Aging with Altitude

The Association for Community Living highlights the best parts of aging during the month of May with Older American's Month.  Across the country older adults share stories of how they are aging their way this year.  From a 79 year old paddleboard racer to the intergenerational and multi-racial women's group who does tea, there are many great examples of how we Age our Way.  This year Colorado Springs is hosting a multi-cultural food box give-away of heritage comfort foods for our residents.

Not happy with your Medicare Advantage Plan? You can make changes during traditional Open Enrollment but also between January 1 - March 31. Roma Costanza, with Colorado's State Health Insurance Program (SHIP) provides tips and answers for how to get the best out of Medicare and Medicare Advantage plans. SHIPs are the best resource for non-biased Medicare counseling. They are funded by the federal government to assist those in Medicare with getting their needs met. SHIP is not associated with any insurance program so they can talk about ALL options. Roma has over 22 years of health insurance counseling experience and is a true Medicare advocate in Colorado.

PEARLS is the Program Encouraging Active Rewarding Lives for Seniors and is run by Cynthia Margiotta.  Cynthia has a Bachelors in Social Work and a solid history of supporting older adults in the Pikes Peak region.  From her work teaching direct care staff best practices to her volunteering with the Alzheimer's Association and the Family Caregiver program with the Pikes Peak Area Agency on Aging, Cynthia has the best background to support older adults who are struggling with anxiety and mental health needs.  The PEARLS program is a unique in-home 19 week program focusing on goal setting and much more.  PEARLS of ColoradoAging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country.  We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado.  The Pikes Peak Area Agency on Aging is the producer.  Learn more at Pikes Peak Area Agency on Aging.

Transcript:

You’re listening to studio 809. This is what community sounds like.

Melissa Marts:

Hi, welcome to all. This is the Pikes Peak Area Agency on Aging’s Aging with Altitude podcast hosted at studio 809 podcast. We provide answers, assistance, and advocacy for people over 60 and their caregivers. Thank you for joining us today. I am Melissa Marts, program administrator with the Pikes Peak Area Agency on Aging. Our topic today is about behavioral health, but let’s just call it kind of anxiety and frustrations that our older adults, some of our best friends, go through and are suffering with and some ideas about how to help them. And to talk about this today we have Cynthia Margiotta with us. Cynthia is typically our podcast host so you’ll recognize her voice from other podcasts, but today she is our special guest. Last year during COVID, Cynthia launched the PEARLS Program of Colorado, a unique behavioral health program here in El Paso County with goals to spread it around Colorado, but she started it here in our region. Cynthia is also a strong advocate for older adults, and she’s supported the aging community for years with her All About Dignity courses, her volunteering with the family caregiver support program at the Pikes Peak Area Agency on Aging, and many other programs. Then also today we have a special masters of ceremony, Ms. Jenny Nihill, who is a military fellow, and she is currently doing this with the Pikes Peak Area Agency on Aging, so thank you Jenny for joining us. Thank you for your over 20 years of military service and jumping in today as the emcee with Cynthia. I’m going to turn it over to Jenny.

Jenny Nihill:

Alright, thanks Melissa for the introduction. I’m happy to be here learning and working with Melissa and the Area Agency on Aging. Now I’d like to introduce Cynthia and learn more about the PEARLS Program of Colorado, so let’s get started. Can you tell us what is the PEARLS Program of Colorado and who is eligible to use the program?

Cynthia Margiotta:

PEARLS Program of Colorado, we just call it PEARLS for short, but PEARLS program of Colorado is a program that is specifically set up to help seniors in our community. We work with the folks 60 plus population. It is an evidence-based program that I took many classes for in order to hold that program here.

Melissa Marts:

Cynthia, what does PEARLS stand for?

Cynthia Margiotta:

PEARLS stands for Program Encouraging Active Rewarding Lives for Seniors.

Melissa Marts:

Thanks. It’s funny how we get so used to just saying PEARLS and then we forget to actually, to call out those really special words that PEARLS means.

Cynthia Margiotta:

Yeah, it’s a great one. I wish I had thought of it.

Jenny Nihill:

So before we came here today I did go looking on the website so I could learn a little bit more about the organization. It did mention that there were coaches. Can you tell us about the coaches, who they are, what kind of training they might have gone through?

Cynthia Margiotta:

I am the only coach in El Paso County, so I travel all over El Paso County from top to bottom, to left to right, but the training. Oh my. So the training I took for this particular program is out of Washington State University. About a year and a half ago now wasn’t it. Then there were some other programs that I also took on my own to make it even more valuable like actually what to do when a person has a seizure. There’s a difference if they have a seizure and they’re known seizure victims or unknown. Different classes like that through the past year and I am currently in a class where I am becoming a PEARLS master trainer.

Jenny Nihill:

That sounds good. Can you tell us what the stool concept of PEARLS is?

Cynthia Margiotta:

The stools concept. You’re very smart. Yes, the stools concept is a great part of the PEARLS program. The way we think of it is a three-legged stool and each leg holds up the person. So those three legs are one leg is the socially active. We encourage people to be socially active, whatever that means to them, and another one is to be physically active. Being physically active actually reduces depression and anxiety so that’s important as well, and then also to be like planning an activity of interest. And I don’t mean planning to go to Mexico in three years, but maybe going to have supper with a friend next week. So those three legs, and then it’s held up by the floor, and the floor is actually in our program, the psychologist and the nurse practitioner so they in a sense they supervise me and help me to understand the medications people are on and what might be a better approach with any particular person. There is really a team of us that do that.

Jenny Nihill:

Great. So when participants are enrolled in your program, can you tell me what they can expect to get out of the program?

Cynthia Margiotta:

A great deal of joy. That is what I hear from people. Yesterday I took on a new client who was suffering with pretty high depression. She’s just getting through the denial stage that people have of her husband’s dementia where, I don’t know. I don’t understand fully why, but it’s very common for people to say “oh mom you’re going crazy, dad’s fine,” “Why is she crazy and he’s not having problems?” It’s very common and so when I went to visit with her, I spent about an hour explaining a little bit about his disease, his kind of dementia to him. I’m also a longtime volunteer with the Alzheimer’s Association so having that knowledge has helped being able to explain that particular dementia. Helping her understand the difference between what she felt. She believes that she’s guilty for his dementia and explaining the difference between guilt and regret. I think when we were done a few hours later she was so much happier. She’s OK, that’s not her fault. That she’s not going crazy. And I liked seeing that in people. I like helping people. This is what really enthralled me about the program. Moving people toward more joy. Just because you’re over 60 doesn’t mean you have to sit on the couch all day.

Melissa Marts:

And Cynthia, as you bring up that story and talk about that personal experience that you had with this woman. I think we haven’t talked about it yet, where does PEARLS happen? When you are meeting with these folks, where are you actually meeting with them?

Jenny Nihill:

Yeah, especially during COVID now because we are still doing a lot of social distancing, with the elderly being a vulnerable population.

Cynthia Margiotta:

They are. Oh yes. I do offer to meet with them over the phone if they would prefer. My preference is to go to their home and be there for them. I see and experience things that you wouldn’t if you meet in the office. I love to always talk about experiences without names. There is one client I have worked with where she was going blind and deaf at the same time, and her husband. Let me explain how it is. She would sit in the chair and had one chair facing her to talk to her. Her husband would sit in a couch behind her. And I would not have known that if I had not gone to that home. What I suggested to her husband is, go to one of the ARC Thrift Shops and buy a chair so that you have a chair where you can sit where she can hear you when you’re talking to her. That’s important in a relationship, but if they had met me in an office, I would have never known that.

Jenny Nihill:

Right, so when you go meet them, how long are you there for? And how long does this program last? Is it a few sessions, is it just continuous as needed?

Cynthia Margiotta:

Actually, the visits are rather long because I try to talk to them about what’s on their mind, what are their needs. It’s not where I set up a goal for them. They tell me what they need help with. Those depend on you know, a little goal of like figuring out how to I don’t know, toast. Using the toaster is easy you know. Where figuring out the difference between depression and anxiety’s a little bit more time consuming. And so they tend to vary in time and length per session, usually somewhere around an hour and a half, and then the period in months we started out with this weekly. Then we go every other week or so. Then about once a month, and then about a phone call every now and again kind of thing. And so slowly over a period of many, many, many months we see them and talk to them less frequently.

Melissa Marts:

And can I jump in again?

Cynthia Margiotta:

Yeah. Oh please.

Melissa Marts:

I’m just kind of curious how you see PEARLS being different than kind of a psychotherapy appointment and how, how is this a different approach for older adults? And along with that maybe answering the question of how it’s paid for too?

Cynthia Margiotta:

People here don’t know, but my husband is a psychologist and so I, and I had nothing wrong with psychology. What I see is a psychologist is there to hear and listen and reflect back. My job is to discuss with them, and to find what it is that they want to work on and help them, so we start from today. What’s going on today. And how can we change those problems into goals and meet those goals? Our funding comes through the Old Age Act, which is part of the Area Agency on Aging, and so we do have a grant through them and we are so appreciative because I love being able to go to people’s homes and say I’m not gonna charge you for these services. So I can see people who have like no money, or have nothing to spend. And yes, we do take donations don’t get me wrong, but you know. It’s nice to be able to see somebody who says “I, I don’t have money to pay you.” It means a lot to me.

Melissa Marts:

I know, and I’m glad that we have that opportunity to do that because oftentimes with counseling people have to somehow come up with money to pay for a counselor, and this is a resource that people can access for free. But again, Cynthia’s point about taking donations, you know the funds are limited. It’s not an unlimited budget, and so for people who can pay it forward when they have appointments with Cynthia and be able to you know, make a donation so that the program can go a little bit further maybe for the next person and other folks down the line is, is really appreciated of course.

Cynthia Margiotta:

Absolutely. I so appreciate that and send thank you notes to folks in hopes that they will keep us in mind in their future.

Melissa Marts:

Great.

Jenny Nihill:

You mentioned earlier that PEARLS here in Colorado Springs is under a larger program of PEARLS. What level is that at, and then where did you see the need arise in El Paso County to start the PEARLS program here?

Cynthia Margiotta:

Where did I see the need? You got three days to talk? No, there are so many folks that believe that once you’re about 60 or so, you should be happy with what I call “glued to the couch.” Where there’s no life. There’s no interests. That you look out the window and wish, and you can’t do things. I’ll use myself as an example. I do suffer with depression. And there are times, my friends all know that I’m a “plantaholic,” if you’ve ever heard of one of those. I am a plantaholic. I love plants. I’ve got more than a hundred at home, in the house. Some are taller than I am. That’s crazy, but I bring that up because there are days I know I need to water my plants. I have a few that say, “water me now or I’m going to die tomorrow.”

Jenny Nihill:

Those are the ones at my house.

Cynthia Margiotta:

Yes, bring them over. I’ll babysit. But in any case, there are times when I can look right at that plant and I can’t get off the couch.  I cannot get off the couch to go water them and that’s depression. And that’s a lot of the folks we work with that can’t get off the couch. I see my job as, what gives me more joy than anything is when I see them get up off that couch, when want to go do things. When they talk to me and they say I wanna go to the senior center.  I want to go volunteer at Area Agency. I want to do things. That gives me a lot of joy.

