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How Prepared Is California For The Booming Senior Population?

 May 22, 2019 at 11:15 AM PDT

Speaker 1: 00:01 Hi, I'm jade Hindman, midday addition returns Thursday at noon, coming up next a k PBS special California Dream Town Hall on navigating the Golden Years. One in five seniors lives in poverty and many suffer in silence. KPBS investigative reporter Amit, the Sharma is joined by local experts to answer questions about affordable housing, caregiving and more gray in California airs. Next, right here on KPBS Speaker 2: 00:32 [inaudible]. Speaker 3: 00:42 Hello. Welcome to our KPBS news special grain California. I'm Amit Sharma. California is headed for a demographic shift that could irrevocably alter its trajectory for decades to come. It senior population is set to double over the next 25 years and the state's high cost of living means a life of poverty for many seniors. Over the next hour I along with KPBS midday addition Cohoes Jade Heinemann, we'll chat with our experts and our in studio audience about the issues confronting California when it comes to its aging population and we'll discuss some opportunities. Our experts are Betsy butler, chair of the California Commission on Aging. Kevin principle, executive director of justice and aging. Paul [inaudible], president and CEO of serving seniors in San Diego and USC. Gerontology. Professor, Donna Benton, I want to start this off with some numbers. California is expected to have 9 million seniors by 2030. That will bring older adults, um, to about 20% of the population. Betsy Butler as head of California, the California Commission on Aging. Um, how big of an impact is the sheer size of this growing senior population having on the state right now? Speaker 4: 02:06 Well, of course we have the same situation happening across the country. Everyone probably knows that we have 10,000 people a day turning 65 in this country for nearly two decades. And in California that means about 34,000 people a month are turning 65. And as you mentioned, um, we do have five and a half million now who are older and we're going to go to 10 million and in the next 20 years and have that unfortunately, 1.1 out of five, um, elders are living in poverty and um, also, unfortunately, women and people of color suffer, um, to even greater levels of poverty. Uh, and so these are big issues that are changing the makeup of California. You know, we have such a diverse population who is aging and who's aging and becoming more poor. Um, and a lot of these people have had great middle class jobs, most of their lives and all of a sudden they've had one healthcare crisis or rent went up. Um, if you're trying to survive on an annual social security payment of $1,200 a month, it's tough. It's tough in a state like California and, um, it's something that the state of California really needs to address because of the large population. Speaker 3: 03:14 So Kevin Prendeville as had a justice in aging, your fight is against senior poverty. How well prepared is the state to handle this elderly population? Boom. Yeah. Speaker 5: 03:27 Yeah. Well, unfortunately the state is not well prepared at all, even in the way that it cares for and, and, and, um, takes care of the seniors that are already existing and living in our states. Um, as Betsy talked about, we have the highest rate of senior poverty in the country and over the last 10 years, instead of investing in programs that could really help support those seniors, we've been cutting those programs during the last recession. We took tremendous amounts of money out of the programs that support the most vulnerable seniors. And since then we've failed to restore those cuts and we haven't made any new investments. And that's just caring for our seniors today. That's not even starting to prepare for this massive demographic shift that you've talked about and meet the, so we haven't taken the necessary steps to really think ahead and plan for how collectively we're all going to care for the parents, grandparents, aunts, uncles, partners, spouses, uh, neighbors and our communities. You know, how are we going to come together to collectively provide for each other? Um, and we've got a tremendous opportunity now we have a governor who has committed to creating a new master plan on aging for the state. So we have an opportunity now, but we have to be honest with ourselves that we haven't done what we needed to do yet. So we need to need to start acting now. Speaker 3: 04:41 Donna Benton, you're a gerontologist and a trained psychologist. What social services could seniors really use? Right now in the state? Speaker 6: 04:51 Uh, you know, when you think about what the available, but with the cuts, um, we really don't have enough senior services that help for housing. Um, because people are living longer, they actually are working longer. And so we need to really look off at workforce development. We also, um, the people for those that are aging with any kind of disability, particularly when we look at problems with dementia, um, what's going to happen for people who don't have families? So do we have people to help as far as paid caregivers, but also we need to support family members who are also unpaid caregivers and we don't have that kind of support as far as social services that are out there. Um, transportation is still consistently the number one thing everyone talks about is needing transportation and meals. And I'm sure that that's what Paul will talk about too. But those are kind of areas that we still don't have. And then a new emerging problem is around the area of social for our seniors. As that population grows and people are staying in their home, they may get isolated. And so how are we going to deal to help people with feeling isolated, lonely, and then we really don't want people to, to become too Speaker 3: 06:12 press. So we have to talk about that a little bit later in the show. Paul Downey, as head of serving seniors here in San Diego, you're in the trenches. Um, what's the biggest need that seniors have in California in this moment? Speaker 7: 06:26 Well, the biggest need is really the lack of affordable housing. That's, that's the key because you can have all of the great services, but if you're worried about where you're going to sleep tonight or if you're sleeping behind a dumpster tonight, or if you're in a house that you own, that you can no longer afford the property taxes and the insurance and the upkeep and you're worried and you're spending 85, 90% of your income on rent, particularly for a substandard housing, uh, none of the other things matter. You're not worried, am I eating properly? Am I socializing mic and my primary care physician? Am I getting oral health care? You're not worried about any of that. You're just worried about surviving tonight. And unfortunately that is, that is the issue in San Diego. And we'll take 11 years to get a section eight voucher. Um, other affordable housing. You can look at six, seven years to get into a facility, a where you have affordable