larimer county summit on aging

Larimer County Summit on Aging

Bonnie Shetler, PhDPresident

Foundation on Aging for Larimer County

Foundation on Aging for Larimer County January 22, 2010

The Foundation on Aging for Larimer County aims to bring about community awareness of the unmet needs of aging – and to be a catalyst for addressing such needs through collaboration that seeks innovative, funded solutions that result in health, happy, and enrich lives for us all.

Presenter/OrganizationLarimer County Summit on Aging

Foundation On Aging for Larimer County January 22, 2010

Bonnie Shetler, PhD

ServiceProviderNetwork

Office OnAging

FoundationOn Aging

Aging-In-Place

Unmet Needs

Aging-In-Place

Unmet Needs

Collaborate

Coordinate

CreateAwareness

ProvideLeadership

FacilitateProcess

Aging as an Out-of-Body Experience

Philip B. Stafford, Ph.D. Director, Center on Aging and Community Indiana Institute on Disability and Community Indiana University

Philip Stafford, PhDDirector, Center on Aging and

Community Indiana University

Aging is not about time and the body, but about place, and relationships

CommunityIndiana University

Our work together should involve creating good place to grow up and grow old

Communities large and small are taking up the challenge

The Summit on Aging positions Larimer County to leap into the future with confidence

“Community is the smallest unit of

health.”

Wendell Berry, Health is Membership In Another Turn of the Crank

Our work should help create good places to

grow up and grow old…

livable communities for a lifetime

What is an elder-friendly community?

Data driven and participatory planning for the future

ADDRESSES BASIC NEEDS

Housing Is Modified To AccommodateMobility And Safety

“% of 65+ householders with home mod needs”

The Domain

The Dimension

The Indicator

• Identify the stakeholders• Understand the issues • Frame the problems• Identify potential action steps• Identify the assets in place/needed• Prioritize actions• Support and monitor the responsible parties• Benchmark and evaluate

Making our community elder-friendly

“Improving a community, from beginning to end, involves organizing

people. Money is secondary.”

Who knows about the

issue?

Who cares about it?

Who can do something about it?

Stakeholders

Community Change

THE GRAYING OF LARIMER COUNTY: IMPLICATIONS AND OPPORTUNITIES FOR THE FUTURE

Susanna D. Bozinovski, Ph.D.CEO and PresidentBozinovski and Associates, Inc.Human Services Consulting12412 King StreetBroomfield CO 80020susanna@bozinovskiassociates.com(303) 882-6826

S.D. Bozinovski/Bozinovski & Associates, Inc.

2.9% 1.9%

7.9%6.1% 4.8%

3.3% 2.8%4.1%

2000-2004 2004-2008 2008-2012

0-17 18-59 60-74 75+

GROWTH BY AGE GROUP, 2000-2012LARIMER COUNTY

National Research Center 2004

Percent of Larimer Residents Age 60+

THE GRAYING OF LARIMER County

Age 60+ and over

45,42915%

Under age 60248,508

All Larimer County Residents

July 2008 Population Estimates, Colorado Demographer’s Office

Boomers & Beyond: Housing Trends in the 21st Century

Janice BlanchardAging in Community Network Initiative

Denver, CO

1950s & 1960s: Growth of the Suburbs

Blanchard, AICN Initiative

• Economic prosperity• Single family homes• Father, Mother & 3 to 4 kids• Mother stayed at home

1950s & 1960s: Birth of Retirement Communities

1970s: Apartments, Condos, Duplexes & Trailers

• Recession/rising fuel costs • Increase demand affordable housing• New demand for multi-family units• Rise in divorces & single households• Mothers enter the workforce

The 1980s: Colonial Homes and Luxury High Rises

• Reagan years of prosperity• Echo boom• Dual-wage earning family is norm• Renewed interest in urban living

The 1990s: McMansions and New Urbanism

• Greed, excess and wealth• Increasing concern of unchecked

growth – Exurbia • Awhannee Principles • Rising inflation

The 1990s: Assisted Living Facilities & Retirement Communities

• Housing for Older Persons Act of 1995 • Golden Age of Retirement• “The Third Place” – new niche market• WW II Generation Values

Housing in the 21st Century:What’s Next?

From Aging in Place…..

What’s Next ?

Shifting the Paradigm

….To Aging in Community

It takes a village to raise our children…

It takes a community to care for our elders.