Melissa Marts:

And I’ll add a little bit to how the need kind of came to be in our region around behavioral health. You know we, a couple of years ago realized that there were lots of conversations happening at the governmental level around behavioral health and suicide, but no one was talking about it from an older adult perspective. Even our county health plan didn’t have a chapter to address older adults and behavioral health. It was really focused completely on people who were under the age of 60, and of course especially adolescents, which we know there was a significant need in that area, but yet we also discovered there is a significant need for older adults, and that the suicide rate for older adults is considerably high.  It might not be a blatant overdose or a blatant suicide, but what it is it’s an accidental overdose of medications that people, as Cynthia refers to sitting on the couch and depressed, and they decide to take their own life with the medications that they have. The reality was we have many folks in our area that are alone, isolated, sad, depressed, anxious. We have two programs in our area that were able to provide behavioral health at the time when Cynthia started PEARLS, and they had waitlists. And so people couldn’t even get help if they wanted it. And many folks were not comfortable calling Aspen Point at the time. Now it’s called Diversus, but Aspen Pointe is kind of the emergency call for behavioral health relief and people didn’t want to call that. Especially older adults who are just sitting on the couch and feel like “well my life is over anyway and why should I call and ask for help.” At the Area Agency on Aging, we really wanted to see an additional resource around behavioral health and in the two years that we’ve been working on this we have seen exponential growth in funding, resources, support, conversations around the needs of older adults who would like to get extra support to feel better about their lives. PEARLS is a nice addition to a more clinical model approach. This is a home-based, much more personal and as Cynthia says, just really getting down and talking about goals. What do you want to do and how can we get there? It’s a great addition to our community.

Cynthia Margiotta:

Pre covid statistically the population of folks over 60 who were depressed, it was somewhere around 20%. And that’s people who acknowledged it. Most folks we find who are depressed say this is just the way it has to be so they don’t acknowledge it. We find a lot of them instead of saying they’re depressed they say, “we’re anxious.” The medication that people take for depression is the same medication they take for anxiety. So even then sometimes doctors don’t even mention to them “well I think you’re depressed. Here’s something for your anxiety.” And again, grin and bear it. It’s that population, grin and bear it.

Jenny Nihill:

PEARLS sounds like a great program with lots of benefits for our senior population. How can they reach out to you to participate in this program?

Cynthia Margiotta:

They can reach out to me, or the family can reach out to me by calling very easily. They can call my phone number. My phone number is 719-459-2017. They can look on the internet. Our website is PEARLSprogram.net. And they can call Area Agency on Aging, talk to people there and say, “hey I need to get a hold of the people at PEARLS.” Family, they can tell family and have family call me. I do prefer to call them because folks who are depressed tend to not get off the couch.

Melissa Marts:

So, Cynthia, again, thanks for sharing about how people can get in touch with the PEARLS program. That’s good information to know. Is there anything that we didn’t ask you? Maybe another story you want to share or something else that we forgot to ask.

Cynthia Margiotta:

Well, thank you for asking. I want to thank you Melissa. You’re the one who introduced me to PEARLS. When you first told me about it, it was like love at first sight. I’d been doing something very similar to this for many, many years where going to people’s homes and visiting with them and trying to encourage them. And to have a formal program that really helps me to do what I see as a better job has been wonderful and I hope that we can spread the PEARLS program throughout Colorado and get more of the Area Agencies on Aging to be involved with PEARLS. And I’ll do everything I can to help them do that.

Melissa Marts:

Well, I know you will and I appreciate you saying thanks to me. You know the funny story is is that when I was looking for more behavioral health resources in the community and I heard about PEARLS and I knew...

Terry Cassidy, Occupational Therapist and owner of Health Partners specializes in the evaluation and support for older drivers.  The week of December 7 is Older Driver's Awareness week and an ideal time to learn more about safe and comfortable drivers to take into their senior years.  To see more about the week's activities visit

https://www.aota.org/Conference-Events/Older-Driver-Safety-Awareness-Week.aspx

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country.  We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado.  The Pikes Peak Area Agency on Aging is the producer.  Learn more at Pikes Peak Area Agency on Aging.

Transcript:

This is Studio 809.

Cynthia Margiotta:

Hello everyone. This is Area Agency on Aging, Aging with Altitude Podcast. Welcome to all of you. This is where we provide answers, assistance, and advocacy for our elders. Thank you for joining us today. Our topic today is Older Driver Safety Awareness Week that’s coming up in a couple of days, yes?

Terri Cassidy:

Starting December 7th.

Cynthia Margiotta:

So let’s get that in our heads. I’m your host, Cynthia Margiotta. I’m a geriatric social worker and a volunteer with the Pikes Peak Area Council of Governments Area Agency on Aging. That’s a mouthful. And CEO of a program called PEARLS Program of Colorado. With me today is Terri Cassidy. Thank you for being here today, Terri. Thank you. She’s got all these wonderful letters after her name so I’m gonna just tell you what they are. The first one is OTD. What is that?

Terri Cassidy:

Doctorate in Occupational Therapy.

Cynthia Margiotta:

And then the second one is OTR/L.

Terri Cassidy:

And that’s just licensed and registered occupational therapist in the state of Colorado.

Cynthia Margiotta:

There’s no “just.”

Terri Cassidy:

No just.

Cynthia Margiotta:

No just. And the third one is CDRS.

Terri Cassidy:

Certified Driver Rehabilitation Specialist.

Cynthia Margiotta:

And that’s a mouthful girlfriend. I like the letters. OK, she’s here to talk to us today about Older Driver Safety Awareness Week. Terri has her doctorate in occupational therapy and is a certified driver rehab specialist, as she mentioned. As the owner of Health Promotion Partners, she empowers people to take positive action toward their health and well-being. She and her team provide driver evaluations and home evaluations to help older adults stay independent and connected with our community. Wonderful, wonderful. So let’s get started with some of the questions. I have a million of them. What is Older Driver Safety Awareness Week?

Terri Cassidy:

Yes. Well, thank you, Cynthia. I’m excited to be able to be here and talk about this topic. Older Driver Safety Awareness Week has such a long title, partially because it’s trying to explain what it is. It was started through the American Occupational Therapy Association really to have a set time to raise awareness to this topic. Just safety of older drivers really in a way that’s non-threatening. That’s really just about a topic that people don’t like to talk about, maybe. So trying to bring some attention from different sectors. So starting with AOTA, but there’s a lot going on even statewide with the Colorado Department of Transportation, nationally with AARP and other partners to promote this week. It’s always the first full week of December so this year is December 7th through the 11th to encourage people to think about and talk about older driver safety.

Cynthia Margiotta:

That’s a very important thing. There’s so many out there and it would be helpful, yes?

Terri Cassidy:

Yes.

Cynthia Margiotta:

So what do you do as a driver rehab specialist?

Terri Cassidy:

So in my role as a driver rehab specialist, I do driving evaluations and driver training. As an occupational therapist is really the background that I bring to this driving perspective. So particular to older drivers, I might see somebody when there is some concern or question either by the family, sometimes by the physician, sometimes by the client themselves. Am I still doing well with driving? Is this still something I should be doing? And so we do see clients and we do an evaluation here in the clinic and then also out on the road to give people feedback about maybe how age related changes are or are not affecting their driving. For some people that’s just giving them a really good baseline of this is what’s going on now so that if there’s concerns in the future, they could come back.

Cynthia Margiotta:

And this office is so easy to get to. You’re just off of Filmore and on Beacon which is not far from I-25 in Colorado Springs.

Terri Cassidy:

Yes. I’m glad that you were able to get here today.

Cynthia Margiotta:

Yeah, me too.

Terri Cassidy:

Something I like a lot about this space is our, we have a very accessible parking lot so it’s a good place for a driving program.

Cynthia Margiotta:

I even parked in it. Not so straight in the line.

Terri Cassidy:

Oh I didn’t look at your car.

Cynthia Margiotta:

Don’t look, don’t look, don’t look. I backed into a parking spot. What are some trends related to older drivers?

Terri Cassidy:

Well, I would say just for starters that when we’re talking for me, talking about driving evaluations, or even in general, for older driver safety. To me it’s not so much about age. I’m really looking at function overall. So for anybody that we’re talking about driving with, I don’t see that you know, a certain age means yes or no in terms of driving or anything like that. Like we’re really looking at physical skills, visual skills, cognitive skills is what makes up a lot of that. And older drivers tend to be more safe drivers. They tend to have less risky driving behaviors, tend to drive less at night, less overall miles. However, the data does show that over the age of 75, the fatality rate for individuals over 75 increases quite a bit compared to drivers of any other age. Except new drivers kind of mirrors that. So the concern becomes, you know, are there just changes that are happening that are affecting ability to drive and there is also an issue of frailty adding to the increased fatality rates. So somebody who’s 80 who’s involved in a crash is more likely to have more injuries, potentially life threatening injuries than a 40 year old person involved in that same crash. So there’s a couple of factors going on there, but I think overall older drivers have good driving habits, safe driving habits. We just want to find ways to keep them safe.

Cynthia Margiotta:

That makes a lot of sense to me. How do we, you know, what’s the biggest barrier to having discussions with folks about older drivers? Those barriers that, you know, I’m fearful of losing my driver’s license. She’s going to take my driver’s license away.

Terri Cassidy:

You said it. I mean that’s basically. You know, it’s a type of topic, and like I said in the beginning, people don’t always like to talk about this subject. Once you bring it up, so when I’m out talking to people, it doesn’t matter the population of people I’m talking to, everybody has a personal story about a relative, a family member, a friend where driving was iffy or where that person successfully decided on their own to stop driving. It’s a type of thing that everybody can relate to, but it’s touchy. Because, I think the biggest reason that it goes so far into our own identity and our independence of being able to drive. So if your child comes to you and says, “I have some concerns, dad, about your driving.” I think it can be hard to not take, get defensive around that discussion. So I would say the barrier is almost this stigma around removing driving, or stopping driving and really, what I would love to see is that our focus, or our value is on being engaged in the community, continuing to do things that are important to you. If you’re the driver or the passenger, it’s ok. You know, how can we just keep people involved in what they’re doing. But sometimes we get really stuck on the who’s in the driver’s seat.

Cynthia Margiotta:

Yes, yes. I have known multiple women who haven’t driven in 20 or 30 years because the husband, or even sometimes the wife, has to be the driver. You take their driver’s license away and it’s almost, and I can’t, you know, it’s for people, I guess for women to understand because it’s generally men who are very sensitive about losing their driver’s license. The closest I can think of to coming to that is you take away a woman’s home, her ability to care for her home. Because the generation we’re talking about, you know, women’s homes were their jobs. And you take that away from them, maybe they would understand a little better about their husband’s feeling about losing their driver’s license. Am I off?

Terri Cassidy:

Yeah, I appreciate that because I think it does go back to the person’s role. And so, you know, in your example, talking about the husband as the primary driver, that’s his role. And when we’re talking about changing that it’s a big deal. So yeah, no, that’s a good analogy of taking, shifting, or changing that person’s role there.