rent. And so it just isn't sustainable and we need to do something about it. And we need to start yesterday. Speaker 3: 07:26 So that transitions me into our next topic. Um, but first I want to listen to a clip. Watch a clip from Carl Russell. He's a homeless man who lives in San Diego. Let's listen. Speaker 6: 07:39 Or why is housing so bad? Speaker 8: 07:41 It's a lot of homeless people out here for real and it's serious and the old like me and I don't see, I don't see any help coming. Speaker 3: 07:53 Betsy Governor Nixon says that he wants to build, uh, many affordable housing units over the next decade. Um, but there is some seniors who said recently at a sit in, in Sacramento that, look, we'll be dead by the time those homes get built. And what can seniors do right now to improve their chances of getting into affordable housing? Speaker 4: 08:14 Yeah, you're right. The governor's has pinpointed that over the next six years we need 3.5 million new, uh, affordable housing units. So, because a lot of, uh, we have such a large older population in California, it stands to reason that a lot of those units would go to older people. Um, I think we have to be really creative about this. Um, there've been a number of bills in Sacramento that have not been successful and you can debate whether they should be or not, but certain cities like Santa Monica and I'm from Los Angeles, but Santa Monica, which is a very, um, economically diverse city, people might think it's really wealthy but it's, it's not, um, they're doing a subsidy program and the city is picking up that there. It's a pilot right now. Um, the city is picking up those subsidies so that people can live in Santa Monica. Speaker 4: 09:00 There is a ballot initiative that's coming up. I believe it's going on the ballot next year. Um, but I think we're gonna have to be very creative. I know that we're doing a lot of intergenerational housing now. I'm also very successful. I th I think that is a great opportunity for young people and, and those with more wisdom to spend time together. And I know that certain communities are also making very big investments in this. So like the Los Angeles LGBT center, um, has just taken over a huge block in Los Angeles. No small feat. And that is all intergenerational housing. There is an, there is an elder section is just for older people, but there's also intergenerational. So I think everyone's gonna you know, you can't wait for the government. The state government did this and Gavin Newsome is also been stricter on cities about making sure they meet their how to affordable housing needs. So you probably read, he's threatening suing some of them if they don't come to the table to do that. So, but the, the need is so awesome and so great that it's really going to take everyone to come to the table to figure out how to address the problem. Speaker 3: 09:59 Paula, you mentioned how long it takes to get into affordable housing for seniors especially. Um, what do you tell people who are on this waiting list who you said are likely not going to get in? Speaker 7: 10:09 Well, what we tell them is we were going to do everything we can to try to find them a place. But I mean, we operate a couple of housing complexes and the reality isn't, you know, I have 150 unit complex in city heights and I have over 300 people on the waiting list. The reality is 80% will never get in. And so what we did, we do, we do the best we can. I mean it's, it's trying to find places to live, but in a, in San Diego, medium price for a studio is $1,500. One bedroom is 17, 2000 for a two bedroom. And our median income at serving seniors for our clients is $935 a month. So you do the arithmetic, you have to try to find places. Uh, and I say we, we need to do in all of the above strategy, we need to build as many units as we can. We need to look at shared housing, we need to encourage building granny flats. Um, and for some folks here may not like this, but I think we need to look at the air B and bs of the world that take permanent housing stock out of the community and make it harder for everybody to find an affordable place to live. And that's particularly in a place like San Diego, we have thousands of units that could be used for permanent housing that are taken off the market. Speaker 3: 11:22 And we have a question from our studio audience on this topic. Jade, thanks and meet that. Our first question comes from Isabelle k from San Diego. Isabelle. Yes. I was wondering whether there are programs that facilitate seniors in finding independent living in a private communal situation sometimes called intentional cohousing. Speaker 7: 11:44 Well, I'm not aware of sort of specifically that type of thing. However, here in San Diego, elder help if some organization that has a shared housing model where somebody who may own their home, uh, would have a younger person may get reduced rent or even free rent in return for doing chores like mowing the lawn and that sort of thing. I can say though that the movement and we build affordable housing and one of the trends that we are seeing and we are doing is intentionally trying to make sure we have intergenerational housing. We have two complexes that are in the works right now and both involve mixing of families, kids and older adults together as opposed to just sort of warehousing seniors over here, kids over here and that sort of thing. I think you need that intergenerational because it's real life. People need to have that real life interaction and both can support each other in a lot of ways that organizations can't. And so we need to, we need to do everything we can do encourage that. Speaker 3: 12:49 Uh, Kevin, so as Betsy mentioned, the city of Santa Monica tried subsidizing the rant of a group of seniors last year and it looks like this might take off statewide. How, how do you perceive the public as, um, as, as perceiving this issue? Do you think that they would like doing that? Speaker 5: 13:10 Well, I think there's a lot of complicated, uh, perceptions in politics and cultural issues around, um, uh, issues of aging. And, uh, and, uh, pretty explicit ageism that we have and a lot of our communities in our politics, in our culture. Um, there's also a lot of ageism that comes out in the housing debates that oftentimes older adults are framed as the ones that are holding onto housing in California and keeping younger generations from being able to get a foothold. But that doesn't actually reflect the real reality. That kind of economic inequality that's happening across our state is also happening for older adults. So in fact, in many communities it's the older adults that are being displaced by rising housing prices. So it's the older adults who have been living in rental apartments, um, and now as those rents go up, they can't maintain those apartments because their incomes are fixed. Speaker 5: 13:59 So they're the ones that are having to move at the end of their life getting displaced out of neighborhoods. So what Santa Monica is doing is, you know, targeted subsidies to help people that have been longterm