For 30 years, Marilynn Huseby has been answering questions about resource availability for people who have reached an age when they need more support to live safely and independently. As a longtime volunteer resource counselor at the Montrose Senior Center and Retirements Services partner, she gets questions about financial assistance for expensive prescriptions, the options available during the Medicare open enrollment period, using a reverse mortgage to help fund in-home services for a spouse with dementia, understanding long-term care policies and all the other resources that help people continue to live at home as they grow older.
“People get intimidated by our over-information age. They have no idea where to look,” Huseby said. “It’s important for people to search out the information about what support is available and where to get it.”
With one out of every five Coloradans expected to be 65 years or older by 2030, the state legislature created the Strategic Action Planning Group on Aging in 2015 to develop a comprehensive strategy for addressing issues of the aging population. Last year, the group held meetings across the state to gather input about which issues were most critical.
The conclusion drawn from the meetings was that “Seniors and their advocates believe health care — which includes rising costs, access, lack of facilities and gaps in coverage — along with the population’s general lack of knowledge about how to navigate services available for seniors at the state and local levels, are two of the major issues facing Colorado’s growing aging population. Those concerns are magnified for seniors on fixed incomes who want the opportunity to take control of their own lives and help other seniors by learning strategies that will enable them to more successfully prepare for aging,” according to the planning group.
In January, Colorado Gov. John Hickenlooper appointed Wade Buchanan as the state’s first Senior Advisor on Aging. He will act as a central leader for planning, coordination and policy guidance on issues related to the aging population. He is tasked with working with foundations, health care providers and private sector initiatives to address gaps while supporting high impact programs across the state.
LACK OF SELF-IDENTIFIED SENIORS
Between 2010 and 2016, according to U.S. Census estimates, the population of people over 65 grew in Ouray County from 17.5 percent to 26 percent, in Montrose County from 17.8 percent to 22.3 percent and in San Miguel County from 7 percent to 12.3 percent. Residents in that age group already account for more than one in five people in Montrose County and more than one in four people in Ouray County.
And yet, people who identify themselves as seniors and participate in organized senior activities is lower than it was a couple decades ago.
“Nobody is a senior anymore. It’s like you’re not a senior until you’re 90,” said Huseby, adding that many senior centers are changing their names to community centers and welcoming all ages to use their resources as a way of giving them a head start on understanding what services are necessary to help themselves and their parents as they grow older.
“A lot of people don’t have the kind of assets needed to protect themselves for long-term care. If people knew where to go to get even a couple of hours of estate planning counseling, it would benefit their family,” she said. “People don’t plan for caregiving, but they should plan for at least five years, which is the average period of care that is necessary.”
In many cases, people without the time or proximity to their aging relatives can’t be caregivers, but they need to learn to be care supervisors who know how to get benefits and services such as home health care. The Montrose Pavilion Senior Center and the Region 10 Area Agency on Aging in Montrose are two hubs of information and education for multiple counties.
Madaline Lake has been volunteering since 1996 for the Senior Center’s programs, which are organized by an all-volunteer nonprofit called The Golden Circle. Now the manager for the Hot Wheels Meal delivery to homebound seniors, she is a senior herself, like many other volunteers.
“A number of us are widows or widowers and get tired of our own company,” Lake admitted.
The home-delivered meals go as far as nine miles outside the city of Montrose. The same meals, a full lunch with a drink and dessert, are also served at the center five days a week for $5 per person. Most people drive but transportation is also provided by All Points Transit. All ages are invited but the group is often as small as 20 people these days.
“When I first came, we were really going great guns. We still had the founders volunteering, and as many as 100 people were attending the lunches at the senior center, 150 during special celebrations. The numbers started heading down in 2005 and 2006,” Lake said.
While she speculated that one reason could be the increase in price from $3 to $5, when government subsidies were reduced, she added, “We are also finding the generation, just below those of us who are 75-plus, are just not interested. They don’t see themselves as seniors so they don’t use our services.”
Besides the meals and resource counseling, the Senior Center holds dances and social events, has a library of useful information, and helps connect seniors to volunteers for handyman services, snow shoveling, leave raking and other assistance. The support services make independent living more manageable, while the social opportunities keep participants connected to the community.
In fact, Lake said she remembers at least five different couples made up of widowers who got acquainted through center activities and ended up remarrying.
‘FIERCELY INDEPENDENT POPULATION’
The programs and services of the Area Agency on Aging are mainly available to people 60 years of age or older, due to restricted federal funding from the Older Americans Act. The agency helps coordinate subsidized services such as dental cleanings and checkups, family caregiver training, in-home cleaning and assistance, legal aid, mental health services, long-term care ombudsman support, meals and transportation.
“When I moved here 20 years ago, Montrose was being planned as a senior retirement community,” Huseby said. “I think Montrose in particular is well supported. Does that hold true for Ridgway and Ouray — no, but Neighbor to Neighbor and similar programs are lifesavers.”
Neighbor to Neighbor is a nonprofit that organizes volunteer services for Ouray County seniors, bridging the gap not filled by family, friends, government programs and companies. To make it possible for people to remain independent in their homes, a current group of 30 volunteers provides transportation, handyman help, critical home repair, bookkeeping help, Meals on Wheels, friendly visiting and phoning, shopping with and for a senior, and a community lunch every Monday, as well as an active social calendar.
Neighbor to Neighbor senior coordinator Mary Cockle explained, “Ouray County is home to a fiercely independent population of senior, homebound and disabled individuals who want very much to stay in their homes, but cannot do so without help. We are truly an effort of neighbors helping neighbors by being fresh eyes and ears, and providing access to other resources that may be beyond their reach. Our intent has always been to do all we can to ensure that those we serve remain safe, self-sufficient and a part of the community they love.”
