading to you, or, or just reading, but you know, there's doc talks, you can go to the Senior Center, you can go anywhere, and learn about nutrition and fitness and do group stuff, if you're not wanting to do fitness by yourself. And I just personally feel, again, I'm not a clinician, by any means. I'm not pretending to be, but I just think, you know, that's to me, if I'm picking three things out of this whole thing that that stands out.


Yeah, I mean, there's a lot of these are very challenging. You know, another one that stands out, it kind of ties in with the respect thing, there's, there's something you know, that's called ageism, where a lot of seniors are discriminated against, you know, in the workforce, or through housing or, you know, lots of different means in I struggle with that, because I'm so passionate about seniors, and people will say, Oh, they can't pick up the digital piece, or they can't, but they there's so much value and wisdom and in many of them can are internet savvy, and could probably, they're an Excel ninja beyond what I can never do of numbers. They offer tons of value. And I think, you know, sometimes younger generation, generation X or whatever they, you know, they dismiss it, you know, we want to get someone that's going to come in and we're going to coach them and mentor him and whoever the younger person is, and we want someone that's hungry, that's going to hustle and in, you know, work hard and not bringing in bad habits and they're going in with that angle in that mindset, not thinking about the best practices, the experience, the life knowledge that someone who might be 75 that still has tons of value to offer an organization. So I don't think people necessarily know that they're discriminating I Um, I just think they get dismissed. And, and, you know, it's something I'm passionate about as well. So I already picked three things in nutrition, the Alzheimer's dementia in the respect, you know, as a physician's group, we're all about our company culture, are all about hiring and retaining and recruiting staff and talent, making sure our team's appreciated that our team has great bedside manner with our patients. And that we're checking in and checking out with the families, the POA is the communities that we're serving. If we do right and do a great job, good things are gonna happen. And in respect comes in a lot of different forms, both for the patients we serve, the communities we serve, and the families and our own team. So I think that's a great one as well.


Yeah, I want to dig a little deeper into the three that you mentioned.


Yeah, I mean, there's multiple reasons of why people get it. You know, sometimes it's, it's real that it ties into my other thing with the nutrition or, or, you know, some of it's hereditary. Some of its, you know, it's, you know, things you can't control, they didn't eat, right, or they sometimes it's, it's, they had a bad accident, they were in a car accident, and they had some trauma. And it caused some form of dementia from it, it's really sad. And so the, I think a lot of the communities that are people that take care of people with dementia can be demeaning. And that also ties on the respect piece, meaning they do stuff for them, they want to enable them and, and let not let them do as much as they can for themselves. And so having systems training, quality assurance, and having, you know, there's a few people that come to mind, one of his deepest snow, where she talks a lot about how to treat people with memory loss, you know, that they still have a great purpose in life, and, and they still have the ability to make choices. And it may not be choices of, hey, you know, Brian or Katie, here's a menu to choose from that can be overwhelming with someone with memory loss. Or do you want a salad for lunch, you know, it, kind of simplify it and give them still the ability to do as much as for that they can for themselves without it, finding that balance of still being independent, but not telling them this is what they need to wear, you know, Choices, choices are really good. I think a lot of people are afraid to talk about sex, you know, just because you have memory loss, and you you know, can't remember if you had breakfast, but those sexual desires don't go away. You know, and so we talk a lot about consent. You know, what that means of when you have you know, it's also find that balance of if you if there people are married, you know, can the person consent, you know, who's the POA sometimes in memory care communities that I've helped manage, you have two people with memory loss that that wants to engage in sex and so, you know, it's, it's a challenge in are they at the same level, it's one taken advantage over the other person, you know, that ultimately they do have the right to have that time together. And so, you know, we have to notify the power of attorney and sometimes they're still married. And so you know, that that comes a whole other challenges and then there's, you know, we have to talk about STD prevention and a lot of this stuff. So, there's a lot that goes into memory loss and dementia and, you know, there's, you know, CBD and a lot of Eastern medicine options that are growing and becoming more popular, where it's not just the historical two medications that most primary care groups like us, you know, recommend which is typically Aricept and Namenda so you know, there hasn't been a lot of really strong medications that I've seen that have worked so slow this disease down in my opinion for for families and adult children and spouses, grandchildren and loved ones who are struggling with someone with who has memory loss you know, my advice is always just love them for the time that you have left and you know, take them out to a park go places play cards you know for for you do as much as you can for them and not overwhelm them. And but but still be able to do fun things you know together and celebrate your time together and enjoy that time because we don't know how much time is left. And so I like to personalize things personally. What's her favorite oil that's going to bring back dads, if dad's passed away, your dad used to wear brood, you know, how do we bring that scent back. And so there's so much opportunity to engage someone, through even through oils, like citrus will lift someone up if they're on hospice, and and then there's lavender that can calm people down. If they're sundowning, or they're agitated, there's lots of tips and tricks to redirect people who are agitated, who are really struggling with, I want to go home and their arms are crossed, and they're sitting in their home they've lived in for 20 years. But with memory loss, home might be for them, it might be where they grew up, in and they may revert back to someone who they were younger in life. And so they're really struggling. And so it's finding again, finding a purpose and finding, getting them engaged in something during that time where they might be coming agitated. So if we know when they're sundowning, literally when the sun's coming down, and they know they need to go somewhere or do something and they're really struggling with that time of day, that's the time with where we should go take them on a drive. Or we should, you know, put on some music or, you know, draw or work on some blocks or, you know, do some trivia, whatever. But, but the more they're just self isolating, and not not doing anything, the more, a lot of times that agitation will progress, especially if it's not handled right. And again, one other piece of this whole thing is, if it's a caregiver, like a spouse, or a caregiver, in a community or at home, everyone has different tiers of what they can do. And so some people just need a reminder for a shower, and they go in and take their shower. Other people, we're setting everything up, it's the right temperature, the shower, we're making sure they're transferring safely, and they can they can take their own shower. Other people were standing outside the shower or handing him things saying, Okay, we're gonna soap her body up, we're gonna wash your hair. And then other people need full hands on care. And so, again, we never want to, we never want to enable seniors or anyone with memory loss to, to do things for them, you know, let them do again, let them do as much as they can for themselves.