residents in Santa Monica stay. And I think that there would be a support for for that in a lot of communities is helping longterm residents who are renters who are low income and who are older adults stay in their communities. That's what we want for a lot of our communities as people not to have to move simply because rents have gone up so high. And I think being able to talk about these issues as really directly impacting older adults in unique ways, but not issues that are unique to older adults. There issues that we're all struggling with. You know, an increased sense of vulnerability as our economics have gotten so split as so many are struggling so much even while a few do so well, how do we better balance, um, and keep our communities connected? Speaker 3: 14:50 And this is going to seem like Speaker 5: 14:51 an obvious answer, but, but what's the benefit of, of subsidizing the rent of seniors who can't afford to pay on their own? Yeah. We keep those older adults in our families and communities, right? We keep them nearby so that we can care for them and so that they can continue to care for us. You know, keeping families together is a value that we share as Californians in Americans. Not always reflected in our federal policies right now, but I'm in California. Certainly, you know, the governor's talked about wanting to strengthen families, poor families out of poverty. And that includes the older adult, older adult is a critical apart of, of our families, both as caregivers and as people that need our care and support as well. Speaker 3: 15:30 And Donna, um, you know, it's hard enough for young, healthy people to find and keep an affordable place to live in the state of California. Um, what's the psychological toll on a senior who, who may not know whether they're going to be able to keep a roof over their head. Speaker 6: 15:46 Yeah, I mean if you think about anytime we have to move, do you know how hard that is? But imagine if you've been there for about 25, 30 years, you know, where you know how to get to the store, you know how to, you know where your entertainment is, you know, your neighbors. We'd always think we don't. But generally, even if you see them a little bit, you probably know them. And so psychologically when you tried it, when you take someone out of that environment, you really put them on a path of, um, usually depression and that you said we're going to get back to that. But people become anxious and depressed. They may actually pull away from family because you're taking them away from the familiar people that they know. So they may pull away from family and become like, well, I don't have any control. Why should I bother? I, you know, why should I go on? Because every I'd, nothing is under my control. So people start beginning to feel helpless instead of empowered. Um, so as we get older, we actually feel like you should have more control over yourself. But yet here you are and things are kind of out of your control when things like that happen. Speaker 3: 16:54 And we are already seeing a lot of that in California. What do you come across? Speaker 6: 16:58 I mean, when, you know, when I've talked to seniors that have, I get, when I've gotten these calls, I'm, they're saying, you know, I don't think anybody really understands what I've contributed in the past. They just see me as this. Like I just popped in as this 80 year old person and they don't know, I can't take my pet with me. And that's been, that's somebody, that's the only animals that I know. I have to leave and try to figure out my doctors. I have to change doctors. That's very important in my health get spiraled out. So those are the kinds of stories that I hear from time to time. Speaker 3: 17:32 And the fact of the matter is, is that many seniors really are leading unstable Speaker 6: 17:38 financial lives. Let's listen to a clip from K in Santa Monica. I didn't have money to eat after paying my monthly bills. I just need, Speaker 4: 17:50 there's, there's literally Speaker 3: 17:52 nothing for nothing. So that's a, you mentioned earlier that one in five seniors in the state of California are struggling with poverty. Um, but there are many, many more, right? Who are grappling with it and they're making this very traces that k refers to in what we just heard. And this is happening in the richest state in the richest country. How, why, and, and what's the solution? Speaker 4: 18:21 Well, and you know, there's a, there's a lot of solutions that, um, or a lot of aspects, so multiple solutions. But first of all, of course women, um, who are gonna, sorry, gentlemen are going to outlive men for the most part. Um, we have not been paid, but we were worth, we took time off to take care of children or older family members, not represented in our social security and our pensions. We, um, also are basically suffering with just our lifelong, um, levels of discrimination that we've experienced. So women are at a worst stage anyway, um, than men. Um, for the most part. Um, and 40% of women are likely to become impoverished, um, older women. So we have to really make sure we're supporting our older population. And it starts at all levels, right? So it starts at the, at the governor's level, but it's every city council. Speaker 4: 19:15 I mean, I think Santa Monica is being very proactive in doing this. They see the need. They are a fairly wealthy city. Um, they have, uh, uh, a good tax base too. Um, but we have to be cognizant of the fact that there are a lot of people who are really hurting who are one healthcare crisis away from being on the street. Um, we're talking about very dire situations and it's, it's only gonna get worse. It's not going to get better. Um, and I think culturally we might be changing too. Um, just as we have a lot of millennials living at home now, I think a lot of older people will be staying. You can have three and four generations in a home fairly soon, which isn't a bad thing. That's a cultural shift for Americans, but it's how the rest of the world actually lives. Speaker 4: 19:57 Um, so, and it goes to the, the housing situation too. I mean there's, there's, there's a, there's a very limited amount of housing that's available. Um, and so we're going to have to, you know, if, if you can't, the, the young woman, the woman who was just, um, on the, on the piece, you know, a lot of people are so pressured by their housing costs that they don't have money for food and medicine. It's frequently one or the other. Um, and that's if they have enough money for housing. So if you're talking about people in the state of California who generally are spending 70% of their, of their written monthly resources on housing, there's just not a, not let a lot, not a lot left for everything else. So yeah, a lot of times, and that goes into the depression and isolation part. You know, these are people again, who've worked their lives, um, worked very hard their whole lives. They're very proud. They don't want to admit that they need help. Um, if there's been any financial abuse at all, either from a loved one or from