Aging with Options

Diane M. StobnickeVolunteers of America

Aging with Options

An overwhelming majority of adults wish to remain in their own homes as they age.

Rapid growth of older adults “aging in place” presents opportunities and challenges.

Opportunities: substantial source of civic, social, and potentially financial ‘capital’. (Volunteers, board members, activists, community leaders, elected officials.)

Challenges: affordable, flexible, coordinated services for an increasing number of frail and disabled adults.

Aging in Place

Diane M. Stobnicke/Volunteers of America

Aging with Options

Community Engagement Programs or Self Help Communities Provide an integrated set of support services such as: social,

cultural, and educational activities; wellness and fitness programs; religious services; service coordination (usually non-medical); volunteer opportunities; transportation

Monthly membership fee

Organized by residents or a service agency

Coordinates services with screened vendors

Example, Beacon Hill Village and SAIL (Supporting Active Independent Lives)

Promising Community Strategies

Aging with Options

Preventive Services and Service Enhancements Evidence based interventions – A Matter of Balance, Arthritis

Foundation Exercise Program, Powerful Tools for Caregivers, Chronic Disease Self Management

PEARLS (Program to encourage Active, Rewarding Lives for Seniors) – Sessions with Social Worker to reduce symptoms of depression

Service Coordinators working with seniors in high rises

Promising Community Strategies

Aging with Options

Injects ‘aging’ into local community planning

Engages older adults in community planning

Addresses basic needs (housing, safety, food)

Optimizes physical health and well-being (promotes healthy behavior, access to services)

Maximizes independence for the frail and disabled (transportation, resources to age in place, support for family caregivers)

An Elder Friendly Community

THE MOBILITY CHALLENGE

Gary D. ThomasExecutive Director

SAINT Volunteer TransportationSenior Alternatives In Transportation

A “perfect storm” of issues will soon impact how Coloradans move about:

• Fuel prices• Climate change concerns• Aging of the baby boom generation

Several initiatives are underway to provide new options – but will the funding arrive in time?

Gary Thomas / SAINT

Several new efforts underway to provide alternatives to private automobile travel:• Fort Collins and Loveland just completed their first ever consolidated Transit Strategic Plan• CDOT has formed a new Transit and Rail Division• Amtrak is considering returning the Pioneer Train service between Denver and Seattle – with possibly a stop somewhere in Larimer County• Major study on the feasibility of High Speed Rail in Colorado is being completed• U.S. Congress considering revisions to the Federal Transportation bill

that will increase support and funding for transit and rail• Mason Corridor Bus Rapid Transit line is funded - design underway

“I will. I will survive” – Scarlett O’Hara

Gary Thomas / SAINT

Health Care Issues for Seniors:Current Problems

Prospective Solutions

Roger P Bermingham MDFamily Practice Residency

Poudre Valley Hospital

Shortage of Primary Care Providers• General Internists

– 2% of graduating medical school seniors plan to go into general internal medicine: 2007 data

• Family Physicians– Currently are 12% of the work physician work force– Only provide a percentage of senior care– Declining number of US graduates going into FP residencies

Roger Birmingham, MD

What about Geriatrics

• In 2007, 91 graduates from US medical schools entered Geriatric Fellowships– Most are destined for academic medicine– Added training with a decreased reimbursement

• Number of practicing geriatricians declined 5.5% from 2000 to 2007

If you get into see the doctor…• Will you have enough time to bring up the issues you need to?

– Average primary care office visit time is shrinking– Longer appointment times less available

• With shorter appointment times– Patients do not bring up all the issues that are bothering them– Providers do not verbally screen for other illnesses (see next slide)

If you get into see the doctor…• Will you have enough time to bring up the issues you need to?

– Average primary care office visit time is shrinking– Longer appointment times less available

• With shorter appointment times– Patients do not bring up all the issues that are bothering them– Providers do not verbally screen for other illnesses (see next slide)

Are there solutions for the impending Senior Health Care crisis?• There is likely not a single solution• Each potential solution has significant hurdles and drawbacks• Many of the solutions take time to develop• We are definitely in a “brainstorming permitted” mode

Roger Birmingham

Some existing solutions

• Medicare plus Choice plans– Offer benefits above Medicare basics often including drugs– Often regionally limited (Kaiser, Rocky Mtn HMO)– May have cut backs in arenas that aren’t evident

• Program for All-inclusive Care of the Elderly (PACE)– Basically is Day Care plus medical services– Primarily for frail elderly with Medicaid– Has to be regionally approved