Cynthia Margiotta:

We don’t like losing our roles.

Terri Cassidy:

It’s true. It’s true and I think any ways we can help redefine our roles as we age, but hold on to, kind of figure out what the most important piece of that is, but on the surface it’s a discussion people tend to shy away from.

Cynthia Margiotta:

Yeah. Oh yeah. What are some good ways to make sure you’re a safe driver?

Terri Cassidy:

So, yes. There’s a great quote. I think it’s a Dave Barry quote that says, “Everybody feels they’re an above average driver.” Something along those lines. Everybody thinks they’re a safe driver. It’s just kind of our mentality. But things change in our bodies as we age and so sometimes it’s worth having those things checked up. In terms of being a safe driver, it’s not just important for your own self-perception. I felt safe during that drive, but doing kind of just routine medical visits. That’s going to affect your safety as a driver. Vision is a huge one, so getting an eye exam, talking to your eye doc about driving. Certainly, just medical routines, typical health examinations, things like that. There are some self-assessments of driving that are available online. I know both triple A and the AARP have those on their websites that people could fine. They’re just asking you questions about your driving. I feel like when it comes to family members, a good question is do you feel comfortable having your children in the car with your loved one. You know, so I think sometimes if you’re the older adult who’s interested in being like, how am I doing? How’s my driving going? Asking people who have driven with you. Just being, opening up to that feedback a little bit of do you feel comfortable driving. Usually, it comes the other way. Usually comes after the fact where people are saying, they’re finding out about it for another reason.

Cynthia Margiotta:

So what you’re saying really, I guess I can equate that to people who have not had glasses. And they get their very first pair of glasses. And they look out the car window. I’ve heard this story from lots of people. And they say oh my gosh. I can see the leaves on the trees.

Terri Cassidy:

Right. I’ve had that experience, yes.

Cynthia Margiotta:

Right. It’s a shock because an older driver thinks they’re being safe, being careful, but maybe they’re driving, maybe they’re weaving a little bit. Or they aren’t using their blinker in time. You know, a hundred things, right. So that’s what I can equate it to that might help listeners to hear gee yeah, I remember when I first got glasses.

Terri Cassidy:

Yeah, and that idea of oftentimes things change slowly so we don’t notice the change. Vision is a great example of that. Of your vision, and something we see a lot is trouble with contrast. So a lot of people maybe their night vision isn’t as good anymore, but they don’t notice it because they’ve just gotten used to it slowly over time. And that’s where I do feel an outside, objective opinion or evaluation can be really helpful.

Cynthia Margiotta:

Yes, that way we can’t blame the kids. We can’t blame the doctor. We can blame that lovely lady, Terri.

Terri Cassidy:

Yes! Absolutely.

Cynthia Margiotta:

It’s all her fault. OK. So driving concerns about an older family member have long been considered a family issue. Shouldn’t this topic just be addressed by family members?

Terri Cassidy:

Yeah, and that kind of gets back to the barriers question and I feel like that has in the past been a big, just part of our culture of, in a different time. Let’s say where people say “Oh, Mr. So and So is not safe behind the wheel. We know what his car looks like and we just try to avoid it” for example.

Cynthia Margiotta:

Yes, yes. I remember that person.

Terri Cassidy:

But our world has changed and sped up and there’s, there’s too many cars on the road to keep track of which ones to stay away from. And I think that, you know the research that’s been done in terms of focus groups, talking to older adults about who do you, who would you want to bring up problems with driving, or concerns that could potentially could affect your driving. The answer has tended to be spouse. Although for a certain percentage the answer is definitely not spouse, so that’s kind of a tricky one. The other person that ranks high is the doctor. So a lot of individuals feel like my doctor will tell me if I’m not safe enough to drive.

Cynthia Margiotta:

Whoa, yeah. Wait a minute.

Terri Cassidy:

It doesn’t necessarily happen that way.

Cynthia Margiotta:

Yeah.

Terri Cassidy:

But I think that’s a perception of, you know, they’re looking at my health. They’re going to look at these decisions with me. And that’s where, you know, a lot of my education is to the medical community. Say hey people are looking to you for making these decisions, here’s some suggestions on some ways that we can do this together.

Cynthia Margiotta:

How could a doctor do that? I don’t understand how they could. Seriously I don’t because I’m thinking of my doctor visits, um, my doctor doesn’t ask about my vision, doesn’t ask about my reflexes and maybe that’s down the road a little bit. Maybe they will, you know, but I have been with many, many people over the years in their doctor’s visits and I can’t recollect a single one doing an eye exam or even checking those kinds of questions.

Terri Cassidy:

Yeah, it’s really interesting because I think of like from my sphere of being in the medical world, we think of somebody’s had a stroke. It should be their doctor that talks to them about, finding out if they’re safe to drive before they go back to driving. So maybe the medical professional in the sense of an acute injury or illness, so this person had a fall, had an injury. But when you say it like you’re saying it, it does seem like a big leap to ask the doctors to then be talking about driving. And so I think there’s potential there. Like I think there’s definitely room for that discussion. And I have, even in town, spoken with some of the doctor’s offices who’ve said “oh, yeah, maybe that’s something we should add to our general questions.” You know with the Medicare health, the physical, yearly physical there’s questions about just about everything else. You know, in terms of emotional state, and alcohol use and all of these different things, but there isn’t something specific to driving. So I think it would be really interesting. There has been some research around primary care physicians and how they could be, just tapping in and asking some of these questions and mostly what they came down to was that it was too much to ask a doctor’s office to perform a screening or some kind of test related to driving. They really found though, just having the physician’s office ask the question: “How’s driving going for you?” Like just even that would be a huge improvement over what we have going on right now. And I love the idea of normalizing that conversation so that you’re asked that every year. And so you’re not defensive when somebody asks you. It’s just an honest conversation of I’ve started to notice that sometimes I think I’m pressing the break and I’m actually pressing the gas. And that can relate back to sensation and that could be something the doctor could help you manage.

Cynthia Margiotta:

Right, so it would lead into so much more information for the doctor. So what kind of solutions are there for someone who has an injury and is having trouble with driving?

Terri Cassidy:

So I mentioned some medical diagnosis. So I mentioned a stroke and for example there are a variety of things that a driving rehab specialist can do with a client to help them get back to driving after something like a stroke. Some of that is going to be in an OT clinic so that might be part of outpatient therapy before somebody comes to see me. Really focusing on reaction time and multitasking and some of these pieces, these higher judgement pieces that we use all the time when we drive and we don’t really think about it. To me the other answer that though has to do with adaptive equipment. So for example, if someone’s had a stroke, and they, let’s say they can’t use the left side of their body. They can still do gas and break with their right foot, but they usually would have done their turn signal with their left hand. So there’s some equipment we can put in the vehicle to make it safer for that person to steer with one hand, to access their turn signal and to keep their attention on the road through that whole time. Or another example would be somebody who has an amputation. We do training for use with hand controls, so you don’t need to use your feet at all for accessing gas and break and steering. So there are some really great ways to keep people driving safely even after there have been some injury or illness changes.

Cynthia Margiotta:

Yeah. Wonderful. And are those expensive? Are those expensive adaptive types of equipment?

Terri Cassidy:

You know, expensive is a good question because it’s all relative. So for someone to get equipment, you know, hand controls can be about $2000. There’s also training involved with that. Evaluation involved with that. That could be another thousand dollars. To me, when you’re looking at that amount versus not driving, you know, so I think the expensive part is hard to answer. It depends on everybody’s particular situation. Driving a vehicle, owning a vehicle is expensive. Paying for insurance is expensive, you know. So it’s...

Older adults have continued to receive much needed services and many new ones during COVID19, with the help of Area Agencies on Aging.  These agencies were started in the late 1960's as part of the Older Americans Act.  Over the years, thanks to advocacy, more funding has come available to add services like counseling, vision support and much more to a program that originally focused on food and transportation.  During COVID19, even more support has been provided by these agencies and their community partners.  Mr. Jody Barker, Director of the Pikes Peak Area Agency on Aging shares many of the ways this region stepped up.

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country.  We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado.  The Pikes Peak Area Agency on Aging is the producer.  Learn more at Pikes Peak Area Agency on Aging.  

Transcript:

Cynthia: This is Aging with Altitude, welcome to all. This podcast is brought to you by the Pikes Peak Area Council of Government's Agency on Aging. We strive to provide answers, assistance, and advocacy for our elders. Thank you for joining us today. Our topic today is COVID-19 Now. I am your host, Cynthia Margiotta, a geriatric social worker and volunteer with the Pikes Peak Area Council of Government's Area Agency on Aging. With me today is Jody Barker.  

Jody Barker: Thank you, Cynthia.  

Cynthia: Thank you for coming. A little bit about Jody... Jody is the director of the Pikes Peak Area Agency on Aging, which serves three counties: El Paso County, Park County, and Teller County in Colorado. He has served in many roles in his twenty-two-plus years in senior service organizations in Colorado. Among those roles have been editor of the Life After 50 newspaper, the director of operations for a home care agency, Central Colorado Regional Director of the Alzheimer's Association, and director of the Colorado Springs Senior Center. Jody's greatest joy is matching services with seniors and their families or enabling staff and services to do so. Jody has served on various boards and commissions over the years and currently is on the Colorado Commission on Aging, appointed by Governor Hickenlooper. I'm impressed!  

Jody Barker: Thank you, Cynthia.  

Cynthia: Well, thank you, Jody! I have known you through several of those organizations, all are so great.  

Q: So, let's get started with our first question about COVID if you don't mind? Jody, how are you at the Area Agency on Aging? How are you still meeting the needs of our community?  

Jody Barker:  

A: Well thank you, Cynthia, it is a pleasure to be with you today. When the governor's order began in early March, we knew that we would have to continue operating even if we had to close our doors. March 17th, St Patrick's Day, as a matter of fact, we packed up what we needed to serve our community. That included telephones and paperwork and our computers and we began to work remotely. So, even a sense March, even with our doors closed to the physical building, we are still 100% operational. We have even added services that I'd like to share with you later. The exciting thing is that our staff has taken this as a really exciting challenge. We continue to answer all phone calls, we're reaching out to our clients, we're reaching out to past clients, we are reaching out to our community to continue to serve them every day.  

Cynthia: It's amazing how much you're doing and I can't wait to talk about that. As the emergency orders have changed we are seeing changing guidelines. As of today which is June 3rd, 2020, in case you're listening to this a little bit further down the road, we are at the Safer at Home stage or in the Vast Great Outdoors.  

Q: What does that mean?  

Jody Barker:  

A: There's a lot of interesting thoughts around the changes in the orders that have been provided by Governor Polis. Originally, as you know, we were in a Stay-at-Home order. It was necessary for all involved to really flatten that curve. This way, we could really understand more about the disease and how it was affecting our community. Of course, because covid affects upper respiratory issues, it has been very challenging for older adults, especially those with underlying health conditions. The Stay-at-Home order was crucial, to begin with. As those in leadership, especially those in the healthcare field, began to understand more about the disease in early May they changed the order to Safer-at-Home. This allowed us to have a little more movement, like maybe going to the grocery stores or getting out and about to pick up a restaurant order instead of sitting in a restaurant to eat. That was was crucial.  