someone they trusted, they certainly don't want to talk about that. They're, they're very private about that. So there's lots of things that contribute to the economic insecurity of aging Americans. But aging California. Speaker 3: 21:02 See, I do want to continue talking about senior poverty, but I wanted to very quickly throw the question to you, Donna. Um, so many of our panelists have talked about the benefits are actually the fact that we might be moving towards intergenerational living. What is the benefit of doing that? Speaker 6: 21:18 Well, I mean, part of that keeps you, um, psychologically healthy and challenged. So there's, okay, so I know it's like, Whoa, how does that happen? Well, one thing is you learn from different generations. We always learn. And so like, um, when I was living with my mom was alive and we were living together, if we'll actually, she actually taught me more about the internet than I knew, but I at least sometimes I was able to introduce some new things to her. I was able to learn from her, her favorite music and then she could learn from me some of my favorite songs. And then when my daughter came along, she learned from her, she kept her energy up. And you know, sometimes just being around different energy levels, having different age groups. I mean having a friend your own age is comforting. You know, you can talk about some things and you don't have to explain, but sometimes we want to stretch ourselves and we want to learn new things. Speaker 6: 22:11 Everybody wants to give one to learn a new thing every day. You do that with intergenerational. So I see that as a really big positive. And of course the younger generation is certainly learning from the older generation. And when they go to school they can actually say, hey, we're learning about missions. Have you ever been to one or you didn't use live when horses were around? You know, they don't know the ages really, but you, you, they're going to keep learning from each other. So I would say that you keep mentally healthy and then if somebody is having any kind of memory problems, you have a built in support system and you can begin to um, help even in the early stages and late stages you can stay with that family can stay together and really support each other by having intergenerational. And when I use the word family, I don't mean you have to be a blood rev relative. It can be a neighbor, it can be a cousin. But that's what I'm talking about. Family and community. Speaker 3: 23:05 And that is in fact how people lived several generations ago. Correct? Speaker 6: 23:09 Yeah, absolutely. I mean that was the, it's, it's more than norm and families, believe it or not, despite the myth, 80 to 90% of care is done by family and friends informally. That's just, nobody is really sending one out. Anyone out on ice floats in ignoring anyone. But um, living together has shifted. People have wanted to be kind of by themselves, but then we have more loneliness, we have more depression. And so now there are benefits of being together. One of the things that could be a problem, and I know Kevin will probably speak to this and you've mentioned it, is that we do have to make sure that we don't put people at risk for any type of financial exploitation or other types of abuse. So, um, there, there does need to be some protections in place even because it's usually not a stranger who commits any type of elder abuse. And I know that's surprising, but it happens within. So that's one of our downsides is we do have to make sure there are protections in place across the board. Speaker 3: 24:16 Kevin, on the Ucla elder index for furs to impoverished seniors as the hidden poor. Does the fact that so many seniors just make do without complaining make this an easy problem to ignore? Speaker 6: 24:32 Okay. Speaker 5: 24:32 Yeah. Perhaps. I mean, um, you know, I, that Ucla study really does a nice job of highlighting that there's a huge group of seniors that fall into that definition of what we consider poor and therefore can qualify for help from different programs. But then there's a huge group that are just above that level, um, so aren't quite poor enough to qualify for help, but don't also have enough to meet their basic needs. Um, and so in that way, they're, they're sort of hidden from the government structures and supports. But I, I think it is time for us to stop ignoring, um, this growing need and our aging population because of ageism in our, in our culture, it is easy to ignore older folks. It's also hard for people to identify as older folks, we have this ingrained ages and where people don't want to say, Hey, I'm older. Speaker 5: 25:20 Um, so it, it, it changes the political dynamics. People don't quite identify as someone who's older. They, they tried to identify as someone who's younger. And that makes it easier for our governments, whether local or statewide to not be responsive to this big growing and collective need. So it is time that we, uh, work through our internal ageism sort of claim. Um, identity as all of us are growing older. And I say I meet a lot of people. Um, everybody I meet, I'm done. Very few of them say they want to grow older, but they all are growing older, right? Um, we're all growing older, so we have to confront that, claim that, and then think critically about how we serve this group. Um, and, and not let it be this hidden problem. Speaker 6: 26:01 So we have all the discounts we can as we get older movies, meals, just think of it like that. Go for it. Speaker 3: 26:10 So we have another question from our audience on this topic. Jade. Speaker 6: 26:15 Amit, thanks. Our next question comes from Sheva Roth from San Diego. Thanks. My question is what organizations can answer questions and give resources to seniors who are struggling financially anyway. Yeah, so, so Speaker 5: 26:29 fortunately if you are looking for help for yourself or for a family member, there is a network of organizations across the state that can, uh, provide resources in a wide variety. Um, our state, we have triple A's area agencies, aging and in each county, um, there's a system of supports and structures and then lots of organizations like the one that Paul runs here in San Diego that work in collaboration together to provide services, but it is going to be different everywhere. The entry points are often a little bit hidden or difficult to navigate. Um, but they are there if you've, if you can find them. Um, and so there's lots of great resources online. Um, but we do need to do a better job as a state of making really clear what's out there, making it really easy to enter those systems. And then we also need to bolster those, those systems so that they can meet this current need as well as the growing need. Speaker 4: 27:23 Can I just comment on that really quick? Yes. So we had a hearing and I was at January, February, uh, what the hell with the Senate Health Services Committee, and everyone said there's just too many silos. We need to have a place where someone can go to get answers. And so it's on our leaders, uh, radar. We'll