Some options under discussion

• The Patient Centered Medical Home– Having access to multiple modalities of care through or at

your primary care physician’s office– Works only for larger medical groups– No current extra funding—but hoped for

• Nurse Practitioners clinics targeted for Seniors– Typically work better in larger cities with higher number of

Medicare HMO plans– Still often need physician oversight

Brainstorming/Other options

• Retraining physicians in geriatric care– Donald Reynolds Foundation grants– Great education but reimbursement/access issues remain

• Using trained lay persons to act as case finders

• Increased loan forgiveness for physicians working in clinics with a higher percentage of senior patients

Findings from the Larimer County Summit on Aging

Kelly Blanchard and Brittany Silvers

Hartford Partnership Program for Aging EducationFellows in Gerontological Social Work

Colorado State UniversitySchool of Social Work

Foundation on Aging for Larimer County March 3, 2010

PURPOSE OF BREAKOUT SESSIONS

Foundation On Aging for Larimer County March 3, 2010

Blanchard and Silvers/CSU

HEALTH CARE

What are the key needs or the main problems around health care for current and future seniors in Larimer County?

Education About Services and Resources

Need More Services and Providers

Communication

HEALTH CARE

What are community assets that are being mobilized already to address health care?

Connecting with Services and Resources

HEALTH CARE

What are the opportunities for improvement around health care in Larimer County?

Education- Provide and Obtain

Collaborative Health Care

HEALTH CAREVision Statement

In a Larimer County that has achieved aging readiness, and is livable and healthy for our seniors…

All seniors are aware and understand the resources available to them; livable and healthy; receive adequate financial resources to meet their needs; through a coordinated environment are receiving the health care they need; preplan and move to more self-responsibility.

SUPPORT SERVICES

What are the key needs or the main problems around support services for current and future seniors in Larimer County?

Affordability and availability of community services

Education and awareness

Quality of Life

SUPPORT SERVICES

What are community assets that are being mobilized already to address support services?

Community Based Resources

National Resources

Government Resources

SUPPORT SERVICES

What are the opportunities for improvement around support services in Larimer County?

Financial

Education and outreach

SUPPORT SERVICESVision Statement

Is a model of innovation that demonstrates high quality and respectful elder friendly communities.

TRANSPORTATION

What are the key needs or the main problems around transportation for current and future seniors in Larimer County?

Public transportation logistics

Alternative options

TRANSPORTATION

What are community assets that are being mobilized already to address transportation?

TRANSPORTATION

What are the opportunities for improvement around transportation in Larimer County?

Structural Improvements

Untapped resources

TRANSPORTATIONVision Statement

Will know how and can easily access a safe, affordable, enjoyable and reliable transportation system service that keeps them connected to our community.

HOUSING

What are the key needs or the main problems around housing for current and future seniors in Larimer County?

Central Resource for Housing Needs

Resources for low income, special needs seniors

Intentional Communities

HOUSING

What are community assets that are being mobilized already to address housing?

National Resources

HOUSING

What are the opportunities for improvement around housing in Larimer County?

Versatile Housing

Collaboration of established organizations for knowledge, creativity and growth

HOUSINGVision Statement

All seniors have options for housing that are accessible, integrated with the greater community, allow for intentional interdependence, and provide a meaningful quality of life.

THEMES FROM THE SUMMIT BREAKOUT SESSIONS

Education and Awareness

Advocacy

Volunteers Available

Single Reference Source/Point of Entry

CONCLUSION

Underlying all of the findings from the Larimer County Summit on Aging is the reality that we, as a community, need

to rally together to show our commitment to value, respect and provide for our seniors.

Following the Larimer County Summit on Aging, the Foundation on Aging will form collaborative groups that will turn this vision into concrete objectives. Everyone is invited to be part of this collaborative process.

Please indicate your willingness to be involved in these activities. Name/Title ________________________________________________________________________ Affiliation _________________________________________________________________________ Phone ____________________________________ Email_____________________________________ FOA website: www.foundationonagingforlarimer.org

Vision Statement

“IN A LARIMER COUNTY THAT HAS ACHIEVED AGING READINESS, AND IS LIVABLE AND HEALTHY FOR OUR SENIORS ALL INDIVIDUALS ARE PREPARED FOR THE CHALLENGES AND OPPORTUNITIES ASSOCIATED WITH AGING IN OUR COMMUNITY.”

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