OneRouge Community Check-In - Week 58

Week #58

'Issues Facing Seniors

Meeting Notes Prepared by Zoë Haddad (Walls Project)

Tasha Clark-Amar (Executive Director, Council on Aging)

• Council est. May 13, 1973 (48 years old)

• Created in Congress by the 1965 Older American Act

• Specifies a couple of objectives: afford certain traditional American concepts of inherent dignity for individuals to assist our older people to secure equal opportunity, adequate income at retirement, best possible physical and mental health, afford and maintain suitable housing with reference to special needs available at cost, comprehensive array of community based services, opportunity for employment without discrimination, efficient community servives and social service assistant

• Team EBRCOA has 141 employees, 23 locations, 25 programs many of which are federally funded and state matched, lots of grant funds

• 5 Pillars:

• One: Access to healthy, nutritious meals. Everyone knows we do Meals on Wheels but it’s more than meals - created by nutritionists, Chef Celeste is our chef. As of last year, even during COVID, we provided 1.8 million meals across the parish in 23 locations and to our homebound seniors. We’re charged with reducing hunger for seniors, attacking food insecurity and malnutrition among seniors.

• Two: Breaking of social isolation. According to the National Institute on Aging, social isolation and loneliness pose higher health risks to older folks such as physical and mental conditions, high blood pressure, heart disease, anxiety, depression, cognitive decline, and is a driver for Alzeihmers. We gather our seniors and do activities that promote cognitive strength - we sew, knit, do tai chi and yoga, have Senior Prom, crawfish boils, Bingo

• Three: Access to decent, affordable housing. There’s 86,000+ seniors in EBRP. Of those, 42,000 seniors in this parish live on social security alone, which averages about $1300. Over half of our seniors live at 50% below the poverty line, which means their monthly social security check averages between $5-650 leaving less than $300 a month they can use for housing. A lot of our seniors live in deplorable conditions. We own one apartment complex called Dumas House, a 64 unit apartment. Just started construction on a $22 million project called Lotus Village. It will be the first senior village concept in Louisiana. 116 one bedroom age-in-place units with 56 buildings. Will have the first ever geriatric healthcare facility within the village. Will address everything they need from medical, dental, physical therapy, behavioral therapy, drug addiction therapy, any issue a senior may have, they can go to the clinic. They will have all the amenities they need…a smart home where you come in independent and leave in glory. We are planning a similar property in Baker.

• Four: Access to senior transportation. 600,000 seniors stop driving every year. When you’re stuck in your home, you’re isolated. We started a free bus system with 11 buses called Lotus Drives. Pick seniors up and take them where they need to go. And we take them on activities...the senior playground (the casino with $20 each!) after the museum of course!

• Five: Disaster agency for seniors. Have a seat at the Governor's Office Homeland and Emergency Preparedness. We have a list of high risk seniors on oxygen, coordinate activities relative to their safety in any disaster, get sandbags, help evacuate, etc.

• We have an onsite food pantry, open air market/grocery store/farmers market/deli...Opened the first ever intergenerational center where the youth and seniors come together. We were just awarded with a new program from IBM, Volunteers with Public Schools, and Tara and Capitol High called the CITECH Program where the seniors and youth teach each other. This summer they will meet three times a week and do activities where each young person has a senior mentor.

Priscilla D. Allen PhD, LMSW (Professor in Aging and Geriatrics, LSU)

• Representing the LSU School of Social Work, been a faculty member for 20 years after coming from Connecticut

• Started as a Meals on Wheels coordinator then moved to a nursing home as a designee with 120 residents. Served as a social worker then opened a nursing home before realizing I wanted to do more to advocate for residents rights

• I’m talking about the intersect of ageism and the fatality of COVID deaths in nursing homes

• 0.06% of the population resides in nursing homes. In terms of large data, it’s a very small part of the population. But upwards of 40% of COVID deaths occured in nursing homes

• The data are showing not just the reality that COVID was so deadly for our nursing home residents but that it exposed a problem already there

• Nursing homes are rated on a scale of 1-5 stars - the health departments come in for inspections. No surprise, the most at risk nursing homes had the highest number of people of color, lower staff ratios, higher turnover of staff...social isolation is one of the most predictive features of studies of quality of life, mortality rates

• Ageism was really unearthed because nursing homes already at risk had the highest rates of death. In LA we have 277 nursing homes. LA was not in the top 5 in the nation (broken down by number of deaths per 100,000) but we were something like seventh. There were states with very high reported COVID deaths in nursing homes, some 50%