Now, with this most recent phase, The Vast Great Outdoors, it simply is an encouragement for people who are able to enjoy the outdoors. Here we are now, on the very front end of summer and this week has been more like summer than June! It feels more like July and August kind of weather. It is very hot! The great thing about this new phase is that it is an encouragement to people who are able to get out and go to their local parks with appropriate social distancing or maybe go for a walk in their neighborhood. There was concern earlier on about even just stepping outside your home. Now, people are encouraged to open those windows and get some fresh air and to lessen the social isolation that was so important early on. Now, we want to encourage people who can, to get out there. There are actually a couple of exciting changes with our providers who are helping to promote the new orders that we will touch on.  

Cynthia: It is so important to get some fresh air and to get a little exercise, even if it's just walking around the block to take take the dog for a walk. I mean, I have a neighbor who takes his wheelchair and he goes and walks his dog. I think it's important to do that!  

Jody Barker: Even in my neighborhood here in town when we are able to get out for a walk, we see so many people out walking their dogs or going to the park. It is people of all ages, you know? So it's really exciting to see people moving about! It's an interesting change from the last two months but when we think about what it truly means for older adults, it's crucial. This is because the older Americans Act, which is a major source of our funding to the AAA, was written in 1965 to reduce social isolation. That is the primary directive around our funding and our programming. Imagine what that's had to look like in the last two months with the Stay-at-Home and even the Safer-at-Home safer orders in place. People we have served in a variety of areas, whether that's senior center programs, transportation to doctor visits, transportations to church or classes at the Senior Center, lunches at the Senior Center, all of those had to change on a dime. All of that was intended to help protect the safety, health, and well-being of older adults, as well as the rest of the community. But, it's probably been most difficult on our older population because someone who lives at home, to begin with, and maybe looks forward to that three to five days lunchtime with their friends at the Senior Center, suddenly are being asked to stay at home. That can be extremely challenging to their health and mental well-being.  

Cynthia: Yeah, absolutely! We could talk about that for hours, gotta get out gotta be involved as much as a person is able.  

Jody Barker: Exactly! An interesting comment came to me a few weeks ago from one of our volunteers who said she was talking with some neighbors. One of her neighbors, who is an older adult, said, "you know, I feel useless because I'm used to volunteering and now, I'm not allowed to. I feel useless." And so, one of the things that our advisory committee is working on is actually not only volunteering for seniors but involving those seniors in that volunteer project. This is to give people a purpose and to give people activities and things to look forward to. I know what will touch on it here in a little bit, but there's so much going on to not just serve the seniors but incorporate the seniors into the process. We're all working on this together.  

Cynthia: In a sense, that's serving them.  

Jody Barker: Absolutely!  

Cynthia: You know you've known me for a while and I'm a big advocate of volunteerism. I think it's a very important part of being part of the community. I think, you know, if you can when you retire don't go sit on a chair! It drives me crazy! If you can, go out and volunteer. If you can't go anywhere, find a way to volunteer from home. People can write notes or they can make phone calls. I can talk about it for hours...  

Jody Barker: I think what we have to remember is that there are opportunities for outreach, not just to our older population but for those older adults to participate in that process. Maybe there's an assisted living or retirement community or a skilled nursing facility in your neighborhood. Call those places and say "I'd like to write someone a letter." You have no idea how much of a positive impact that person can make.  

Because maybe you live at home but you might have three or four rooms to move about in. But someone right now, during this time, who lives in assisted living or a skilled nursing facility is being asked to stay in their room. Their meals are delivered to them, their activities are brought to them in the hallway, and they are being asked not to leave their room due to social distancing.  

So even just taking the time to write a note to an older adult who lives in a community near you could make a world of difference. You don't have to ask permission, you don't have to be part of a larger group, to do that. You can pick up the phone, you can write that letter on your own, and it will be such a positive impact on the staff and on the residents.  

Cynthia: Just the thought of me being in a room for a month... I'm an extrovert and I would have no hair because I pulled it all out. I absolutely think those are wonderful things we can do. I mean, we can even write a note to our neighbor. It doesn't have to be an official volunteer program.  

Q: So tell me, what are some of the service delivery changes and supports that have been implemented that you have found interesting or effective or both?  

Jody Barker:  

A: That's a great question! As you might imagine, as we started hearing more about this virus and as it began to grow, even at the end of February, before we closed our physical building, before the Stay-at-Home orders came from the governor, some of our providers were already beginning to make plans and make changes to their service delivery. For example, one service provider who many of you will know is Silver Key Senior Services. They are the primary meal site provider for El Paso County. So, when you think of meal sites, you're thinking of Colorado Springs Senior Center, Fountain Valley Senior Center, and the Mountain Mennonite Church in Palmer Lake. Those places receive meals from Silver Key Senior Service's kitchens. They're hot and fresh meals that get delivered to people who come into a congregate site. These people meet up with their friends. They might come early for a class or stay late for a concert. That is their time to get together. As you might imagine, as soon as that Stay-at-Home order came into place in mid-March, that service had to stop.  

So, what did Silver Key do? Silver Key immediately implemented appropriate social distancing. They increased their home-delivered meals. They increased their pantry of delivered meals instead of people coming in via transportation on a Silver Key bus, going to the pantry to do their own shopping, and then get back on the bus to go home. Silver Key tried to reduce that contact in their pantry. The pantry is big until you start putting 15 people with shopping carts in there. You know, it can get very crowded. It is shoulder to shoulder sometimes. To avoid this, what they started doing is packing up those pantry boxes and delivering those to their regular pantry clients.  

That was one thing that they did, another thing that they did is they converted those congregate meal sites into what are called grab and go sites. For example, every Monday at the Colorado Springs Senior Center, the Silver Key Senior Services blue meal truck shows up. Instead of daily pickup, they prepare multiple meals and flash freeze them. This way, clients have all five meals for the week. Clients also have the opportunity to pick up fresh produce, dairy products, and things like that depending on what silver Key has on hand or what has been donated.  

The Senior Center, normally provides classes such as educational classes, moving for better balance, tai chi, and more. Those are the kind of programs that we fund with the Older Americans Act and Older Colorado Act dollars that we administer. For obvious reasons, they had to close as they were not allowed to do congregate-type programs like those physical classes. So what they did was they started making calls of reassurance. The YMCA and the Colorado Springs Senior Center host over 16,000 members who are over 60 years of age. So, staff and volunteers began picking up the phone and calling in to check on their constituents. In addition to this, they created what they call a phone buddy program. Silver Key would invite someone to the program and have that person tell a little bit about themselves. They would then collect a little bit of information from an older adult who is interested. They then paired volunteers with participating older adults. So, think of it almost like a pen pal program, but by phone. The Senior Center has begun to host those pairings of phone buddies. Instead of Senior Center staff making those calls out daily, weekly, twice a week, those phone buddies can now be a lifeline to one another. All they have to do is pick up the phone to check in with each other, talk about common interests, and that kind of thing.  

Silver Key is also providing some meals to people who do not have access to the Senior Center to pick up their own meals. They're delivering those meals on a case-by-case basis. The Fountain Valley Senior Center, as you know, is one of those congregate meal sites. They have now become and one of the Silver Key grab and go sites. Under the front of the building, they have set up a drive-through system. People line up in their cars and they can pick up the meal, they can pick up information, they can check-in and see how they're doing. One of the exciting things that I heard about, as it relates to Fountain Valley Senior Center, was that the city of Fountain did not layoff their staff, but sent a great many of them home to work remotely. This is because they did not have the same functions during that early stay-at-home process. Someone from the city government contacted the Fountain Valley Senior Center director, Jolene Hausman, and said what can we do? How can we help at this time? And they began with 20 city employees making those calls of reassurance. These employees were making over 100 calls a day. At first, it was only going to be a couple of weeks. Now, it is becoming an ongoing project because the seniors love it and staff from the city love it. Now, Jolene is talking about when things slow down, she would like to have a barbecue so the city employees can meet their phone buddy. The Senior Center is actually been talking about putting on something when it's safe to do so. So that those phone buddies can meet one another.  

It's just been really neat to see those programs, even some of the smaller programs like Teller County Senior Coalition, based out of Woodland Park. This group has provided fresh fruits, vegetables, and even restaurant meals to their clients. This way clients are getting choices and variety, not just the same box of food every week. There is just a lot of neat things going on.  

Unfortunately, some of our providers were limited. Providers who were contracted with us to provide certain services like transportation, suddenly found themselves not allowed to provide their service. So, they reached out in other ways like helping with telehealth or counseling services to make sure that people's needs are being met.  

The irony in all of this is that it's changing almost daily, and definitely weekly, as our providers determine what needs must be met. Providers are determining what the outreach needs to look like as they plan for the future. Right now, we don't know what congregate programs are going to look like for the next few months or the long term. However, I would encourage people to take a look at the Colorado Springs Senior Center website at epymcappymca.org.  

On the website, they can find the Colorado Springs Senior Center. They have already begun art classes using the online zoom system. So, zoom, if you're not familiar, is really more of a teleconferencing system where you can log in and see each other if you have a smartphone or a computer at home. Using the camera on your computer or smartphone, you can see one another and you can see your teacher. They began art classes using that online platform last week and they had something like 16 or 20 people from all over join that class. So, they are going to be doing a variety of both free and fee-based classes as they begin to look at what serving the community needs to look like with these new circumstances.  

Cynthia:  

Q: These are some mighty changes, yes?  

Jody Barker:  

A: Yes! These changes are distinctly different than what we traditionally thought of about senior services. I'm really excited that so many of our providers are looking at how they can continue to serve the needs of our community in a new way.  

We have about half a dozen services that we provide directly out of our offices by our staff. These services include family caregiver support services. We are also going to be doing our own support groups via zoom and by electronic media. The exciting thing about this is that it means we can provide services to those who are caring for older adult family members, spouse, or parent. Instead of just the caregiver coming to a support group, he or she can invite family members from across the nation to join the caregiver in that support group. We now have the electronic technology in place to be able to do that. So, real silver linings are coming out of the challenges that we've faced due to COVID-19.  

Cynthia: Yeah! You know national support groups would be an asset ongoing.  

Jody Barker: Absolutely!  

Cynthia:  

Q: I like that idea! Will there be issue-specific support groups, or will they be more generalized?  

Jody Barker:  

A: I believe they're going to start somewhat general to begin with, but there is discussion around some more specific topics. So, if someone has a specific challenge or need in a certain area that person will be able to sign up for that specific support group. To expand on that, you know the Colorado Chapter of the Alzheimer's Association is also doing something very similar. It may be nationwide, but they're beginning to do a lot more online support groups for that very reason. Again, it's one of those silver linings that has come out of the changes that we are having to make as we do our best to meet the needs of our constituents. Even though we can't be...

The resilient second-halfer through wisdom and personal stories is prepared and empowered for the second half of life.  Tom Rasmussen, Income Protection Specialist with Clear Solutions, shares his proven insights about how to thrive through life happenings.  This two part podcast explores first what makes a good life and second how to financially build resiliency.