just see how quickly it's it's you can break down the silos to be able to get all the answers at some of them might need on whatever condition they might. Yeah. Speaker 7: 27:48 Yeah, and I'd agree. I think that there's a no wrong door approach we, but we need a broader system, but I think we also need to work on educating our elected officials. I mean, we're seeing some progress here in California, but I would say in Washington less so that there's the human cost. I think we can all agree that from a human standpoint it's the right thing to do, but it's also the right thing economically to do. The cost of a homeless individual on the streets here in San Diego or anywhere in California is enormous. When you take into account police, fire, paramedic, er, longterm care, I mean we're spending a lot of money taking care of people the wrong way as opposed to investing in a system that takes care of people the right way by investing on the front end, whether it's affordable housing, whether it's nutritious meals where has access to a social worker or a nurse or a dentist. Speaker 7: 28:43 Those are all things that we can, we should be investing in rather than the the consequences of not doing nothing. And I think that as we lay it out, there's an economic argument to be made that in addition to doing the right thing, it makes sense to invest and take care of it. However, there is an imperative. We all know the demographics. You talked about it in your opening that if we can sit around and do nothing or what's going to end up happening, if we do nothing, we're going to see this explosion of people who won't have access to services. Expenses will continue to go up. We need to make the investment now. We need elected officials to make this a priority rather than worrying about the next Twitter cycle. Yeah. Speaker 4: 29:28 Can I, can I make a comment and it goes to caregiving. So my father passed away of Alzheimer's and when he was diagnosed, my mother, he's, my brother's two years older, so he was diagnosed when my, when my dad was 67, um, and my mother had to just figure all this out on our own, you know, and so through the stages of his disease and my father had the disease for 17 years, so it was quite a long process. But how she found out about adult day health care, which I still say saved her life without my mother being able to drop my father off for adult day healthcare, five to six hours a day, my mother wouldn't be alive because of the tool that, that caregiving takes on those who are giving it. So, you know, there's all kinds of reasons why we need to make it as easy as possible, especially since this population is getting so large and the caregivers who are taking care of them is only going to expand as well. Speaker 3: 30:18 So Kevin, I, um, you know, both our panelists outline to this issue of practicality versus whether you know, you should care and if, whether you should care. It isn't an argument that swears sways you. Then what about the issue of practicality? How, how widespread is the understanding that it's, it's cheaper to actually care and do the right thing? Yeah, Speaker 5: 30:39 yeah. I don't think it is widespread. I mean our, our, our governments aren't, um, well equipped to handle what actually is pretty simple but seems very complex. This idea that by investing and supporting people, we can actually improve our economy. And a good example is that, um, there's a program called supplemental security insurance and that's a federal program that provides a basic level of benefit to the most low income seniors and people with disabilities. People that are no longer able to work to support themselves. Um, that program, uh, you know, is, is sorely underfunded. And any new dollar that you give a senior who's already living below the poverty line is going to go right back into our economy. They're not taking that dollar and saving it for a rainy day. That rainy day is right here for them. So they're spending that money in local stores, in local businesses. The money's going right back into the economy. So, you know, any new investments we make here are going to go right back into the economy. Whether it's giving more support directly to seniors or spending smarter, I'm on housing instead of emergency rooms. You know, there's, there's tremendous, um, positive economic impact of providing care the right way. Let's see if I can try. Speaker 7: 31:52 Okay. Cause when you, when you look at things like you mentioned UCLA elder index, so elder index for state of California, just over think $24,000 a year in federal poverty level is $12,000 a year. So think Kevin had alluded to it earlier. There's this whole group of people cohort who don't have access to services, but trying to get the elder index, which is a much better measurement of poverty to be used as the measurement is almost impossible because you talked to Republicans and Democrats, they'll say if we use that, the costs of providing services to people who are economically insecure is more than we can afford. And so there is a bit of a burying our head in the sand and let's just continue using the federal poverty level as the measurement rather than at least acknowledging a better measurement and striving to to meet it. But right now there isn't that will, I mean hopefully the master plan will address that, but we need to get a will that we need to actually open our eyes and see what is actually happening rather than, you know, pretending patting ourselves on the back that we're taking care of people below FPL. Speaker 3: 32:58 So that's a very crucial point. There is a another factor that's contributing to a senior poverty. Let's listen to a clip from Roseanne Goodwin of San Diego. Speaker 6: 33:10 The big problem is people at bed 55 who can't get jobs because they're considered too old. Speaker 3: 33:21 So Paul and I have spoken to so many seniors who say, look, I want to offset my expenses but it can't find a job because of ages. And how, how do you change that mindset among employers? Speaker 7: 33:35 Well, I mean actually, I mean it's been alluded to, but I think we need a me too movement for ageism. I mean, I, I'm, I'm serious because ageism is okay. It's accepted. I mean, none of us would agree, but, but in the broader community, ageism is, is perfectly accepted. I'm an NF. You want, I can prove my case, go to the local hallmark store looking at a birthday card for anybody over 40 and I guarantee there will be some, you know, why's comment about, about aging? Look at TV. I mean, older adults are portrayed, is crotchety, hard of hearing, cantankerous. They're not usually portrayed as being intelligent, participating members of, of the family. So we have to get past that. Um, we have to get people the skills they need in order to find a job. I mean, I talked to everyday to people who said, you know, the last time I looked for a job, I bought a newspaper, but look pulled out the one ads I circled, you know, the jobs and I went in person and applied and now I've got to do it online. Speaker 7: 34:38 I've got to upload this and do that and don't