Larimer County Summit on Aging

1. Larimer County Summit on Aging Bonnie Shetler, PhD President Foundation on Aging for Larimer County January 22, 2010 Foundation on Aging for Larimer County

2. Larimer County Summit on Aging 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. January 22, 2010 Foundation on Aging for Larimer County

3. Larimer County Summit on Aging Bonnie Shetler, PhD Presenter/Organization Aging-In-Place Facilitate Process Unmet Needs Collaborate Service Provider Network Office On Aging Provide Leadership Aging-In-Place Foundation On Aging Aging-In-Place Coordinate Unmet Needs Create Awareness January 22, 2010 Foundation On Aging for Larimer County

4. Larimer County Summit on Aging January 22, 2010 Foundation on Aging for Larimer County

5. Larimer County Summit on Aging

6. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University 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 • January 22, 2010 • Foundation On Aging for Larimer County

7. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University • Presenter/Organization Aging as an Out-of-Body Experience • Aging is not about time and the body, but about • place, and relationships • 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 • January 22, 2010 • Foundation On Aging for Larimer County

8. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University “Community is the smallest unit of health.” Wendell Berry,Health is Membership InAnother Turn of the Crank • January 22, 2010 • Foundation On Aging for Larimer County

9. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University Our work should help create good places to grow up and grow old…livable communities for a lifetime • January 22, 2010 • Foundation On Aging for Larimer County

10. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University Aging as an Out-of-Body Experience Data driven and participatory planning for the future What is an elder-friendly community? • January 22, 2010 • Foundation On Aging for Larimer County

11. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University • January 22, 2010 • Foundation On Aging for Larimer County

12. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University The Domain ADDRESSES BASIC NEEDS The Dimension Housing Is Modified To Accommodate Mobility And Safety The Indicator “% of 65+ householders with home mod needs” • January 22, 2010 • Foundation On Aging for Larimer County

13. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University Making our community elder-friendly • Identify the stakeholders • Understand the issues • Frame the problems • Identify potential action steps • Identify the assets in place/needed • Prioritize actions • Support and monitorthe responsible parties • Benchmark and evaluate • January 22, 2010 • Foundation On Aging for Larimer County

14. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University “Improving a community, from beginning to end, involves organizing people. Money is secondary.” • January 22, 2010 • Foundation On Aging for Larimer County

15. Larimer County Summit on Aging • Philip Stafford, PhD • Director, Center on Aging and Community • Indiana University • January 22, 2010 • Foundation On Aging for Larimer County

16. Larimer County Summit on Aging • S.D. Bozinovski/Bozinovski & Associates, Inc. • Presenter/Organization THE GRAYING OF LARIMER COUNTY: IMPLICATIONS AND OPPORTUNITIES FOR THE FUTURE Susanna D. Bozinovski, Ph.D. CEO and President Bozinovski and Associates, Inc. Human Services Consulting 12412 King Street Broomfield CO 80020 susanna@bozinovskiassociates.com (303) 882-6826 • January 22, 2010 • Foundation On Aging for Larimer County

17. Larimer County Summit on Aging • S.D. Bozinovski/Bozinovski & Associates, Inc. • Presenter/Organization GROWTH BY AGE GROUP, 2000-2012 LARIMER COUNTY National Research Center 2004 • January 22, 2010 • Foundation On Aging for Larimer County

18. Larimer County Summit on Aging • S.D. Bozinovski/Bozinovski & Associates, Inc. • Presenter/Organization THE GRAYING OF LARIMER County Percent of Larimer Residents Age 60+ July 2008 Population Estimates, Colorado Demographer’s Office • January 22, 2010 • Foundation On Aging for Larimer County

19. Larimer County Summit on Aging Boomers & Beyond: Housing Trends in the 21st Century Janice Blanchard Aging in Community Network Initiative Denver, CO January 22, 2009 Foundation on Aging for Larimer County

20. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization 1950s & 1960s: Growth of the Suburbs • Economic prosperity • Single family homes • Father, Mother & 3 to 4 kids • Mother stayed at home January 22, 2009 Foundation On Aging for Larimer County

21. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization 1950s & 1960s: Birth of Retirement Communities January 22, 2009 Foundation On Aging for Larimer County

22. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization 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 January 22, 2009 Foundation On Aging for Larimer County

23. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization 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 January 22, 2009 Foundation On Aging for Larimer County

24. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization The 1990s: McMansions and New Urbanism • Greed, excess and wealth • Increasing concern of unchecked growth – Exurbia • Awhannee Principles • Rising inflation January 22, 2009 Foundation On Aging for Larimer County

25. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization 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 January 22, 2009 Foundation On Aging for Larimer County

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

27. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization What’s Next ? Shifting the Paradigm From Aging in Place….. January 22, 2009 Foundation On Aging for Larimer County

28. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization ….To Aging in Community January 22, 2009 Foundation On Aging for Larimer County

29. Larimer County Summit on Aging Blanchard, AICN Initiative Presenter/Organization It takes avillage to raise our children… It takes acommunity to care for our elders. January 22, 2009 Foundation On Aging for Larimer County

30. Larimer County Summit on Aging Aging with Options Diane M. Stobnicke Volunteers of America January 22, 2009 Foundation on Aging for Larimer County

31. Larimer County Summit on Aging Diane M. Stobnicke/Volunteers of America Aging with Options Aging in Place • 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. January 22, 2009 Foundation On Aging for Larimer County

32. Larimer County Summit on Aging Diane M. Stobnicke/Volunteers of America Aging with Options Promising Community Strategies • 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) January 22, 2009 Foundation On Aging for Larimer County

33. Larimer County Summit on Aging Diane M. Stobnicke/Volunteers of America Aging with Options Promising Community Strategies • 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 January 22, 2009 Foundation On Aging for Larimer County

34. Larimer County Summit on Aging Diane M. Stobnicke/Volunteers of America Aging with Options An Elder Friendly Community • 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) January 22, 2009 Foundation On Aging for Larimer County

35. Larimer County Summit on Aging THE MOBILITY CHALLENGE Gary D. Thomas Executive Director SAINT Volunteer Transportation Senior Alternatives In Transportation January 22, 2009 Foundation on Aging for Larimer County

36. Larimer County Summit on Aging Gary Thomas / SAINT Presenter/Organization THE MOBILITY CHALLENGE • 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? January 22, 2009 Foundation On Aging for Larimer County

37. Larimer County Summit on Aging Gary Thomas / SAINT THE MOBILITY CHALLENGE “I will. I will survive” – Scarlett O’Hara • 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 January 22, 2009 Foundation On Aging for Larimer County

38. Larimer County Summit on Aging Health Care Issues for Seniors: Current Problems Prospective Solutions Roger P Bermingham MD Family Practice Residency Poudre Valley Hospital January 22, 2009 Foundation on Aging for Larimer County

39. Larimer County Summit on Aging Roger Birmingham, MD 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 January 22, 2010 Foundation On Aging for Larimer County

40. Larimer County Summit on Aging 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 January 22, 2010 Foundation On Aging for Larimer County

41. Larimer County Summit on Aging Roger Birmingham, MD 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) January 22, 2010 Foundation On Aging for Larimer County

42. Larimer County Summit on Aging Roger Birmingham, MD 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) January 22, 2010 Foundation On Aging for Larimer County

43. Larimer County Summit on Aging Roger Birmingham 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 January 22, 2009 Foundation On Aging for Larimer County

44. Larimer County Summit on Aging Roger Birmingham, MD 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 January 22, 2009 Foundation On Aging for Larimer County

45. Larimer County Summit on Aging Roger Birmingham, MD 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 January 22, 2009 Foundation On Aging for Larimer County

46. Larimer County Summit on Aging Roger Birmingham, MD 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 January 22, 2009 Foundation On Aging for Larimer County

47. Larimer County Summit on Aging Findings from the Larimer County Summit on Aging Kelly Blanchard and Brittany Silvers Hartford Partnership Program for Aging Education Fellows in Gerontological Social Work Colorado State University School of Social Work March 3, 2010 Foundation on Aging for Larimer County

48. Larimer County Summit on Aging Blanchard and Silvers/CSU Presenter/Organization PURPOSE OF BREAKOUT SESSIONS March 3, 2010 Foundation On Aging for Larimer County

49. Larimer County Summit on Aging 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 March 3, 2010 Foundation On Aging for Larimer County

50. Larimer County Summit on Aging Blanchard and Silvers/CSU HEALTH CARE • What are community assets that are being mobilized already to address health care? • Connecting with Services and Resources March 3, 2010 Foundation On Aging for Larimer County