| VailDaily.com

Meet the team at Elevated Dental in Vail

Going to the dentist may not be the most pleasurable experience, but the team at Elevated Dental in West Vail aims to provide excellent dental care in a relaxed and friendly environment so that you can keep your smile looking good.

“A lot of people are very fearful and nervous when it comes to the dentist,” said Justin Moses, DMD, and owner of Elevated Dental. “Our team does a wonderful job helping that person relax and leave feeling great.”

Originally from Pennsylvania, Moses is a third generation dentist who completed dental school at the prestigious University of Pennsylvania and did an advanced training residency at the University of Colorado. 

“With extensive training in advanced dental procedures such as implants, wisdom teeth and cosmetic dentistry, we try to keep things simple for our patients and treat them at our office without them having to drive to another office for services,” Moses said.

The Elevated Dental name may be new, but the practice isn’t. Shortly after moving to the Vail area in 2015, Moses crossed paths with Dr. Paul Corcoran, who has been a dentist in the area for over 35 years. Corcoran and his wife Jean have provided excellent care to many valley locals through their dental practice.

“I met Dr. Corcoran through my soon-to-be brother-in-law, Andy Larson, and we worked out the best path for the future of the practice,” Moses said. Following in the Corcoran’s footsteps, it will be a husband and wife team at Elevated Dental. Moses will wed Maddy Larson, who takes care of the business side of the office, later this month.

Elevated Dental also wants to take care of your financial worries by focusing on preventative care and early diagnosis. “Thousands of dollars and hours of appointment time can be saved by diagnosing a cavity in the early stages,” Moses said. 

They also offer the Elevated Care Plan, which helps if you don’t have insurance or have poor coverage.

“No need to worry about the extra cost of x-rays, we just package your x-rays, cleanings and check-ups together for just $300 a year and you can add additional family members for $250,” Larson said. “If you are a member of the Vail Valley Partnership, we offer the Elevated Care Plan for $250.”

“I love seeing the transformation that our patients go through when they come to our office. I love helping patients who are a part of our community and visitors who made need our services while on their trip. Nobody wants a vacation ruined because of a toothache,” Moses said. 

To learn more about Elevated Dental’s services and care plans, call 970-476-3991 or visit www.elevateddentalvail.com.

Eagle County Commissioners: Bending the curve on behavioral health

Just over a month ago, during our annual State of the County presentation, we challenged ourselves and our community to find ways to influence negative trends we want to disrupt, or in other words, to “bend the curve” toward positive outcomes. We shared our belief that when we see the trajectory of an issue going in a direction that is not optimal, we can choose to wring our hands or roll up our sleeves and make a difference. We said we have the right people in the right place at the right time to empower action. Wow, was that an understatement.

Vail Health’s pledge of $60 million over 10 years toward addressing critical behavioral health needs in the Eagle Valley is a game changer. In partnership with other community groups, a new nonprofit will be created to build facilities and improve access to care. The commitment is jaw-droppingly huge.

There is no doubt we are in the middle of a mental health crisis. More than one million Coloradans struggle with a behavioral health condition. Eagle County averages nearly a suicide attempt per day — 324 in 2018 — and nearly one in four local 7th and 8th graders seriously considered suicide in 2017. County voters in 2017 approved a tax on marijuana to be used for mental health services. Since then, community groups, schools and individuals have stepped up to fill the gap and provide care for our residents.

Now, we have the opportunity to build a state-of-the-art behavioral health system, encompassing both mental health services and substance abuse and addiction services, that will provide care for people no matter their circumstances. The hope is that this model can be replicated in other communities experiencing the same challenges we are.

With credit to Vail Health for being a leader and champion for the cause, the creation of Eagle Valley Behavioral Health is truly the culmination of a tremendous effort by dozens of community members and organizations. It is a testament to the power and potential of everyone in this county. The right people in the right place at the right time, taking action and bending the curve.

Haims: Living with Parkinson’s and turning challenges into success

Life has a way of presenting us with many challenges. Those that face the challenges and have the fortitude and perseverance are the ones who experience success.

Over the years, I have had to take more than a couple profile tests. Perhaps my first was with a college advisor who explained to me that such a test would help him, and me, better understand my personality traits and therefore be helpful in directing me to a college best suited to me and my goals. I took another when applying to the Air Force and another when purchasing Visiting Angels.

I have found a recurring question often found in these test — “tell me about your heroes.” Steadfastly, I have always responded that I do not have heroes. Rather, I have people I respect and admire. Consistently, all such people are those who have experienced adversity and turned challenges into success.

Life is a challenge

Challenges are a part of life. Without them, life would be meaningless as we’d have little understanding of achievement and failure. Life would be complacent and boring.

Facing and living through life’s challenges and adversities provides us with experience that define our lives. The secret to our successes is rooted in our challenges, failures, and adversities.

As with any ailment, people have the choice of letting the disease take over or fighting back. Fighting back against Parkinson’s is taking many people to places they may have never thought of. Some are attending yoga, Tai Chi, pool exercise programs, and even the boxing ring.

Recently, I assisted a few locals to a Parkinson’s therapy session at a somewhat unlikely place — a martial arts and boxing studio. If the paradox is not clear, let me illuminate. Parkinson’s inhibits movement and boxing is all about movement.

Research is showing that non-contact boxing is therapeutically beneficial for Parkinson’s patients — physically and mentally. Physically, boxing is proving to help balance, agility, and hand-eye coordination. Mentally, boxing provides a stress release and is empowering. The sport teaches people to be mentally strong and overcome adversity. If nothing else, a right hook to a punching bag or strike mitt can curb anger and can be quite cathartic.