have the skills to even look. And even if they get an interview as they sit across the table from a millennial, they kind of say, you know, there, there's not a chance in the world they're going to hire me. So Hey, we need to bust through ageism. First and foremost. We need to get the skills for people to be able to actually be able to go and compete successfully for a job, whether it's a minimum wage job or a permanent full time job. Um, I think we need to bust through the idea that 65 is retirement age, uh, that an older adult, if he or she wants to work till 70, 75 or 90, that's perfectly fine. And that we don't need to put you out to pasture and give you a gold watch when, when you hit 65. Yeah. Speaker 3: 35:23 I remember reading a quote recently by a woman who said that, you know, when she goes to look for a job, she hands over her resume and she gets the sense that the person over the counter isn't looking at the resumes, just looking at them and has pretty much ended the conversation. So John, there are cultures around the world who revere seniors for their wisdom. Um, they feel like they're viable still, that they have a contribution to make. How do seniors fair in those environments? Uh, emotionally and physically, Speaker 6: 35:53 you know, when they look at what they call the blue zones, part of that, um, is that the older adults are integrated in, in, and they live longer. And that's because they find that they are able to have the intergenerational, they are looked to for advice about anything. And they're also seen as like mediators. They act, they are seen as people that, you know, like, okay, you've gone through this experience. Why should I have to do this again? Can you give me advice? So keeping an older adult engaged in all of those things Illinoisans their life and it makes the community healthier. Um, I think that that's what we can learn across cultures and within each culture. Um, you know, say within the African American culture or the Latino culture, you still have that, um, reverence for the older population and um, knowing that they have different skills and as we get older, it might be, you know, when we talk about jobs that we may have to have more than one career in our lives. I have multiple careers. Speaker 3: 36:58 Thank you. And I understand that there's another question out there, Jay. This one is from Speaker 6: 37:02 Denise Chamberlain and she's from San Diego. She asks what services are available for seniors who want to have another career that will sustain them for many years? Donna, you want to take that on? Um, the area agencies on aging actually have workforce development within each of their agencies. So that might be one approach is to go to the area agency on Aging, talk to the workforce development so that you can look at another career. Certainly within the junior colleges and other colleges, you can go back, get certificates, get retrained, and also have an opportunity for another career. And as you're working right now, it's good to think, what do I want to do that might be completely different than what you have now. You know, some people, you, you see the, you know, like we work for a while too for money, but then what do we do for our soul and our spirit? And so maybe you look to doing something, it's not going to pay as well maybe, but that's a different time of your life where you want to enrich your soul and spirit. That could be another way of going. Speaker 3: 38:07 Okay. I want to switch gears right now, Betsy. Um, there is a shortage of geriatricians and nurses, um, in this state to, to manage, um, healthcare, uh, in California. Um, what's the solution here? What can the state do to help that? Speaker 6: 38:28 Actually the California Commission on aging looked at the possibility of adding a budget item to our state budget a few years ago to make sure that, Speaker 4: 38:36 um, gerontology and older, um, older American issues are included in general education at RC CEO's shoes and our community colleges. Right now you can get a, a social, a degree in social work and there's no talk of, um, older people or even intergenerational, um, relationships. And so, you know, you're a millennial or even slightly older and you have children and you're taking care of your mother. This is not part of the curriculum for social workers right now. So, um, I think that we need, I mean it's, it's employment, um, opportunities Galore, right? If you're going into work for, for our older California ans, and so we need to promulgate that as much as possible and, and introduce it to youngsters. I've actually been to a couple, um, courses at Ucla. They require internships at, um, all kinds of different places where there are older, um, uh, Californians. Speaker 4: 39:32 And so they, they get to work with them and understand them and help them and be supportive. So there are programs like that that are very successful in California. We really need to make sure that we continue to fund them. But the need is really great to get. I, I believe the number is one geriatrician for 2,500 right now. Um, and it gets really bad really quickly in the next decade because they don't believe that a lot of geriatricians are, are going into that line of work. And then also, um, geriatricians who are needed for psychological issues in psychiatry. Those numbers are really, really bad. It's like right now it's like one, um, psychologists to 11,000, um, older Americans, which, so if you're talking about isolation or you're talking about, you know, you've been fraudulent, Lee, I'm harmed or you think you've been fraudulently harmed, you want to believe your neighbor or your niece that they're not harming you. But who do you go to and who do you talk to them? They don't exist. And so how are we going to encourage people to go into those fields? And again, it's employment security Galore. So, yeah, we need to make sure that, that we are making it as easy as possible for people to understand these, these careers exist. And then also how to get into them. Speaker 3: 40:41 Kevin, so many seniors can't afford health care. They can't afford their prescription expenses, um, to say nothing of the high cost of in home caregiving. Is this solvable? Speaker 5: 40:53 Yeah, absolutely. But it starts with understanding the situation. So a lot of people assume that older adults, their healthcare is covered. Once you qualify for Medicare, that's it. You're on the, on the freeway to a wonderful healthcare coverage and Medicare is a wonderful program. But once you get on Medicare, you realize that comes with lots of extra costs. There are copayments, premiums, deductibles, and then gaps in coverage as well. Um, there's no long term care benefit, um, and Medicare and certainly not a benefit that really is designed to support you to stay at home and in the community for low income older adults, we do have a strong medical program or Medicaid, you know, but in California, the medical program, but that program hasn't been in terms of who can qualify so that we're not capturing, um, everybody who needs extra help paying