• There’s a dashboard in LA and reporting rates were very irregular...the data say that the residents who died of COVID died because of staff bringing COVID to the facilities, without PPE and proper hygiene and infection control

• We worked nationwide and when they could show up the calls were ghastly...they were waiting to move people out, there were refrigerated trucks outside the nursing homes...so we must do something continually to provide more advocacy for our nursing home residents, more knowledge of what goes on, and focusing on those with highest risk

Craig Kaberline (Executive Director, Capital Area Agency on Aging)

• Been with the CAAA for the last year, been dealing with aging issues for about 16 years

• Also worked in residential with people with developmental disabilities and dealt with mental health in schools

• We cover Older Americans Act basic programs as well as employment programs across 13 parishes

• COVID brought a lot of challenges across our program

• We have resources and information to hook seniors up with programs around the area

• Health and wellness programs have also been a challenge during the pandemic but it’s key to keep our seniors outdoors, healthy, and socially involved

• Talking about social isolation and transportation, it’s a big part - giving up a vehicle is one of those last pieces of independence

• It plays in to the other big issues of our senior population such as access to food, healthcare, other community resources

Raymond Jetson (MetroMorphosis)

• Please recognize how the things we heard from Tasha, Priscilla, and Craig were interrelated with every other area we’ve talked about. None of these issues exist in isolation, which is why this collaborative effort is so important.

• The other thing I’d like to emphasize is the connection and the deeply entrenched impact of poverty on seniors. We often think of poverty, its consequences and impact on families and children but we must see the impact on seniors.

• One of the special things about this work is that we ultimately find our community. It’s not about the specific issue, but it is people concerned about making this community better.

• Tasha lifted up the notion of intergenerational activities. I would suggest that that is a critical driver in all of our work. Those who are aging in our community do not exist separate and apart from younger folks. There is value in connecting those generations.

• Finally, a critical element of this work is rooting this in data - what we feel and see is important but if we are going to make a difference it has to be grounded in data.

Coalition Questions and Discussion

Pat LeDuff (CADAV): Wanted to also add the issue of grandparents raising grandchildren...we have assistance for the children but we need to think about the grandparents.

Tyler Litt (NSBR): The first question is around geriatric mental health and counseling. Are there local programs centered around not just memory loss but actual trauma informed counseling? Second, are there any organizations utilizing the Senior Corps program where seniors can work for a year and then use that educational award for themselves or gift it to an immediate family member?Tasha Clark-Amar: When we have issues with our seniors, we normally refer them to Ocean’s Behavior and Care South. Those are two entities that have wrapped counseling in a nice package relative to seniors’ mental health. We don’t utilize the Senior Corps Program.

Pat LeDuff: Scotlandville CDC has gone through AARP through the last 7 years. We don’t have paid staff - we go through them and they are awesome. They are usually retired from HR, retired from hospitals, and they do an awesome job running CDC and CADAV.

Ann Zanders (BRCC): Back in 2016 when the flood occurred, we were partnering with a few agencies that dealt with specific challenges. What bothered me was that those seniors who were deaf hardly had any assistance. There was no electricity, they were isolated and so afraid. So now in 2021, has anything occurred to change that compounded isolation for those seniors who are also challenged with being blind or deaf? I love what Tasha said about getting the intergenerational group together because we were even looking at, and I hope we still can, work with AARP to teach senior volunteers signing so that they could have enough capacity to volunteer and partner with a senior with other challenges, help them in their day to day life

Tasha Clark-Amar: We work with some groups - we provide tablets for them so they can communicate with us, specific Bingo cards, accommodations for activities, etc. I don’t have it in front of me, but contact me so I can get you that information.

Pam Wall: Rebuilding Together Baton Rouge has over 1,500 applications for home modifications for low-income, elderly homeowners and, with only part time staff, can address only 150 a year......many homes they have addressed with adaptations really need to be demolished. How can we address this as a community? Our goal is to keep seniors in their homes longer by making them more safe and healthy.

Tasha Clark-Amar: We signed a CEA prior to the pandemic to start working on home modification projects with them and we had committed some dollars to start this project that got delayed because of the pandemic, but it is our intent to pick that project back up. We also sent a letter to help them with a federal grant they are applying for. We want to help whittle down these applicants and work with the city to address these issues. We want to make sure our seniors live as long as possible, as independently, as possible...we look forward to reestablishing this program.

Manny Patole (Co-City): Are there programs to help access Medicaid resources using pooled trusts?

Tasha Clark-Amar: We have licensed Medicaid and Medicare counselors in office who I can connect you to.

