Marin should develop a plan for an elder shelter, do more to ensure seniors receive emergency alerts and lobby for state funds to treat seniors with mental illness and dementia and Alzheimer’s disease, according to the Marin County Civil Grand Jury.
The report, titled “Marin is Aging: Are We Ready?,” notes that Marin’s seniors constitute a growing segment of the county population.
“Today, 27 percent of Marin residents are over 60 years old,” the report states. “This number is expected to increase to 34 percent by 2030.”
In general the report, released last week, gives Marin high marks for supporting its older population.
Teri Dowling, former chairwoman of the Marin Commission on Aging, said, “It seemed to really recognize the good work that is going on in the county to support older adults.”
The grand jury writes that it “was pleased to find that seniors in Marin County have a wealth of information and services available to them” and that “Marin goes beyond the requirements of both federal and state law by providing additional support and funding to agencies responsible for elder care.”
However, the grand jury also adds, “there still remain some areas where improvements can be made.”
One of the improvements the grand jury suggests is the development of a “plan for a designated elder shelter.”
The report states that the number of people who are suffering elder abuse and neglect is unknown, though it adds that one “comprehensive review article” estimated that 10 percent of all seniors have been subject to physical, verbal abuse, sexual abuse, financial exploitation or neglect. A New York state elder abuse prevalence study found that for every case known to programs and agencies, 24 were unknown.
The report states, “In an emergency situation, Adult Protective Services (in Marin) may place abused or at-risk elders in temporary housing, such as hotels or motels.”
The grand jury writes that although the stay is usually short-term and social workers provide some services such as transportation and meal delivery, “not all seniors dealing with a crisis situation would be best served left alone in a motel.”
“The elder shelter was a very interesting recommendation that really warrants further exploring,” Dowling said.
The state’s only shelter for at-risk elders is in Sacramento. The grand jury suggests a range of options for filling this gap: working with a nonprofit to run a safe house similar to the one in Sacramento; working with a nearby county to establish a shared safe house; providing a bed in a residential care facility; or establishing a network of screened homes where an elder could be sheltered, similar to emergency foster housing for children.
LOW DEMAND CITED
Lee Pullen, director of Marin County’s Aging and Adult Services division, said, however, “The demand isn’t there for a full-time elder shelter here in the county when you think in terms of the cost.”
Pullen said crisis situations requiring a bed for a senior due to abuse only occur once or twice a year in Marin.
“Our team here has been able to find places for people when they’ve needed one,” Pullen said.
The grand jury report states that Marin’s law enforcement and fire departments’ training goes beyond minimum requirements for responding to the needs of elders, including how to recognize signs of dementia. In San Rafael, more than 50 percent of 911 calls are in response to people 65 and older.
The grand jury expresses concern, however, that many seniors may be out of the loop during an emergency such as a wildland fire or flood. One of Marin’s primary emergency notification systems, “Alert Marin,” can send alerts to cellphones or voice-over-internet phones, by call, text, email or smartphone application; but the alerts go out only to people who have registered.
The grand jury writes, “Many elderly people either are not familiar with newer technologies or may not be in the future as aging takes its toll on memory.”
The grand jury recommends that the Marin County Board of Supervisors direct the county’s Department of Health and Human Services to include information about how to register cellphones for emergency alerts as part of its community outreach.
The grand jury also recommends that the Board of Supervisors actively lobby state legislators to allow Mental Health Services Act (MHSA) money to be used to help seniors with dementia and Alzheimer’s disease.
The state requires that MHSA money be spent solely on mental health. Because dementia and Alzheimer’s disease are classified as physical illnesses they are not covered, even though dementia may be co-occurring with mental illnesses, such as depression or alcoholism.
Dowling said, “I really strongly support the need for more advocacy to allow the Mental Health Services Act funds be used to help older adults. That really made sense.”
PAUCITY OF FUNDING’
Chrisula Asimos, a Marin Commission on Aging member and psychologist who has worked on psychiatric emergency units, said, “There has been such a paucity of funding for mental illness treatment for older adults.”
Asimos cited a report issued by the UCLA Center for Health Policy Research in January that found the state’s public mental health system lacks adequate services designed specifically for older adults.
“Many of our older adults who are mentally ill aged into mental illness, and now they have dementia,” Asimos said. “We really need to have some specially trained people who can assess this properly.”
Asimos said that currently, when seniors are brought to psychiatric emergency units, medical personnel are often unsure what to do with them.
“That’s why I’m excited about this elder shelter recommendation,” Asimos said. “If there is a shelter that would be perfect, because they could be properly diagnosed and assessed.”
April 30, 2018
Marin Independent Journal
By Richard Halstead
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