Hands to Help Seniors
Burbank, CA Speaking at the C4A
Conference 2023: Mapping the Future of Aging and Disability in California, held
here May 9-11, The California Department of Aging had a number of team members
come to describe their data collection methods and how they look forward to
using the data for inclusion.
That translates to
providing better services to minority groups like African Americans, Asians, Hispanics,
the LGBTQ community and Native Americans. Marina Castillo Augusto, Equity Officer,
California Department of Aging, said that she is the first Equity Officer at
the California Department of Aging. “We
have a responsibility to lift support services,” she said, and that means
looking at subsets of the senior community which may have very different needs
than the overall senior community.
Ross Lallian, Chief of Research, California Department of
Aging, said that the research focus of his group is on the LGBTQ community to
better understand service gaps and to drive policy and program decisions. Recent research has found that members of
the LGBTQ community that have been out for many years go back into the closet when
moving into assisted living or a nursing home.
Therefore, Lallian’s group is working on a LGBTQ+ study of
older adults. “We are studying aged 50+ who
are more likely to live alone. Two
thirds report not disclosing sexual orientation to LTC facilities,” said
Lallian. The Department of Aging is
They plan to survey at least 2,000 people in a statewide
coalition which will be guided by a LGBTQ+ Advisory Committee comprised of older
people who identify as LGBTQ, service providers, and members of the Area Agency
on Aging (AAA).
“Having these trusted voices help distribute these surveys
is critical. We would like to do the
survey on a regular basis. We plan on
making this data public. Research and
policy folks will be able to use this data for advocacy,” he said. The goal is to improve access to medical and
Master Plan for Aging Project Director, California Department of Aging, said
that they were working with U.C. Davis to do a formal evaluation on how to
better serve local communities and to lift diversity.
“There’s a lot to be gleaned from speaking with our diverse
communities. We should care for them as
they age, and treat them with dignity and pride. We are all different and we all don’t start
in the same place,” she said.
Sarah Steenhausen, Deputy Director of Policy, Research, and
Equity, California Department of Aging, agreed.
“Everything we are doing is trying to infuse equity. Everything we are doing requires
stakeholders,” she said.
It’s nice to see that there is a smaller government agency
working on these important issues for minority seniors. They are likely to be more nimble and be able
to get things done more quickly than other larger State and Federal agencies.
Burbank, CA Speaking at the C4A Conference 2023: Mapping the
Future of Aging and Disability in California, held here May 9-11, panelists on
the “Aging In Community: The Affordable Housing Crisis that No One is Talking
About” panel lamented the lack of government incentives to build affordable
Cherly Brown, Chair, California Commission on Aging and
Former Assembly Member said, “Someday you’re going to get old. There are an increasing number at risk of
being homeless.” She pointed to the high
poverty level of seniors in California.
She said that the poverty levels of seniors, paired with a and
lack of assets (seniors have an average of $54K in assets, which is the median
cost of just one year of living in an assisted living facility).
Meea Kang, SVP Development at Related California said that
“Independent living is primarily how folks have been aging in their own
homes. As seniors age, they often need
more care and support. One step beyond
that is assisted living and Board and Care facilities (6 beds or less). One step further would be skilled nursing
facilities. As a commission, our goal is
for advocating and providing for a range of services for long term care.”
Unfortunately, only two, IHSS and skilled nursing, have government
funding. “This is causing seniors to
fall into homelessness at rapid rates.
There are over 200K living in assisted living facilities in California today. The majority of the residents in assisted
living today consider these homes their permanent living space.”
Tim Dunn, Associate Director of Housing Development at Mercy
Housing at Laguna Honda Hospital in San Francisco said that Mercy Housing (a
non-profit) is working on housing projects with 23K units in the country and
10K in California, all deeply below 60% of the poverty level.
“Service enriched housing is one of the options for the
senior population,” he said. Mission
Creek Senior Housing is a project that is about 15 years old. Rents are only about $300 a month for residents with subsidies, roughly a
third of their income as rent. There are
also services on the site. “There is a
resident service coordinator to make sure people get IHSS, transportation, etc.,”
an important factor.
Residents get annual health surveys of Activities of Daily
Living (ADLs). There is also an Adult
Day Health Care Center on-site. They can then go to their apartment in the
evening with IHSS support. “It’s not
24-hour care. We don’t do IHSS, but we do
get people connected. One of the things
you can’t do is plan for unscheduled needs.
We can’t administer medications.
San Francisco has experienced a great lost in assisted living which was
historically small mom and pop facilities which are now no longer financially
viable,” he said.
Laguna Honda Hospital Campus is a 62-acre site with capacity
for large development, right on the muni line.
The city is allowing development of senior housing, which can support 250
to 300 units. The city of San Francisco
will provide free land and about $50 million in capital financing.
However, he said that, “Even with all of these resources we
still are hitting a barrier with doing the licensed care. This
particular property is currently on hold due to financing issues,” he
said. Hopefully development will start
Two other panelists, Dan McDonald, Deputy Director of
Lending at Community Vision California Capital and Consulting and Michael
Siglala of Innovative Development and Living Solutions of California worked on
a project called Magnolia Crossing for years.