Priscilla Allen: Somebody put AARP as a resource for general areas of interest. There’s a powerhouse lawyer who knows so much about adjudication, conservatorship...there are people out there who help with that.

Manny Patole: As we learn about the ALICE population, there are folks who have homes but because of their assets are limited to accessing Medicaid in addition to their Medicare benefits. The idea of using a pool trust helps remove that balance that would prohibit them from accessing Medicaid into an account that’s no longer considered part of that individual's money. That money can then be put in a trust used to pay for other bills. I only found out about this over the last three years because of my mother’s situation...the idea of being too rich for certain things but too poor for other things and a lot of the elderly - a lot of us - are in that same boat

Casey Phillips: I was just thinking about Pam and the rebuild needing more resources, the quick list would be AMIKids, SVP, Serve Louisiana, AmeriCorps, City Year, veteran groups

Pam Wall: The group Silver Hammers has been a huge resource. A lot of people don’t realize that Rebuilding Together has 6 part-time staff. They do 150 homes a year, the low cost high impact things like rails, levers instead of door knobs, lighting, and grab bars. The problem is a lot of the homes just need to be rebuilt because they don’t do things like sheetrocking, except for the flood. AARP and Red Cross gave them in the years since 2016 almost a million dollars. They actually did total rebuilds of houses that were flooded and had a lot more corporate volunteers to do that. There was a recent HUD grant that was going to allow...the thing is the federal government is realizing there will probably not be enough nursing home beds for the baby boomers who will need them. They are realizing the longer you can keep your seniors in their homes, healthy and safe, the less the burden on nursing home beds. There were several people on this Zoom who were very helpful in getting us support. In 70805, the demographic data is abysmal. The Feds wanted grantees to focus on elderly that were 80% of AMI. Right now Rebuilding Together does 30-50% AMI and still can’t serve the people who really need just things like grab bars in the shower.

Raymond Jetson: I lifted up Pam’s comments because I think they are really instructive in a couple of ways. The work at the heart of all these folks' efforts, specifically the organization Pam mentioned, should remind us that the needs facing our community and those aging in our community is more than any one organization can accomplish. It is impossible for Rebuilding Together to meet the structural needs by themselves. Secondly, the real life experiences of those aging in our communities will not be addressed by a single intervention. Even if Rebuilding Together had a staff of a thousand people and money to rebuild every home, that would not eliminate isolation, food insecurity, poverty, and other issues being addressed in our community. It is beyond the scope of any one intervention. Every day, 10,000 people turn 65. That will happen until the year 2030. This is not something that’s going to go away. It’s only going to grow in its immense impact in our community.

Tasha Clark-Amar: And add to that we are living fifteen years past the life expectancy. Seniors are living beyond what’s expected. Wednesday I went and celebrated four seniors in the Scotlandville area who turned 100 at the same time.

Casey Phillips: Korey Patty and Reverend Anderson both asked something really important - what are the opportunities for policy improvements at the local/state level that would impact senior outcomes. And Reverend Anderson asked did you all see COVID decrease the power of the senior population at the legislature?Tasha Clark-Amar: I felt like our voice was louder this year. Seniors were the population affected worst. Federally we received quite a bit as it relates to the CARES Act, second and third round. They paid attention to seniors first because we lost quite a few seniors. The state mimicked what the Feds did. I don’t think we lost our footing on many things relative to policy with seniors. From my perspective we’re in a good stand point relative to our policies. Policies can always improve but sometimes it’s good to leave well enough alone.

Reverend Anderson (PREACH): We are seeing a frighteningly high number of seniors come through the parish prison and a lot of them are related to serious mental illness, dementia, and domestic violence cases. Because LA is the number one incarcerator in the world, we have one of the highest aging incarcerated populations as well as one of the highest formerly incarcerated populations that consists of seniors because the sentences are so long. Do any of the presenters have programs specifically either educating the criminal justice system on the particular special needs of senior populations and/or servicing those populations whether it’s in a facility programming to help seniors or working with groups like VOTE to help them navigate getting seniors into programs?

Tasha Clark-Amar: We have been wrapping services around those that are formerly incarcerated as they come out. We have a program we work with that calls us as they come out. We provide material aid, access to housing, and help them get set up. Started a reentry program relative to employment. We have quite a few, maybe 25, reentry employees who are actually some of my best employees. We have a program where we have aligned with the Dept of Corrections. Relative to the pet piece [in the chat], we have a pet program where we were funded by National Meals on Wheels where we provide pet food quarterly, pet vaccinations...they love it.