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country.  We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado.  The Pikes Peak Area Agency on Aging is the producer.  Learn more at Pikes Peak Area Agency on Aging.

Transcript:

You're listening to Studio 809. This is what community sounds like. 

Cynthia Margiotta:  

This is Aging with Altitude, welcome to all! Brought to you by the Pikes Peak Area Council of Governments Area Agency on Aging. We strive to provide answers, assistance, and advocacy to our elders. Thank you for joining us today. Our topic today is Life Happens. What is your plan? I'm your host, Cynthia Margiotta, a geriatric social worker and volunteer with Pikes Peak Area Council of Governments Area Agency on Aging. With me today is Tom Rasmussen, Rasmussen, Rasmussen, I will never get your name right. He is an income protection specialist with Clear Solutions Insurance Services. Tom is an income protection and longevity health planning specialist advising on life, disability, extended care, and health care planning. Tom has helped thousands of people with income protection planning across the country. He was a national broker to hundreds of agents across the country, and as a received top awards for management and production. He's published articles for industry magazines and local papers as well been interviewed on radio several times now a podcast regarding senior issues and the importance of planning. He's a member of the nonprofit Long Term Care Forum Panel of Colorado, advising state legislators and industry experts on long term care planning issues in the state of Colorado. He holds the designation of CLTC, which classifies him as a certified long term care specialist. Tom is currently doing educational workshops and seminars on income protection throughout Colorado. He's the co-host of the streaming TV show New Horizons, Living Life to the Fullest, which illustrates how resilient and empowering the second half of life can be. Tom contributed to Kevin Gussman's Amazon bestseller Retire with Freedom and Confidence, and released his own book called Are you Protecting your Greatest Asset in December of 2018? You've done a lot, haven't you? 

Tom Rasmussen: 

Well, I like to keep busy. 

Cynthia Margiotta: 

Yes! 

Tom Rasmussen: 

Don't we all? 

Cynthia Margiotta: 

Don't we all? Yes. So let's get started with some of our questions. First off, what is meant by "second halfers"? 

Tom Rasmussen: 

Well, that's a great question, and appreciate you allow me to be on the show here. So, "second halfers"...you know, there's a term that has been used for a number of years called seniors. And I've never liked that labeling, because it identifies that certain segment of society as being maybe has no value. I mean, that, you know, we're in a society that let's face it, our particular culture doesn't really cherish seniors. And I decided to coin a new phrase of " second halfers", because it doesn't identify somebody by what you would consider their age. And so, if I said senior to somebody, what age do you define that by? Sixty-five or older would generally be the response? If I say "second halfer"? You mean 45, 48? Sure, why not? It just it's a way to break down this the perceptions of society that you know, seniors are not ready to put out to pasture. 

Cynthia Margiotta:  

Alright, I like your term, by the way, I think it's a really useful thing. I think we should switch it up a little, huh? You did something like that. So what is resiliency? 

Tom Rasmussen: 

Resiliency is an interesting word because when I do workshops, I always ask the audience, are they resilient? And it's interesting, the puzzled look you get from people. And so I have to go a little bit further and I ask, have you ever made it through a challenge, whatever that challenge may be? Oh, yeah, yeah, for sure I have. Well, the dictionary defines resiliency as recovering strength and I always have to point out that resiliency is achieved by pushing through a challenging situation. So, resiliency is something that we probably have all experienced in our lives. But I don't know if we have identify it as such, when we actually achieve it. 

Cynthia Margiotta: 

Yeah, well, it's hard to be resilient. I think that that's a good term to use. I don't think that's used very often in our society. 

Tom Rasmussen: 

Well, for resiliency was easy than everybody be doing it.  

Cynthia Margiotta: 

I mean, it's not used that word, you know, either you did it or you didn't do it. Not that you became more resilient in and learned from it. 

Tom Rasmussen: 

Well, it's words are powerful. And I tried to take a very strong look at the words I use to identify either meanings beyond what people perceive certain things to be, or change the perception of what people think, like seniors to "second halfers". 

Cynthia Margiotta: 

So, what is empowerment?  

Tom Rasmussen: 

Well, I use those two words together, because sometimes people identify them as being the same thing. And they're really not, you know, where I stated the dictionary basically defines resiliency as recovering strength. Empowerment is defined as to give power to. So even though they're not the same thing, they're very much connected. Because when somebody pushes through a challenging situation, and is resilient, by doing so they empower themselves. And so that's where the connection comes from. And so that's why I like to use those two words. Because it really came about when I was writing my book, it dawned on me after I was about three quarters away of writing it that after thirty some odd years of doing what I do, nobody actually looked at putting a planning strategy together as empowerment. And I had to ask myself, and other people as well, why do we not think of that as empowerment? And so we had to define what was empowerment? Well, empowerment is anything that gives you the ability to be resilient. And so empowerment, on one hand, can come from resiliency or you can empower yourself to provide you more resiliency. 

Cynthia Margiotta: 

So they are wrapped up in each other very strongly. And they, like a circle, they come and they go. The circle can go clockwise, as well as counterclockwise. 

Tom Rasmussen: 

I mean, from the standpoint of putting together strategies that help what I call "life happens events", what's more empowering, to have a funding plan in place to help you push through those "life happens events", like a disability, an extended care situation, and unexpected death. You know, that should be a more prideful ability to say, look what I did, then to push it away, don't talk about it, and then not have it at all, and then have those things come into your life. And then is that the thing that could have created the resiliency to get through that? And because of that you didn't you achieve resiliency? 

Cynthia Margiotta: 

Hey, smart to be prepared? 

Tom Rasmussen: 

Well, we'd like to think so. Yeah, I wish everybody would take that a little more seriously.  

Cynthia Margiotta: 

So they definitely relate to each other. Absolutely. Yes. So what does this have to do with the second half of life then? 

Tom Rasmussen: 

Well, with having thirty-plus years, working with, you know, the "second halfers" that I have, there's things that we have to understand that as we go through our seasoned years, so to speak. Then, can we better position ourselves back to the preparedness and planning to be able to be more empowered to get every moment to its fullest capacity? You know, that's that's how it relates. I mean, there's several different things that I always attribute to when I give workshops and seminars and regards to how do you achieve empowerment and resiliency. And there's four things that I always talk about. So it's decluttering, telling your story, doing the paperwork, and have a funding plan. 

Cynthia Margiotta: 

Is that are part two? Is that the question for our part two? I don't want to ask that yet. So don't let don't get there yet. Oh, good. What are some of the things one can do to bring about resiliency, and empowerment to the second half of their lives? 

Tom Rasmussen: 

Well, like I mentioned decluttering, let's talk about that. So decluttering is a very interesting thing because who we as maybe a human nature, we like to keep things, collect things, gather things, for whatever reason. And I don't know about you, but through my life when I've had either four situations or by design, or I decluttered my life, it was very freeing. I use an expression many times that, do we own things or do things own us, you know, the more things we have, it takes a lot more of our time to maintain those things, whether it's time or financially contributed to the maintaining those things. So decluttering is one of those things that as we go into our second half of life, the more we declutter, it's two things, it's less for us to worry about as we get closer to our end result, which let's face it, we're all gonna pass away someday. And it doesn't leave that burden to our loved ones, to figure out what the heck they do with all your stuff. And a lot of times, we have this assumption that they want our stuff. And if we don't have that dialogue, we don't know if they want it or not. And so I've always said this, the decluttering can take away from the experience of embracing the whole passing of a loved one, because they can't fully be in that embracing of that passing and that cycle of life because they're stressed out about what to do with the stuff. 

Cynthia Margiotta: 

Stuff is a pain in the back! 

Tom Rasmussen: 

And declutter, it's part physical, material. But it's also emotional. 

Cynthia Margiotta: 

Okay. Okay. 

Tom Rasmussen: 

Have we decluttered the emotional regrets that we might have, because of relationships because of things that were said one way or the other? You know, that's part of decluttering, too. 

Cynthia Margiotta: 

It's important to do that maybe, for our mental health. You make me think, Tom, 

Tom Rasmussen: 

I've always said that. If we know, the two certainties in life, that we're going to age and we're going to pass away someday. Then, if we can, as mentally as we can think through this, especially as we come being in our second half of life, as opposed to doing how do we define a good life lived? Is that how much stuff we have? Or how many moments and impactful events that we had with other people as well as to ourselves? 

Cynthia Margiotta: 

For me, I'd say it'd be the people. Think of how many people have been positively affected by my life? 

Tom Rasmussen: 

Well, if we don't actually ask that question of ourselves, how do we ever know what that means to us personally, before we can go forward, and have that good life left. 

Cynthia Margiotta:  

Right. Good questions. You're throwing questions back at me, Tom. I'm supposed to be interviewing you! 

Tom Rasmussen: 

Yeah. Okay.  

Cynthia Margiotta: 

So how does telling your story bring about empowerment?  

Tom Rasmussen: 

Well, I've found that we're not capturing our life stories, as much as we probably should. And I'll give them my own personal story with that. My mother did a lot of genealogy had many different records, and she had boxes and boxes of photographs when she passed. Well, I inherited those. But what I didn't realize is none of those photographs had any information on them. So I had no idea who these people were. And so it got me to think that if we're able to pass on the wisdom that we have learned in our second half a life, how can we pass that on, if we don't record it in some nature, whether it's written, whether it's video, whether it's just, you know, audio? If we don't tell our story, it's lost when we're gone. And even to our own children, because our own children only know us from the time that birth was given to them going forward. They've really don't know who we were prior to that unless we had those conversations. If they don't know it, how can they pass it on to our grandkids and great grandkids? 

Cynthia Margiotta: 

Right. Information is important to share within families. Yeah, my mother had, I ended up with all her photos, and everything had initials, which is better than you got, I will say. But, you know, one of those many pictures was marked CJ. And it was lots of pictures of CJ. Who's CJ? Well, CJ was my mother, Claudia Jones. 

Tom Rasmussen: 

Oh! 

Cynthia Margiotta: 

When she married my father, she became Claudia Cleaver. So who was CJ? So those pictures, you know? It took a little, I guess, hard guesswork to figure out that those younger pictures have that 10-to 15-year-old were actually my mom. 

Tom Rasmussen: 

You know, it's not only telling our story so we don't lose ourselves once we're gone, and that can be passed on to generations and generations. But there's a real important thing that has to be, I'd say it has to be earned. I don't know if everybody agrees with that. It's called wisdom. Are we passing wisdom on to our generations that will precede us? Because if we can help them understand, as they get to a point where they can learn, maybe they don't have to go through those failures and mistakes to learn that wisdom. If we can pass it on, prior to them having to learn that on their own. 

Cynthia Margiotta: 

But, the young people don't want to hear mom and dad's wisdoms. 

Tom Rasmussen: 

You know, it's funny. Maybe you had the same scenario that I did. But I've heard this from people and I and I have actually experienced this. It's amazing how smart my parents became the older that I got. 

Cynthia Margiotta: 

Right? Yeah, my mom suddenly got a brain. And I was like, wow, who knew? 