It’s a textbook case of a project that works but was
developed about ten years ago and the model unfortunately isn’t financially
viable anymore. McDonald said, “I joined
in 2012. I had worked for a bank working
with private and memory care. The only
financeable projects at my bank were large wealth developers. I began to believe that affordable assisted
living was possible,” he said.
This project worked because U. S. Bank purchased the tax
credits (assisted living waivers). “What
we would like to do is replicate how to do this in other communities. The expansion of the assisted living waiver
program(would help and many other programs with the state would provide the
money that the community needs,” he said.
Sigala said, “I always worked in urban planning, and wanted
to do some development. I was the primary
caregiver for my mom. I saw this as a
big emergency need for seniors, how do we house them? One of the first people I talked to was Dan.” In Clovis, they developed a project called Magnolia
Crossing senior living community.
They had a mixed income model of home like assisted living
project. There were a total of 48 units,
developed in 2013, and they did it as a non-profit. They received $10 million in funding to do a
project that had never been done before.
The project was three homes about 10K square feet each. One had 16 units of memory care, 36 other units
were assisted living. They were studio
units, where everyone had their own bathroom.
“Isolation and loneliness are two of the main factors
influencing the senior community. We
have 35 full-time caregivers, LVNs, cooks, care and support staff.” There are both very low income on Medi-Cal
living with private pay. 10% of their residents
are over 100 years old! The new market
tax credit program was the only program available at this time (you had to show
a commercial component (services)) to make it work. “The Assisted Living Waiver program is
great but it’s unpredictable. The reimbursement
rates are 10-20% below what they could be to make this feasible,” he said.
Burbank, CA Dr. Joshua Bamberger from UCSF Family
Community Medicine appeared at the C4A Conference : Mapping the Future of Aging
and Disability in California, held here May 9-1. He described a fascinating study of the
homeless that he did right during the height of the COVID-19 pandemic.
On a panel entitled Aging in Community: The Affordable
Housing Crisis That No One is Talking About, he said “March 17, 2020 I left
UCSF and started surveying people in the homeless shelters in San Francisco.” 3,500 homeless adults were moved into
housing, mostly using tourist hotels. “We
can house everyone if we want to. “We’ve
proven that during the COVID crisis.”
Each of the 3,500 people were given a medical assessment. He found that most people really didn’t need
anything other than a safe place to live.
“The vast majority need a decent, permanent housing with
some on site services. About 10% need
more,” he said. He noted that when they
did the survey, most of those over 50 had a diagnosis of congestive heart
failure. About 90% of those with congestive
heart failure used methamphetamines.
Dr. Bamberger said that by augmenting the existing permanent
housing with support services, this helped the homeless dramatically. Also speaking on the panel was Dr. Margot
Kushel, Professor of Medicine at UCSF and Division Chief for the UCSF Center
for Vulnerable Populations and Director of the UCSF Benioff Homelessness &
She noted that homelessness is a function of structural
assets and the presence of a safety net.
“In California, in 2023, you do not need many vulnerabilities to become
homeless.” She noted the lack of
affordable housing, income inequality and structural racism.
“In 2023 in California we have 24 affordable housing units
available and affordable for every 100 extremely low-income households. We have 1.3 million in this group.” She said that in San Francisco less than 5%
identify as black, yet 37-38% of the homeless population in S.F. is black. In 1990, 11% of the homeless are 50 years or
older, while today 50% of homeless are 50+ (data according to the HOPE HOME
Study which has been done since 2013 and is funded by the National Institutes
Of the people 50 and older who were homeless, 44% had never
been homeless before. This is unlike the
larger pool of homeless, many of whom had drug addiction or mental health
issues. Of the 50+ group, 44% had never
been homeless before.
She said that the late onset homelessness looked very
different. They led very typical lives
but had low-wage jobs with no pension.
These people typically had a crisis, like a marital breakdown, they or
their spouse had an illness, or they had suffered through the death of a spouse
or parent. Many had been caregivers for
their parent, and then lost their job and their home.
She noted that more than a quarter meet the criteria for
cognitive impairment, and nearly half had problems with Activities of Daily
Living (ADLs). “50 is the new 75 for the
homeless,” she concluded.
Alzheimer’s disease, Parkinson’s can be a devastating disease which can take a
heavy toll on your body. There have been
few new treatments for both diseases, which has been disappointing. The disease hasn’t gotten a lot of attention
from researchers until last December when a report said that Parkinson’s
disease strikes 90,000 older Americans each year, 3x the previous estimate of
30,000 per year. See a neurologist if
you suspect that you or a loved one may be noticing shaking and other symptoms
of Parkinson’s disease.
published in Nature Magazine showed that tiny spurts of exercise throughout the
day are associated with significant reductions in disease risk. The researchers used data from fitness
trackers collected by the UK company Biobank.
They looked at the records of 25K people who did not regularly exercise,
with an average age of 60 years old.
They followed them over the course of almost seven years. Those who engaged in one or two-minute burst
of exercise three times a day like speed-walking or rapidly climbing stairs
showed a nearly 50% reduction in cardiovascular mortality risk and about a 40%
reduction in the risk of dying from cancer as well as all causes of
mortality. This shows that it’s not
necessary to do vigorous workouts—every little bit of exercise helps.