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The Kings/Tulare Master Plan for Aging Advisory Committee presented its findings to the receptive crowd that filled the room at the Wyndham Visalia Hotel on October 19th.

Committee members included people representing various organizations, non-profits, governmental and county agencies, and county officials committed to improving resources and services for older adults in both counties.

The committee had been given the task of developing a "Rural Master Plan on Aging" to carefully consider the needs of rural elders and develop specific recommendations, goals and strategies for Kings and Tulare Counties to be incorporated into the state's Master Plan for Aging.

Meetings were held monthly for two years to develop the master plan.

The committee found that the five main concerns that seniors in Tulare and Kings Counties have are caregiving and memory loss, housing insecurity, food insecurity, transportation and outreach.

Each of the concerns was addressed at the presentation.

Dayna Wild, director of the Kings/Tulare Area Agency on Aging, and Jason Kemp Van Ee, Social Services Program manager for the Kings County Human Services Agency, gave the opening welcome. Video remarks from State Senator Melisa Hurtado were then shown to the gathering.

"The Master Plan is a living document with five bold goals," said Jackie Siukola Tomkins, Ph.D., Senior Strategist for the California Master Plan for Aging with the California Department of Aging.

Helen Miltiades, Ph.D., a consultant to the committee, then explained how the survey was conducted.

"Seniors are so vital to our community," said Tulare County Supervisor Pete Vander Pool. "It's lamentable how seniors in the U.S. are treated. Elders are idolized in Japan."

Kings County Supervisor Joe Neves addressed the need to provide more services to seniors, including transportation.

Miltiades, a consultant to the committee, explained in very simple terms how the survey was conducted.

"We just went out and talked to people to see what concerns they had," she said.

Actually, the process was much more complex. An analysis of which people to interview relied on demographic data from In Home Supportive Services (IHSS), the U.S. Census, the Alzheimer's Association, and the Kings and Tulare County Area on Aging.

The committee reviewed lists of calls to 211, CSET and the Kings County Commission on Aging.

Questions came from the call lists and AARPs Age Friendly Community Survey. Fifty-four interviews were conducted and there were two focus groups.

Caregiving and Memory Loss

Caregiving includes either receiving help from family or friends, as well as receiving help from paid caregivers and/or IHSS.

Kemp Van Ee discussed caregiver needs, saying that caregivers need "support in three main areas: support and training, how to connect with services, and needing a break."

Family members who act as caregivers are often unable to pay someone to care for their loved one even briefly.

"Getting a respite (from caregiving) was a huge thing in our survey," he said, adding that dealing with dementia is also a major concern. "Cognitive decline is a growing problem in Tulare and Kings Counties."

Nineteen respondents had someone in their family who was being cared for due to cognitive decline. Five people said they had memory issues.

To deal with caregiving concerns, the suggested solutions are:

1) Increase knowledge and awareness of existing services;

2) Increase the capacity of existing services and organizations through partnerships and resource sharing;

3) Increase support at home;

4) Advocate for resources to expand respite and caregiving services, including services from IHSS;

5) Home modifications (ramps, grab bars, etc.).

Housing Insecurity

Housing insecurity focused on the needs of community-dwelling older adults, as well as adults residing in skilled facilities or assisted living communities.

"The ability to stay in housing is often times prohibitive," said John Mauro, deputy director of the Tulare County Health and Human Services Agency, who made the presentation on this topic.

Those surveyed expressed three main concerns:

1) Lack of affordable housing of all types;

2) Lengthy waitlists and application process; and

3) The need to link care and housing.

Respondents said communities should be walkable and accessible with transportation, stores, and health and social services. Homes should be accessible with ramps and bathroom remodels.

The committee recommended housing that is set aside for older adults and adults with disabilities, and housing that is flexible to intergenerational situations.

Cities should create zoning codes to encourage development of 55-and-older communities, and an Assisted Living Waiver Program should be established to cover the costs of assisted living.

Food Insecurity

Bobbi Wartson, executive director of the Kings County Commission on Aging, then addressed the concerns seniors have about food.

This part of the presentation focused on the needs of community-dwelling older adults. Of the people interviewed, 60% expressed some concerns about food insecurity, which for some was due to health concerns that limited their ability to go out, prepare meals, or to eat well.

Some were limited by the lack of transportation, while others had difficulty affording groceries.

The committee listed organizations, city departments, food banks and churches that can assist those with food concerns.

The committee's goal is to raise awareness of existing services, and provide transportation and support to older adults who have health concerns.

Transportation

"Transportation is dear to me," said Dinuba City Council Member Linda Launer, explaining that while living on the east side of Los Angeles, she had to take a long walk to the first of three busses she took to get to school on the west side.

Speakers at the "Master Plan for Aging" presentation included Kings County Supervisor Joe Neves, Tulare County Supervisor Pete Vander Pool and Jackie Siukola Tomkins, Ph.D., Senior Strategist for the California Master Plan for Aging.

Survey respondents discussed their transportation challenges when the subject was supposed to be caregiving, and food insecurity. They also expressed concerns about transportation in general.

The committee recommended expanding transportation options, public transportation routes and hours, and increasing public transportation availability in rural areas, providing specialized transportation for those using wheelchairs.

Outreach

"We want to raise awareness about agencies and their services," said Raquel Gomez, division director for community initiatives with CSET.

The committee's recommendation to address this concern is to increase awareness of and access to services by providing more community education and outreach. The committee recommends creating materials in Spanish, coordinating existing service providers, and connecting service provider efforts across counties.