She admitted some people fall through the cracks when they are unaware of the services or don’t reach out to ask for help, but she added, “We search out some of these people to see if we can get them involved. They’re all precious.”
Neither Ouray nor San Miguel counties has long-term care living facilities, for those seniors who need even more services every day, “and the prospects for getting one are not good,” according to Cockle. So, it’s even more important to have services that help modify homes to make it easier for seniors to be on their own and safe, as well as access to home health workers.
Local senior service leaders agree the biggest need to keep our elderly living independently is home health care, which refers not so much to medical services provided by health professionals but to various chores provided by workers with no special certification. Montrose has at least seven companies providing those services to homes around the area, but no companies are located in Ouray or San Miguel counties. When in-home nurse visits become necessary, that type of service is even less available.
“Skilled home health care is very limited and short-term rehab or long-term care requires leaving (those two counties),” said Eva Vietch, community living services director and long-term care ombudsman for Region 10.
Often, seniors only need a two-hour visit each week from someone who can help with changing the beds and various housework, as well as meal preparation and shopping, but sometimes need help with personal care such as bathing and dressing. For this type of service, the charge ranges between $20 and $35 per hour, which is often paid privately but is sometimes paid by insurance policies, Medicare or other government programs. Local agencies can accommodate those short shifts, but it’s less economical for seniors living outside of Montrose. The agencies charge for the driving time from Montrose, which can add two to three more hours to the charge.
Skilled home health care is available on a limited basis in San Miguel County, and Region 10 assists with transitions back to the community following hospitalizations or rehab in other communities, Vietch said.
In the Norwood and Redvale area, seniors have access to home-delivered meals, legal aid, homemaker and personal care services, and caregiver respite.
“The Nucla senior meal site is the third largest in Region 10, serving 30 to 40 seniors three days per week. Emergency boxes and frozen meals are provided for those who live too far out for hot meal delivery,” she added.
LONG DISTANCES TO ACCESS SERVICES
Carol Friedrich, director of Ouray and San Miguel County Social Services, said, “Housing a workforce is a major challenge for senior services agencies. Also, historically we have lacked the demand for full-time staff to perform these duties. As a result, providers travel long distances to provide services to a few seniors in need at high cost.”
Her office coordinates with Region 10 and other organizations to inform seniors and caregivers of available services and resources such as those provided by Tri-County Health Network. Each county also offers Adult Protection Services to at-risk adults, investigating allegations of physical and sexual abuse, caretaker neglect, and exploitation, as well as self-neglect of at-risk adults. Those offices offer protective services to improve the health, safety and welfare of at-risk adults, using community-based services and resources, family and friends when appropriate, and other support systems.
In addition to the need for affordable housing for the workforce, “There continues to be a need for affordable and accessible housing for people age 55- plus throughout Region 10,” Vietch said.
According to the U.S. Census, the average Social Security monthly income is $1,413 in Montrose County, $1,712 in Ouray County and $1,575 in San Miguel County. Meanwhile, according to Trulia.com real estate guide and home search website, median monthly rents are $1,225 in Montrose and Olathe, $1,500 in Ouray, $3,000 in Ridgway, $5,400 in Telluride, Placerville and Sawpit, and $950 in Norwood. Median house sales prices range from $212,000 in Norwood and $215,000 in Montrose and Olathe to $425,000 in Ridgway and $462,500 in the Telluride area.
“Habitat of the San Juans has built some homes in Norwood,” Veitch said. “Funding for affordable housing is not easily accessible and the competition is great.”
Those seniors who can afford to continue living in the area then face the issue of finding and getting to adequate, affordable health care. While Montrose has a hospital and several medical offices, each town outside that city has no or very few local health clinics with large patient loads.
“An area of need is access to specialists. Seniors with complex medical needs involving specialists may choose to move out of the area to be closer to their health care providers,” she said.
For seniors who are unable to drive long distances to medical appointments with specialists and at hospitals in Montrose, Grand Junction and Denver, All Points Transit has been increasing its services for senior citizens and the disabled, with varying options that are free or discounted. The Montrose-based nonprofit has a door-to-door Dial A Ride program that serves Montrose County, including the West End, Delta County and Norwood in San Miguel County. Public flex routes are in the City of Montrose and Olathe, and a volunteer driver program is mostly serving residents of Montrose.
Region 10 and Tri-County Health Network support a regional medical shuttle operated by All Points that has already transported more than 800 people to their non-emergent medical appointments in the last year. The shuttle serves Nucla, Naturita, Norwood, Telluride, Placerville and Ridgway, but does not go as far as Ouray yet.
Region 10 has also begun a Senior Companion program that may add another transportation option, similar to what is provided by Neighbor to Neighbor. The Ouray County nonprofit arranges volunteers to help provide transportation to seniors, has a van with a wheelchair lift and has even transported seniors to Denver for medical services.
“CDOT has increased transit funding but All Points Transit continues to struggle. The recent loss of Liberty Mobility was yet another roadblock. There are monthly meetings throughout the region to address the problem,” Veitch said.
She points out that funding support from the Telluride Foundation, Montrose County and other organizations make various senior services available, especially targeting people “with the greatest need and the low-income, frail elderly.”
“Community support in the form of volunteers and monetary support will be needed to sustain all of these programs,” she said. “Letters to state legislators and Congress to promote the ongoing need for services to seniors in rural and frontier areas are needed. Region 10 serves six counties and over 10,000 square miles and receives a little over 3 percent of the state’s allocation for senior services. Monetary donations would help prevent waiting lists for essential services.”
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