Chris Spalatin (LSU): I’m wondering what the demographics are of the senior population in EBR, what their status is, if they’re living in a single family home, public housing, if they’re homeless, if it’s a multigenerational household along with any other demographic data which might help set the stage for what benefits could target certain groups.

Tasha Clark-Amar: You can call the Governor's Office of Elderly Affairs. They have the official statement. It’s also on their website.

Priscilla Allen: Thank you everyone. Iowa has a really good nursing home network, so if you know people, specifically social workers, put them in touch with me and I’ll put them in touch with the network.

Craig Kaberline: Look forward to helping solve some of these issues we all face in the populations we serve.

Tasha Clark-Amar: Thank you for having me - I’m going to add some links to the chat and I’ll be sending you all an invite to the grand opening of this intergenerational center with is June 18 and we have the 25 programs we do so if you have a senior that needs something please reach out to us.

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Community Announcements

Ann Zanders: These two organizations are phenomenal. The work Tasha and Craig are involved in is critical to the healthy living of folks with early onset disease as well. Lastly want to say that Dr. Allen spearheaded an effort for Capitol Area Agency on Aging and our symposium Aging Well in Louisiana in November. It’s really for practitioners and people who engage seniors, to educate them on misconceptions we have on serving the aging population.

Reverend Anderson: I wanted to add it’s critical that we take care of the caretakers as well. If we don’t take care of them, they can’t take care of their loved ones.

Casey Phillips: I think it’s a missing part of the national conversation - another barrier of poverty is equal pay. Look at the impact of COVID on women in the workforce. There’s a lot of dialogue around childcare but not around the very obvious question of senior care that’s also factoring into the workforce shifts. We’re having too narrow a conversation when we talk about equity in the workforce.

Sherreta Harrison (MetroMorphosis): I wanted to lift up that I attended a conference around intergenerational relationship building and one of the high school kids said “I don’t know why we keep having this conversation, I feel like youth should be included in every conversation because after all we are the future.” We know it, but hearing a young person say, why am I not included in every conversation as opposed to youth issues stuck with me. Even though we’re talking about older adults, high schoolers will be future older adults. We’ve got to start including young people in these conversations early.

Rinaldi Jacobs: We really need to drill down and focus on making sure that if a younger person has to go live with a grandparent and make housing decisions that they have clear understanding and ownership of the property. This really goes back to Katrina. Part of that intergenerational wealth...look at all the young people being raised by grandparents. If the grandmother dies, they end up losing the house because nobody has proof of ownership. Alfreda Tillman Bester: Our research at SU Vulnerable Communities and Peoples Initiative tells us the biggest predictor of dying in poverty is being born in poverty. We’re trying to breach that gap through policy. We know that people’s assets are considered when they are determined eligible for Medicaid benefits, the “value of their assets”. That’s a policy we really need to start looking at. Nobody asks corporations to pledge their property when they receive tax benefits. We need the same kind of things in families. There tends to be intergenerational living arrangements. If the property is taken away it doesn’t just affect the family member entering a nursing home, it impacts the whole family. It’s good to be on this call because it brings it all home. Kudos to Tasha for the intergenerational commitment you have. If there’s not clear planning and preparation...a lot of things are impeded by policy.

Reverend Anderson: The BREC bill was defeated...two of our jewels, the park and our library system, and the Council on Aging quite frankly, are always targeted for having those dedicated tax dollars be somehow recouped for other purposes or private entities. While it was a victory to have it defeated, it was also a bill pushed with little to no support from the community. The session is still going on until June 10. I encourage everyone to get down there and show their faces, say we are citizens and we want to check out what’s going on. We are putting our Bail Education posters in all the BREC community centers. I’ve mentioned before that cash bail is one of the biggest drivers of poverty in low and no wealth families, particularly as we’re talking about seniors, a lot of grandmothers will put their house or their savings up to make sure a grandchild is not kept in a dangerous place. We have two community bail funds: Bail Project and YWCA. There are options for families. They don’t have to take money from education and rent. You don’t know which families have been impacted by incarceration. There are people who need this information who will never ask you for it because it’s not the type of thing we have in public. But having these flyers is really helpful. We have that relationship with BREC but I’m offering it to everybody.

Alfreda Tillman Bester: One of the things we’ve seen is that a lot of people will pledge their homes without understanding what they’re doing. I think Dr. Bell will agree with me...what I do as an attorney...do not pledge your home no matter what you do. It can actually be lost and there are courts that will take them. Flitcher Bell: Sometimes their emotional ties get caught up more than logical thinking. They do it thinking it’s just to get that person out. They don’t understand that that bond is set. We need to spread that information and insight on their actual true obligations.