for these costs. Speaker 5: 41:40 So there's proposals in the capitol right now that would make it easier for older adults to qualify for MediCalc get that extra assistance to help them cover those medicare costs. And then also to cover long term care costs. But the big issue on the longterm care, especially getting services at home, is that there is no program, there's no program outside of medical to help people pay for, for costs of care at home. And we know that something like 70% of all people that are 65 today are going to have a longterm care need. Um, and that long term care need could cost them tens of thousands of dollars a month. And so there's a very small group of people that could afford that on their own and then no public program to do it. So again, there's ideas already percolating in Sacramento to design a statewide system that would be a way that all of us could contribute to and then receive the benefits of a longterm care system. Speaker 5: 42:32 So that's a place where yes, the solutions are out there. Washington state just implement, just passed a new program. We know what to do. We just need the political will to do it. Sipping it back to the present. What's the results of not having a longterm care program right now? Yeah. Right now it means that people have to completely impoverished themselves to pay for their longterm care costs. And that has intergenerational impacts as well. Um, you know, if you save up all this money to support yourself as you grow older with maybe the hope too that you could pass some of that onto your, your kids, your grandkids, so they can be, you know, get it, get a step up as they move along, and then you have to deplete all of that money. All of those savings in the final years of your life. Um, you know, it's not good for our economy. It's not good for our families. That's not good for the people that have to do that, to have to watch all anything you save, just wash away and then now be completely exposed and vulnerable and reliant upon the state programs, which, thank God they're there. But we need a system that's stronger than that. Oh, go ahead. Speaker 7: 43:31 And we, we, we see that every single day. So it's serving seniors. People come in who are homeless, who have been on the street, and when you ask them why it's longterm care, I mean, it usually it's a spouse gets sick. These are people that have done everything right. They've saved their money, have life savings, maybe have a small pension, um, and it prepared. And then somebody gets sick and it wipes them out. And they ended up showing up homeless or on the verge of homelessness, uh, because they simply have spent hundreds of thousands of dollars in some cases to take care of that person. And we don't have that, that ability to help them. Or we have people show up who say that they're just a little bit above medical and we have to tell them, spend down, you know, spend some money so you get poor enough to qualify for longterm care. And that is crazy that we, that's what we have to do. I mean we need a better system and the system is broken and we know we have a whole lot more people. I mean we there that sense of urgency needs to be there to do something and we need to do it now. Speaker 6: 44:38 Okay. My segway, cause we're talking about longterm care. It's talking to all of us. This isn't somebody we don't know. [inaudible] this is us. And so we have to think about what would we want for our lives in 20, 30 years. Speaker 3: 44:55 It's a very important point. Thank you. Okay, so I'm just going to segue into our next point. Um, so, so seniors, as they get older, they lose spouses, they lose other loved ones, friends are passing away. Um, it's a little bit more difficult to move around and that can all contribute to loneliness. As Eleanor stone at San Diego explains, Speaker 6: 45:19 I'm all alone. I don't have anybody. Speaker 3: 45:24 So Donna seniors can go days if not weeks without seeing another soul. How, how damaging is that kind of social isolation? Speaker 6: 45:35 Um, sometimes people say that being alone like that can be added and this is not, I don't want to say that it's accurate, but it's a good demonstration. It's like smoking a pack of cigarettes a day. That it really is, it has a physical damage on your health. But I mean, just imagine if you didn't talk, maybe there might be one day when you don't want to talk to anybody, but imagine going four or five days with not even having the option of talking to another soul. How would you feel? You know, you're, you have no one to think with, laugh with nobody to, to really just kind of just say, oh, I'm bored today and you don't even have the option of getting out. So I think we can all think about times when we felt lonely or alone. And Not by choice. And in this case it's the not by choice. Speaker 6: 46:30 And then so what can we have? We can have more programs that allow for natural ways of people getting out in the community, making sure our housing has been adapted so that you don't end up having three stairs on your front to get out your front step and that that's what keeps you from getting outside the house when maybe if we had enough social programs that helped with just building a ramp so somebody could easily get down those three stairs instead of being afraid, having um, more friendly visitors and neighborhood watches that work together that way. So, Speaker 3: 47:04 okay. So you, you just covered what I was going to ask. Sorry. No, no, no. Maybe I'm, any one of you can elaborate. So what can we as a society do to reduce that social isolation? Anyone? Wow. Speaker 7: 47:16 I would say go back to the, you know, the, the good old days of actually knowing your neighbors, saying hello, checking in. If you lived next door to an older person, you know, stop by, say hello, stop in for a cup of coffee. Invite them in, but just check on them, make sure that they're okay and if there are opportunities to invite them to a neighborhood picnic or something, just something to get them that the out because Donna is exactly right. I mean the, the lack of socialization is devastating physically and mentally, uh, takes a toll and it's simple to solve it and that's get them into social situations and uh, and there are ways to do it. Even if there are homebound, you can do it. Their senior centers without walls. There's, there's lots of different things. The local senior center is a, is a good place to go, but you've got to, sometimes people are reluctant, they, you know, getting them to inertia to move and, and, and get involved. But you, you need to nudge, you need to control and, and we just need to look out for each other. We've lost that somewhere along the way of looking out for, for our neighbors. And this is the easiest way to deal with that problem. Speaker 4: 48:28 Can I, I make a point and just an observation that our culture is changing too. So I've never married, I have no children. Most of my friends have never married and have no children, or are they married? Either there's still married or divorce, but they didn't decide