Tom Rasmussen: 

You know, they couldn't turn on the TV but boy, we can't mistake wisdom for, I guess, intellect. You know, there's a lot of smart people that I've met through my life, but I wouldn't say that we're really wise. So there's a difference between intellect and wisdom, wisdom is learned. And life will continue to give us these lessons to learn the you know, and if we don't, we'll repeat them. But the only way that we gain wisdom is acknowledging how we get past that lesson, resiliency. Empowerment comes from the knowledge of understanding of I shouldn't do that again. 

Cynthia Margiotta: 

Learn from my past mistakes. What is that saying? You know, something about doing it over and over again? 

Tom Rasmussen: 

Einstein said the definition of insanity is doing the same thing over and over again, expecting a different result. 

Cynthia Margiotta: 

There you go. That's the exact saying! It was Einstein, huh? Yeah, he should be my hero. So how does doing the paperwork bring about empowerment? 

Tom Rasmussen: 

Well, that kind of goes back to the decluttering. If we've decluttered the things in our lives and we've told our story, then we have the documents in place to help our loved ones know what to do with our passing. Or, if we just become incapacitated or incompetent. You know, they have to step in and take over our lives. How do they know what to do? Do they know who to contact, you know, so advanced directives, a will, or a trust, who is my insurance agent, my banker, my attorney? If we don't put this in some form of writing, whoever is supposed to fill in for us can go to and have those contacts, as well as have the authorization through, you know, the proper forms, to be able to make those decisions like the power of attorneys and, and those kinds of things. Then again, we're putting that burden and that stress on our loved ones when it wasn't necessary because we didn't want to get around to that.  

Cynthia Margiotta: 

I think it's so important to do that. Get those papers in order, have them all, you know, somewhere. Tell the people that are involved in those papers where they are and how to get to them. You want your power of attorney to know what's going on, what your expectations are, what your needs are, what your wishes are. And if you don't do that, they're lost. 

Tom Rasmussen: 

Even getting down to the details of who you want to step in for your financial matters, that might not be the same person you want to step in for your health issues. You might want to separate those two.  

Cynthia Margiotta: 

I think that's brilliant, separate them. In most cases, it's very important. When I became my mother's medical power of attorney was very good. I did not want her financial powers of attorney. And so my sister kept those and she was in charge of the money. And I was in charge or, no offense, but in charge of the body. And I think it worked out well for us in our family. But what if you only have one kid, you know? 

Tom Rasmussen: 

There are other ways to have, you know, people that can fill in those roles, like fiduciaries. You know, there's there's different ways that you can have people fulfill those roles.  I hate to say it, but I've seen situations where the individual who had the purse strings was also making the medical recommendations. And because they knew if they spent money on the medical, that they would reduce their inheritance. So that played a role in their decision making. 

Cynthia Margiotta: 

Right? And that's where some of the problems start, right? You know, between the two people. Then when you're only at one, okay, so you have you just shared the one if one person's in charge of both. If you have two people, you can sometimes have the problem. It's sort of the opposite where the medical wants to do one thing like, oh, let's say mom needs a new hip, we got to get her a new hip, we've got to pay for that. Let's do that. And then the financial power of attorney says, "no, I don't want to spend that money". 

Tom Rasmussen: 

That's not what that's about. It's putting...

Talking about death doesn't make it happen, yet so many of us are afraid that this will be the case.  Join MSW, Kent Mathews, as he discusses the differences in palliative care, hospice, what Medicare may pay for and how families can ask for help.

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country. We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado. The Pikes Peak Area Agency on Aging is the producer. Learn more at Pikes Peak Area Agency on Aging.

Transcript:

You’re listening to studio 809. This is what community sounds like.

Hi, this is Dave Gardner. I just want to make sure you know that during these unusual times peakradar.com/virtual brings local arts and entertainment right into your home. From local music to gallery tours to classes in dance, yoga, writing, and more. Our community is still creative and invites you to join in at peakradar.com/virtual

Michaela Nichols:

Hello and thank you for listening to Aging with Altitude, a podcast series elevating the issues that matter. This series is produced by the Pikes Peak Area Council of Governments Area Agency on Aging. Today’s episode is about end of life issues. My name is Michaels Nichols and I’m here with Kent Mathews. Kent is a care manager in the Family Caregiver Support Center at the Pikes Peak Area Agency on Aging. He has over 27 years of experience as a social worker and has worked in hospice care as well. End of life issues can often be hard to talk about. Many people hope that they will be able to make their own decisions or that a loved one will be able to make their own decisions toward the end of their life, but in many cases they lose that ability so being unprepared can put loved ones in uncomfortable positions. So can you talk a little bit about what barriers individuals experience when beginning to make end of life plans?

Kent Mathews:

The most common barrier I hear coming from caregivers when I was doing hospice work coming from even hospice patients was when it comes to like the advanced directives, they would say well I’ll execute them. I’ll fill them out when I need them not knowing that they probably wouldn’t be able to execute them when they needed them because they would be like in a physical state where they were unresponsive, couldn’t speak or something like that where they wouldn’t be able to even begin to fill out those documents. So I think that’s one barrier. Another one is we don’t like to think about our end of life. We don’t like to think about our deaths, and we live in a very death aversive society. Generations ago when we were still a very rural society and weren’t as urbanized as we are now, and still a lot of people living on the farms or out in nature and what not, we were still very much in touch with the cycle of creation. Earth, life, death. All of that. And now, we’re really, really removed from that. And so that’s a huge barrier as well. I think another barrier that comes to mind is, people don’t have an easy place to go to get good information about what’s really going on with their physical condition. I recently ran across a statistic that said that if asked to do a treatment and a doctor knew that the treatment wouldn’t do any good for you, 40% of doctors still said they would recommend the treatment, which is in my estimation is just rather appalling that they would even do that. So a lot of times people rely on their doctors to give them that information to tell them what’s really going on, but most doctors aren’t equipped to do that. They don’t have the skills to do that. They may have the knowledge, but they don’t know how to communicate that in a way that is comfortable for them and therefore makes their patients comfortable. Everybody’s kind of walking around in the dark. You know, the medicines that we take, a lot of the medicines for chronic illnesses cover up the symptoms which then creates the illusion that I’m not as sick as I really am, which is another barrier. Why would I want to execute that because I feel fine? I may be taking 8 to 15 different medications, but I’m not going to die so why would I want to execute those things. So those are some of the barriers that I’ve been encountering in my career.

Michaela Nichols:

In the confusion around what end of life care is, can you talk about the differences between nonmedical and medical decisions that they need to think about?

Kent Mathews:

So I get phone calls from caregivers and they’re wanting to know where they can go to hire a nurse. And then talking with them on the phone, they’re looking for somebody to come out to the house to help mom or dad or a family member with like maybe bathing or dressing, and maybe making sure that they are taking their medications. You really don’t need a nurse to do that. In the home care industry, there are different levels of skill that a home care worker has. In Colorado when they required home care agencies to be licensed, they established a two-tier system. There is a class A and a class B license. The class B license is the nonmedical. The class A license is the medical or what’s often called the skilled. The two differences between those two licenses, there’s a number of them, but the major difference is the A license, or the skilled license, is that home care agency has what is known in the healthcare world as skilled positions, so you have the nurse. An RN, an LPN,  maybe a NP. You also have skilled positions like the therapist, the occupational therapist, the speech therapist, the physical therapist or what’s called the OT/STs. Those are all skilled positions. CNA’s are considered a skilled, semi-skilled position. And the class A’s have CNAs. The class B’s have what are called personal care workers and homemaker companions. When you’re looking at home care agencies, and you’re looking for what kind of care, if you’re needing somebody to come out and help mom or dad with maybe some light housekeeping or some bathing and dressing kind of a thing, you don’t need a nurse to do that. You don’t even need a CNA. You could use like maybe a homemaker companion who could do the light housekeeping, the light meal preparation. If you wanted them to help with bathing and dressing, you’d have to have like a personal care worker because that person then can legally touch your family member and provide that hands on, physical care. And going back through all those levels, the least amount that you’re going to pay per hour is a homemaker companion. In the Colorado Springs area, that’s probably running $18/$19 an hour right now. Then the next higher level would be like a personal care worker. That’s going to run in the low $20 per hour. Then you’re going to CNAs. That’s going to run in the mid to upper 20’s. And then when you get to like a registered nurse, you’re looking at $30 or more per hour kind of a thing. So to pay, you can choose between somebody that has the same skills a personal care worker who you could pay maybe around middle 20’s or so or an RN, you’re paying 30 or higher. You’re saving money to go with a personal care worker. And so that’s some of the difference between medical and nonmedical.

Michaela Nichols:

What are some misconceptions around these different types of decisions that people have to make?

Kent Mathews:

I’ll go into like, because I did 15 years of hospice social work. Some misconceptions, one of the huge misconceptions about hospice care is you have to be bed-bound. Now there is nothing in the rules or regs by Medicare which licenses and oversees the hospices. There’s nothing in the Medicare rules and regs that say you have to be bed-bound. But most people have that misconception that if my family member is up and walking around and able to do stuff, then they’re not sick enough to be on hospice care. And in reality, what qualifies a person for hospice care is not what they’re doing or not doing. It’s do they meet the specific medical criteria for a specific condition or disease to qualify. And oftentimes people can meet those conditions and still qualify for hospice care, but be able to do a lot of taking care of themselves. I had hospice patients in my career that were going on two-week cruises and going on vacations to Disney Land and Disney World or Las Vegas or travelling eight or nine hours across country to go visit family members for 7 or 5-8 days and they were the ones doing the driving, but they were still on hospice care. So it’s not qualifying for hospice care is not about what you can or cannot do. It’s about do you meet the medical criteria. Another misconception is people think that their doctor has to say that they’re ready for hospice care. I teach a concept called hospice 101 and basically after listening to a caregiver tell me what’s going on with their family member physically, what kind of chronic illnesses they have, often times I will say so have you thought about hospice care and they will say my doctor hasn’t said that dad’s ready for it. Most doctors, unless they have done time as a hospice medical director, do not know all of the specific medical criteria that go into qualifying a person for hospice care. And doctors like all of the social workers, healthcare professionals, even people on the street, we all have our misconceptions, misunderstandings about hospice care. So if doctors have those misunderstandings and misconceptions, they may not be willing to recommend somebody for hospice care. Years ago when I was in Arizona, I was working for a hospice who also had a homecare and the hospice was having difficulty getting people from their homecare over to the hospice side for a lot of different reasons. Some of them for the misconceptions we’ve talked about. I remember this one daughter was taking care of mom. First time I went out to visit her as the home care social worker, mom was living in her own apartment and mom had cancer. We talked about everything, and mom said I’m not ready for hospice care. I’m still doing treatment. I said that’s ok. And then, oh I don’t know, maybe three, four months later I was asked to go back out again as home health and this time mom had moved into daughter’s house. Daughter greeted me at the door and when we were walking down the hall we walked by mom’s room and mom was laying in bed. Her bed was elevated at a 45 degree angle and mom’s jaw was relaxed so it was dropped. Her mouth was open, her eyes were rolled back in her head and she was doing what we call chain breathing, so really rapid and in succession. So when I sat down with the daughter I said I think your mom is starting to enter what we call in hospice the active dying process. So before I could stop her, daughter picked up the phone and called the oncologist and the oncologist was screaming at the daughter and demanded who told her that mom was dying and she said well I have a hospice social worker in here and he said put him on the phone. I held the phone about two feet away from my ear and I heard the oncologist perfectly because he was yelling that loud into the phone and he was accusing me of practicing medicine. He was saying how did I know she was dying. Only doctors knew that kind of stuff. And he said if she stops her treatment now she is going to die because she needs to finish her chemo treatments in order to stay alive and all of that kind of stuff. I hung up the phone and had a conversation with the daughter. We figured out a way to go to another doctor to get an order, which then allowed our hospice to send out one of the hospice nurses to do the evaluation. Long story short, mom died the next day. We got her into hospice care that night. She died the next day. Sometimes, all of us have our misconceptions and this oncologist evidently had his own misconceptions about what hospice was. I’m not even going to speculate what those were, but that happened over 20 years ago and I still have a vivid memory of it. So when it comes to this whole end of life issue, because we have a lot of barriers, we also, and because we’re not talking about it anymore. It’s not an easy conversation. When I talk to caregivers, sometimes they talk about well, you know. I’m thinking dad’s really sicker than he really is and then they begin to apologize because they think that by talking about death, and that’s another misconception. If you talk about death, it’s going to happen. We can talk about death all we want, but that doesn’t mean it’s going to happen. But that’s how deep our fears go as human beings when it comes to death and dying is we believe that when we invite it in, it’s going to kill us.