to have children. And so, you know, I call my mother every single solitary day and um, at almost 93, she texts me all day long. She, um, she's sending me emojis anyway. Um, but I'm in contact with her every day and, um, when we have neighbors and whatnot, but it's a completely different dynamic. This is the golden girls on high. I mean, we're talking my girlfriends and I talk about how we're all going to take care of one another because we don't, there, there is nothing else. Um, there are no other, there are no children. Um, I have a very small family as it is. So it's, that's, that's really, you know, and I've heard so many millennials talk about the fact that they don't want to get married and have children, so it's not a priority for them. Um, so it's, it's a different, it's a different level of need Speaker 3: 49:26 and, and social isolation is something that that could be addressed. Um, I just want to segue into the next topic. So governor Newson says that he wants to, he's working on a master plan on aging and Betsy, how optimistic are you about that? Speaker 4: 49:45 Well, I, I believe we have to be optimistic. Um, I don't, I don't think there's another route to go, but I mean, this is a new governor. He has a lot of commitments. He's made a lot of commitments. Um, I'm hopeful right now there's about 150 bills moving through the legislature having to do with a cola or a tax credit or a new line item, a new budget item. Those are all expensive things. So the governor is going to have to decide what he wants to put where. And even though the master plan on aging has been talked about, I don't believe we're going to, we're not going to answer all the questions and address all the situations. In what period of time? Certainly not two years or three years or five years. What period of time is that? Um, I'm, we just had a may revise. Speaker 4: 50:29 We didn't see a lot of, um, aging related items added to that, revised on, you know, there's even a lot more now on his plate to figure out whatever legislation gets passed. Of course wouldn't take effect till early next year, which I guess is fine, but I'm waiting to see what his priorities are. Um, he, uh, as many of you know, he lost his father recently and went through these issues. And unless you're a caregiver, unless you've been through it, I have staff members who, I have them do a project for me either for the California Commission on Aging or on the executive director of the California Women's law center. And they're there. They're just absolutely petrified about the status of growing old in California and on this country. And they're all new issues then because they don't have an aging parent or relative or, or a friend. So, um, I'm hopeful that the governor has expired now experienced it. He understands how, how large and great the need is and that we will address it in California. Speaker 3: 51:28 So Kevin, there has been some disappointments, um, some concern expressed in some quarters about the lack of movement or at least public movements on this master plan on Aging. Do you share that perspective? Speaker 5: 51:41 Well, I think you're hearing some of it. And what Betsy is talking about too that I, I agree with Betsy that this is a time to be optimistic about leadership in the state from governor Newsome and, and some key legislatures that are finally willing to say they're going to take this on. But we can't let the plan be an excuse for further, um, delay in taking action on what we know needs to happen today. So as Betsy mentioned, the May revise that governors new version of his proposed budget for next year included no new investments for older adults, even after having been, you know, vocal about an amendment to a master plan on agents. So let's start acting now, let's start planning, but also let's start taking action. And so that's partly on the governor and it's partly on all of us to tell the governor what's important, to not be that hidden voice, but rather to as a community collectively across the state come together and say, we want action, we demand action. We're going to hold our elected officials accountable to taking some action. Um, so, so I continue to be optimistic, but it's a reminder, this may revise that we have a lot of work to do to really demand action now. Speaker 7: 52:43 And Paul, what's the risk of doing nothing? Well, the risk of doing nothing is that we're going to wake up on New Year's Eve in 10, 15 years and say, gosh, where did all of these older folks come from and why didn't we do something about the situation? I mean, there's a, there's a social impact. There is an economic impact. You know, you hear all of the stories to discussions about social security is going to go bankrupt and how we're gonna pay for Medicare and all of these things. So the risk of doing nothing is, is almost catastrophic from a socioeconomic perspective in, in this country. When you look at the numbers, I think it's census is another 1520 years people 65 and older will be the cohort in this country eclipsing 18 and under. So we're going to have all of these older folks and we need to figure out how we're going to take care of them, but we also need to figure out how we're going to take advantage of them because they've got skills and abilities that can be useful to the community. And this notion that at 65 you're going to go sit in the rocking chair and baby play shuffleboard is our as long gone. And so it's not only how do we care, but we need to make sure that people remain engaged in the community. We take advantage of their skills and abilities. As Donna was saying, it may be they want to do something different than what they've done, but let's take that knowledge and wisdom and put it to some good use. Speaker 3: 54:08 And you have taken me directly to my next question, Donna. So what's the benefit of addressing these issues head on, Speaker 6: 54:17 um, as, as, as a nation, as a state. If we don't address these things head on, we are going to have, um, who wants to, who of you wants to be found on the street? Who Love you? Want to see your relative when you go to try to find something to help your relative wanting to be told, sorry, we can't help you. And so if we don't do anything, we, I think California will be that much more. I mean, we just, we won't have a system and it doesn't help across generations. We have to have children, adults, older adults. We all have to work together for a stronger future in California. They really do. Speaker 3: 55:01 Thank you. And we're going to have to end it there. I want to thank our guests, Betsy Butler, Paul Downey, Kevin Prendeville, and Donna Benton and cohost Jade Hindman ans our studio audience. It was an insightful conversation. I hope you all thought so. Um, this has been a California dream collaboration with KPBS Aiman Nathan's Sharma. Speaker 6: 55:24 Okay. Speaker 2: 55:24 [inaudible].

Seniors are the fastest growing population group in California. The state faces numerous challenges in helping seniors deal with issues from financial stress to access to healthcare and housing.