Michaela Nichols:

That’s a really powerful story. And it shows that people rely on their doctors as well and they’re not always the specialist in end of life issues.

Kent Mathews:

Right.

Michaela Nichols:

So I guess, along the line of medical care, and you were talking about hospice care. Can you talk a little bit about the different between palliative care and hospice care?

Kent Mathews:

1. So I’m going to try to give as good of a verbal picture about this as possible. The picture is, draw a circle about the size of a quarter and then draw another circle that’s about the size of a small plastic lid on a container. And that small circle, the size of a quarter, needs to be inside that larger circle. And so you’ve got a small circle inside a big circle. So palliative care is the big circle. Hospice care is the small circle. So with that said, all hospice care is palliative care, but not all palliative care is hospice care. And there’s differences. The biggest difference between palliative care and hospice care is on palliative care you can continue treatment for whatever your hospice diagnosis may be. So let’s say it’s chronic obstructive pulmonary disease or COPD which means your lungs aren’t working well and it’s difficult to breath and it’s going to lead to your death. And so, if you’re on palliative care any treatment that you were doing for the COPD you can continue. On hospice care, any treatment that was “to cure the COPD” you can’t do. I think a better example than COPD would be like cancer. So on palliative care you can continue to get your oncology, your radiation for the cancer. When you’re on hospice care you cannot do the oncology. You cannot do the radiation. You have to stop those. So that’s the biggest difference. Another difference between palliative care and hospice care is the support level. When people are in hospice care the support they get is really well defined because Medicare pays for the hospice care and Medicare says that hospice care is provided by a team, and the team consists of a registered nurse, a CNA, a social worker, a chaplain and a volunteer. Medicare says in those policies that the only person that the hospice patient has to see is the nurse and the nurse has to visit them at least once every two weeks. Most people when they’re on hospice care take the full team. The nurse, the CNA, the social worker, the chaplain, and they even ask for a volunteer. On palliative care, it’s not as well regulated because I’ve had conversations with professionals in the community who are involved with the palliative care programs and the palliative care program is struggling to figure out a way to properly bill Medicare. Under hospice care there is very specific billing codes you use. Under palliative care there’s not. So you can get reimbursed by Medicare for palliative care, but it’s not easy to do as a provider. The other is because it’s not regulated by Medicare like hospice care is, you can have a palliative care program where it consists of a registered nurse or a nurse practitioner going out and visiting the patient once every three or four weeks to check on things like their pain level or their medications and maybe make some adjustments in the medications or what not, but that’s it. Nursing visit once every three or four weeks kind of a thing. There are some palliative care programs where they will allow a CNA to go out to help with maybe some of the physical care. I know of maybe one, possibly two palliative care programs in our community where they offer the full team. A nurse, a CNA, they’ll maybe pull the social worker from maybe the hospice side kind of a thing. A chaplain would be from the hospice side kind of a thing. No volunteer, but those four people to go out and support the person while they’re on palliative care. To be really honest, those programs that are doing that are really losing money off of the palliative care because Medicare doesn’t reimburse well for palliative care. I’ve had conversations with professionals in the community that have said, I have said until Medicare decides to license and regulate and oversee palliative care like they do hospice care, palliative care is not ever really going to catch on and take off because hospice care was suffering from the same thing back in the early 70’s and what not when hospice care came over. All of the organizations that were doing hospice care were non-profits and the professionals were volunteering their time or if it was a very organized non-profit they’d raise the money so they could at least pay the nurses and maybe the doctors, but the rest of the team were volunteers. And it wasn’t until Medicare came up with the hospice Medicare benefit which is under Medicare Part A, that hospice really began to take off and flourish. My point is, the same is going to happen with palliative care. It’s going to struggle, but when Medicare decides to regulate it and license it like they have hospice care, it’s going to take off. But those are some of the major differences. You can be on palliative care, but not on hospice care. You can be on hospice care, but that also means you’re getting palliative care and there’s restrictions either way. The other similarities between hospice and palliative care is it’s provided wherever you are at. So if you’re in a home, if you’re in a care facility, assisted living or nursing facility, palliative care can go there. Hospice care can go there. When I was doing hospice work in Arizona, I had one patient who the hospice care started. He was living under a bridge and then the other hospice patient that I remember, he was living in three large cardboard boxes in the middle of the dry riverbed of the Salt River. But hospice care, that’s another misconception. People often think that hospice care is a place. It’s not. It’s a type of care and hospice care will go wherever you are at.

Michaela Nichols:

End of life issues are so hard to talk about and America has a fear of talking about death. How would you recommend someone going about talking about it for themselves, talking to their children or loved ones or for a child talking to their parent about what they want?

Kent Mathews:

So I’ll start with the easy one first. So an adult child talking to their parent about what they want. The adult child needs to be thinking about what they know mom and dad have said to them. So why is the adult child coming over to take care of them? It’s because mom and dad want to stay in their home for as long as possible. OK, What mom and dad don’t understand is that they have to put some certain things into place to absolutely guarantee that. So a good starting point would be to say, dad I know that you really want to stay in the house and I’ve been coming over to help you stay in the house, but to really guarantee that you stay here until you die, which is what you told me, we

Go vote!  Shelly Roehrs, President with the Pikes Peak Region League of Women Voters reminds us the deadline to postmark a ballot is coming.  If you mail it in, it must be postmarked 8-10 days before November 3.  Yet, ballots can be dropped off at drop-box locations anytime up to 7:00 PM on voting day and of course you can vote in person.   Find drop-box locations at govotecolorado.gov.

The League has been an active, non-partisan voice encouraging voter engagement and understanding of issues since 1937.  Visit 411.org to review summaries submitted by candidates and issue sponsors.

Visit the local League at lwvppr.org for more information.  Additional ballot issues are discussed at the League podcast at lwvppr.org.

Transcript:

Cynthia: Hello everyone, this is Cynthia Margiotta with the Area Council of Government's Area Agency on Aging, volunteering some time to do an interview with Shelley Roerhrs. She is with the League of Women Voters of the Pikes Peak region and their mission is to empower voters and defending democracy, thank you. The League of Women Voters has fought since 1920 to improve our systems of government and impact public policy through citizen education and advocacy. The League is a nonpartisan and grassroots organization. The League of Women Voters from the Pikes Peak area region has been active since 1937. Members actively promote voter and civic education by registering voters in high schools and nationalization ceremonies, attend city and council government meetings, present the pros and cons of the issues of our elections, and much more. The League of Women Voters has two separate and distinct roles: better service and citizen education and action advocacy.  

What this means to you guys who are listening, is the league's mission is to inform voters about the issues and candidates on our ballots. Candidates and issue organizations fill out information provided to them in an online voter guide and voters can visit vote411.org for this convenient information. The League also encourages active participation, whether it's in the office of an elected representative, City Council meetings, writing a letter to the editor, or at rallies. The program also empowers voters by emphasizing the power of the voter and promotes voting in every election: presidential, gubernatorial, municipal, primaries, and special elections.  

Wow, you guys do a lot!  

Shelley Roerhrs: We do, we do. We keep pretty busy, especially in a presidential year.  

Cynthia: I bet you do! Now, it's like every commercial out there is about elections.  

Shelley Roerhrs: It is, it is. We try to strive like you mentioned the presidential, gubernatorial, and municipal, we want you to vote in every election. We don't care who you vote for, we are a very nonpartisan group. But again, it doesn't matter who you vote for! For us, as long as you vote in every election, that includes your primaries, municipal elections, and special elections as well.  

Cynthia: Yes, I agree with you it's important to vote. We are leaving ourselves out of the discussion if we don't vote.  

Shelley Roerhrs: Yes, ma’am.  

Cynthia: Let's get to our first question!  

Q: We are a mail-in-ballot state. Is there a lot of voter fraud in a mail-in-ballot state? Will my vote be counted?  

Shelley Roerhrs: So, yes, 100%! Mail-in-ballots are safe. The unique thing about Colorado is that we've been a mail-in-ballot state for quite a while. They are pretty much the grade A of how other states basically relate to and say "this is what we want to do in compared to Colorado." So, you know, there are no issues with mailing in your ballot, as long as you mail it in on time. We'll get to kind of some dates later on as far as when you're supposed to mail it in. But yes, mailing your ballot or you know, what's even more convenient is if you don't want to Mail it in, the El Paso County has all of those drop boxes. So, they are located all over the city and the county. Just go to one of those drop boxes and drop off your ballot if you don't feel like mailing it in. Again, so another convenient way the drop-off box.  

Cynthia:  

Q: Where do the drop-off boxes tend to be?  

Shelley Roerhrs: I think like there sixty-something boxes across the county. I know there's one on that, of course, the El Paso County Clerk and Recorder on Garden of the Gods typically have them. DMV places typically have them. Community centers, like your Municipal Court, have them. City locations, anywhere a lot of people congregate, that is a government facility, are typically where they're going to have one of those drop boxes. I know there's one down at the courthouse downtown as well.  

Cynthia: Yes, that's typically where we drop ours off.  

Q: Do you have a calendar of important upcoming dates? 

Shelley Roerhrs: Well, I want to go back to when you said is there a lot of voter fraud. I want to solve voter fraud because you see a lot of that coming from our leaders who say mail-in ballots are not safe. I think just a couple weeks ago there was a time when our president was actually telling people to vote twice. That's actually not a good thing, right? We don't encourage that. It's actually a felony in some states to vote twice. So from a voter fraud perspective, this is from Chuck Broerman, we have our own podcast called "Making Democracy Work" and we interviewed Chuck Broerman for this specific reason regarding voter fraud. Because, honestly, my dad thinks that mail-in-ballots are rot with fraud. Now, he comes from a state that does not have mail-in-ballots, so we try to educate him. Again, one of those things that the League of Women Voters does is try to educate voters. In my case, I'm trying to educate my father as a voter. Your mail-in-ballot, if you do choose to mail it in, is safe. It is not going to be manipulated. It will count. The great thing, again M. Broerman, the Clark County Recorder you know? They have specifically designed our ballots so they have a special barcode on special weighted paper that they know exactly when they come in. That might be a fraudulent ballot and the number of fraudulent ballots that actually come in is very, very minuscule. I think it's a matter of the ones, that he said that came in, and someone voted twice. And again, it was very small. So the thought that we need to spend money on trying to fight voter fraud is, I think, somewhat comical actually. You know, if some people think that there's voter fraud out there I would encourage them to actually talk to their Clerk and Recorder. The Clerk and Recorder is the person who deals with your voter registration in your elections. They know exactly what is going on. Just don't believe everything that you see on T.V. or look at in the paper. It's not necessarily the truth. But your last question was; will your vote be counted? I think yes, as long as you vote. That's the most important thing, right? The most important thing is that you vote and yes, it will be counted.  

Cynthia: They have a specific weight, you know? I don't know how anyone would mimic that so well.  

Shelley Roerhrs: There are some smart people out there, but again, I think that they're doing things in other ways to manipulate our elections rather than this voter fraud that we're focusing on. I think, for your listeners, yes drop it off if you feel that the mail-in- ballot is rot with fraud. Mail it in or go ahead and drop it off in one of those drop boxes knowing that that goes directly to the Clerk and Recorder's office. There's no in-between man and the post office is not in there. But, again, mail-in-ballots are safe. Here's the thing, the military people didn't have a choice, right? Overseas, people don't have the choice to mail it in. You know, they have to mail-it-in.  

Cynthia: Right!  

Shelley Roerhrs: Your other question was about important upcoming dates. I'll just kind of move into your other question! Military and overseas voters, they have already started mailing those ballots. So they are arriving in the next couple of days if you haven't already received them. So, those specifically were already mailed in. Our ballots, for everybody else, will be mailed out on October 9th.  

Cynthia: Okay, good!  

Shelley Roerhrs: So that's when we should be looking for them in the mail.  

Cynthia: That gives us plenty of time to do our individual research to see, you know, who do we want to vote for? I like that you guys are nonpartisan, that's an important part of who you are because you're not trying to convince people to vote one way or the other.  

Shelley Roerhrs: For candidates, I will say that. I'm going to preface that a little bit because we are going to get into some ballot issues, right? We do not specifically tell you who to vote for, especially candidates as a League of Women Voters. You know, that's not our job. There are certain ballot issues that we do take a stance on, just because it goes with our advocacy. Whether that's the park's air quality or the water, right? Those are big, important issues of the league and for us. We do kind of take and give you. There is one proposition, 113, which is a state ballot issue. The national popular vote is coming up. And, again, we will get into those ballot issues. That is one where we would like you to vote yes, right? We don't want the same issue to happen again with the Electoral College. You know, we want every vote to count and that is exactly how every vote counts, is the national popular vote.  

So, that is one thing but another date that is going to be important for your listeners. In the state of Colorado, two notices come out. One is a state notice that the state puts out, and it's on state issues. Those come out around the same time as our local ballot issues, which are local to El Paso County and the city and certain things. The state does a blue book, and we have a tabor notice for the local stuff. So, there are specific things, you know, those are coming out probably in the next few weeks that you'll see that. I know from vote 411, for your listeners, the League of Women Voters does vote for 411.org for candidates and any other issues pros and cons. You can go to vote411.org and get any information on the candidates. Now, the candidates have to fill it out and if you see that a candidate did not fill out the League of Women Voters nonpartisan vote 411 information, that tells you a lot about that candidate. They don't even want to take the time to give you the information.  

This is a national thing so it's not like just Colorado. This is a really good thing for candidates and issues, right? If you got an issue like Amendment B and Amendment C, we got a lot of stuff on the ballot this year. They try to shove it all in one year so it kind of is a lot. It really is. Well, the presidential year is obviously the biggest turn out here, right? The most turn out, it's I think it's like over 70% turn out, in a presidential year. So, it's got a lot on the ballot.  

Cynthia: So, if we could get it to 95%, that would be great! 

Q: When do I need to mail it back?  

Shelley Roerhrs: So, if you're going to be mailing it, you want to mail it at least seven days in advance. They're actually even recommending 8 to 10 days, right? I would even say you want to get it in the mail 8 to 10 days in advance of November 3rd. It cannot be postmarked November 3rd and have it count here in the state of Colorado. They actually have to receive it by Election Day for it to count. In other states, as long as it's postmarked it counts. In this state, you have to mail it in and it has to be received by November 3rd.  

Cynthia:  

Q: So eight to ten business days?  

Shelley Roerhrs: Correct! Or, drop it off the day of. Remember, at those drop-off centers, you can drop it off the day of the election, just like you're voting on Election Day. Drop it off that day. If you mail it, it is 8 to 10 days in advance. If you drop it off, you can go the day of.  

Cynthia: That would be good!  

Q: Do they have lines at those things?  

Shelley Roerhrs: Typically, you might have one or two cars in front of you. Usually, they have people out there making sure that things go pretty smooth.  

Cynthia:  

Q: What do I do with it? Where do I take it?  

Shelley Roerhrs: Again, those drop-off centers. I will tell you two places in Colorado Springs. You can visit govotecolorado.gov or the El Paso County Clerk and Recorder Ofice website. They have a list of the drop-off boxes there.  

Cynthia: Good.  

Shelley Roerhrs: If you have questions, call them. Their website has, literally, locations for ballot drop boxes and voter services centers. I forgot to mention one thing, they have these things called voter service centers here. El Paso County has them on Garden of the Gods, there are voter registration office. Then, they have these voter registration offices that are all kind of on steroids, just little pockets of accounting where you can go as well. So those are kind of, you know, all over. I would recommend going to the clerk and recorders office to kind of find exactly which one is closest to you.  

Cynthia:  

Q: Yeah, and if I'm not registered, how do I get registered? What do you do to be registered?  

Shelley Roerhrs: If you're not registered, you can do it online or you can go in-person. With COVID, you know, online is best, as long as you have a driver's license or ID. Go to votecolorado.gov, just go on there and it literally says "click register to vote." OK?  

Cynthia:  

Q: It's that easy?  

Shelley Roerhrs: It is that easy. Now, if you have a problem because sometimes it doesn't accept your driver's license or whatever, then you do have to go in-person. Again it's a really simple registration here in Colorado. So you can go on the day of the election on November 3rd.  

My son did it, he turned 17 this spring so he was not 18 when the primaries came up. In the state of Colorado, if you are 17, you can register to vote and vote in a primary if you'll be 18 before the general election. So we went the day of. he registered that day, and he voted in the primary. Now, of course, he's voting in the general election as well because he turned 18. So, for that instance, you know, again, Colorado makes it so easy to vote. 

 I find it hard to believe sometimes when people have an excuse not to vote, right? There's something else that I forgot to mention, in the state of Colorado, if you are a convicted felon, as long as you have served your time or you're out on probation, you are good to go. You can go and register to vote as well.  

Cynthia: Oh!  

Shelley Roerhrs: I know, isn't that amazing? So, again, if you served your time, whether you're a convicted felon or not, you should not lose that right to vote. It is one of the fundamental things that we have. So, again, Colorado, if you know someone who is disenfranchised because they think "gosh I'm a convicted felon, I don't have that right anymore," they do in the state of Colorado! Some other states do as well. Here, go and register, I recommend it!  

Cynthia:  

Q: What if they are still in prison? Can they vote then?  

Shelley Roerhrs: Oh no, so if they had been convicted and they are in prison, I do not believe so. If they are awaiting trial, and not convicted, 100%! If they are still kind of in limbo, not yet, they can't. Again, if you're out and you served your time, go and register.  

Cynthia: Good!  

Shelley Roerhrs: One of the things is updating your information. It is not just about registering to vote, because a lot of people that we come across have already registered, right? You're like, "gosh, what is the league doing if everyone is already registered?" It's also important to update your information because there are a lot of inactive voters. That's what they are called, "inactive voters." You might not get a ballot, right? So, if you think "I may have moved since the last time I voted" ...if the last time you voted was in the presidential year in 2016, or if something is happened, right? You know, there are a lot of military around here and a lot of people moving in. So we also encourage you to go to govotecolorado.gov because you can update your information right there as well. It's really convenient to get your ballot.  

Cynthia: Yes, get that corrected. 

Q: If you don't have a driver's license, what can you use as an ID to register?  

Shelley Roerhrs: That's a very good question and I'm going to have to refer to the Clerk and County Recorder's Office. Typically, you're going to need a passport, you're going to need a military ID, or some other type of state-issued ID is what they require. You know you don't have to have a driver's license because the state will give you an I.D for free, right? In those instances, my first instinct is to say your passport, your free ID, or birth certificate. If you need to prove your identity, like to get a driver's license. they would take any of those types of things. But, I'm going to refer to the Clerk and County Recorder's Office, just to kind of confirm. It will say on there, govotecolorado.gov, exactly what you need. For online registration, you actually have to put in your driver's license or state ID number, it does not let you put in your passport. So, if you have something other than that, you have to go to the office.  

Cynthia: Some people, when they're no longer driving, they just let it expire.  

Shelley Roerhrs: Correct.  

Cynthia: They don't need, in their opinion, they don't need another form of identification.” I'm eighty, so I don't drive anymore,” kind of thing. So that would be helpful, thank you.  

Shelley Roerhrs: I still think they need some form of ID, though. At some point, right? Usually, you know for any type of Medicare or Medicaid, don't they need an ID?  

Cynthia: I think so, but some people just let it go and they just show their expired license. If their doctor says "no more driving" they may not drive anymore but they still have that.  

Q: So, what do I do if I don't receive that ballot?  

Shelley Roerhrs: So go to govotecolorado.gov, or check with our El Paso County Clerk and Recorder. Their phone number, I'm going to give you that real quick, just because there are a lot of questions that we refer to them. That number is 719-575-8683 to vote. Again, 719-575-8683. You can go update your information with them. Again, go to govotecolorado.gov and you can update your information there. If you don't receive your ballot, I would 100% either go to the El Paso County Clerk and Recorders Office or call them and find out why.  

Cynthia: Very good.  

Q: So, voting during COVID this year, what do the listeners here need to be careful of when voting during COVID?  

Shelley Roerhrs: Well, I think the main thing is, if you do go and vote in person, you want to wear the mask and take all those protocols. But, you know, if you don't have to go and vote in-person, and you want to just drop off your ballot, that's probably the best thing to do. Because of COVID, the only thing I can say is just don't not vote. It is so easy to vote, even in the current situation. We have it much, much better than some states. I come from South Carolina and I think their representatives just allowed, so there if you want to vote in-person or get a mail-in-ballot, you have to have an excuse. You...