One gentleman in the group is just shy of his 90th birthday. I was informed that prior to his joining the boxing program, his family was distraught that they could not motivate him to get out of the chair. As I sat and watched him work out, I was quite impressed every time I heard the loud crack from his hands as he hit the hand pads of the instructor. Should I make it to be close to 90 years of age, I hope I move as deftly as he. He is inspirational and has turned formidable adversity into success.  

Others in the group were in their 70s and 80s. Each had donned their red boxing gloves except for one who danced around the floor mats in bright pink gloves. Yes, women too participate. 

Watching the comradery of this group and their united front to work through the difficulties this movement disorder presents them with is encouraging to me and should be encouraging to anyone who may be fighting a health ailment.

I admire each and every one of these people. They have not given up, nor do they whine and ask “why me?” While I am sure each has had their down moments, they have not thrown in the towel and given up. They have chosen to fight adversity.

My mother has Parkinson’s, as did my grandmother. It sucks. But does Parkinson’s suck more or less than cancer, multiple sclerosis (MS), cardiovascular diseases, ALS, vision or hearing loss?  

While many people living in our valley are pretty fit and try to be healthy, it won’t last forever. If we want to remain in the valley we love when life’s challenges present themselves, we must take action NOW to promote and develop resources that can help us stay here.

Within the past three months, I know of four longtime locals who have had to leave the valley they love because we do not have the resources needed to assist them. (I’m sure there’s many more.)

There are organizations that are being proactive. Howard Head Sports Medicine has developed a program called Brain & Balance. The program helps treat stroke patients, Parkinson’s patients and those with impaired balance and proprioception concerns. Additionally, the Parkinson’s Association of the Rockies has brought Power Punch to both our community and Colorado.

We are all going to get old and experience challenges with our health. Get involved, donate, better utilize resources we already have, and think out of the box. These are things we can do to help build a community that will assist us in ensuring we can remain in the valley we love.

Judson Haims is the owner of Visiting Angels Home Care in Eagle County.  He is an advocate for our elderly and is available to answer questions. His contact information is, www.visitingangels.com/comtns, 970-328-5526.

The key to longevity is lifestyle habits

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While there’s no foolproof way to ensure a long life, our choices along the way have a lot to do with it

Written By Lauren Glendenning
Brought to you by Kaiser Permanente

Colorado mountain resort communities have some of the highest life expectancies in the nation, but it’s likely not the beautiful mountains that keep people living longer.

The lifestyles of those who live here have more to do with longevity than geography, according to research on what’s known as Blue Zones — regions in the world with the most centenarians. Their lifestyle choices are what they all have in common.

“Being able to consistently eat healthy and exercise regularly has been shown to maintain health as we age,” said Dr. Jeannine Benson, Internal Medicine Physician at Kaiser Permanente’s Edwards Medical Offices. “These lifestyle changes can prevent diabetes, heart diseases, strokes, cancer and many other health issues. Maintaining a healthy weight and lifestyle can also keep joints and muscles healthy, which improves mobility as we age.”

The elders in Blue Zones have nine common lifestyle habits, including moving their bodies regularly, eating plenty of vegetables, winding down from stress and never overeating. They value family, feel a sense of purpose and belonging, and surround themselves with friends who also practice these habits. They also enjoy a glass of wine or two a day, according to the research.

These lifestyle choices can have major impacts on overall health, but Venable said there’s no surefire way to ensure longevity.

“Prevention is one of the key aspects of medical care,” said Dr. Carol Venable, Internal Medicine Physician with Kaiser Permanente’s Frisco Medical Offices. “Certainly not everything is preventable, but it is important to prevent the diseases we can. Vaccinations, healthy lifestyle choices, avoidance of substances that are deleterious to health, screening for those cancers for which we have good data for screening, testing for treatable diseases — like diabetes, hypertension, hepatitis C, HIV, etc. — and control of chronic medical conditions are all important.”

Preventative care for the body, mind

Younger, healthier people might not need to see a doctor annually, but annual checkups do become more important with age, Benson said.

“It is important to have regular checkups with your doctor and make sure that you are up to date on age and gender appropriate cancer screenings.  It is also important to find activities that can help keep your brain active.  This is just as important as keeping your body active,” Benson said. “Mental Health is also important as we age. With aging, issues like depression and anxiety can come up. These things are important to address with your doctor as well.”

This proactive approach to personal medical care goes hand in hand with healthy lifestyle habits. Benson said brain exercises include social interaction, reading books or doing puzzles, continued learning such as taking a class or watching an educational program, and volunteering or working in order to feel a sense of purpose.

“Having a purpose and something to contribute to the community is very enriching,” she said.

The amount of physical exercise that’s right for a person varies. Venable said exercise plans are not “one size fits all.” She said patients should create an exercise plan with their primary care physician.

For those who may hate a gym environment, Venable said to look to outdoor exercises that are popular in the mountains such as skiing, snowshoeing, hiking, biking, kayaking, paddleboarding, yoga and other activities. Even activities such as gardening can be a good way to move the body without going to a gym, Benson added.

“Find something that you like to do, but also involves exercise,” she said. “It is also helpful to have a friend or a group of friends join you. This can help keep you motivated and you can cheer each other on.”

As people age, spending time indoors tends to become more common, but research shows that could be detrimental to the various aspects of overall physical and mental health.

“I think it is important for folks to attempt to get out of the home, interact with people and be active in the community,” Benson said. “Isolation tends to lead to a sedentary life. We know that keeping the body active helps the mind stay healthy, as well.”

In orthopaedic care, a focus on activity preservation

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Keeping people doing the activities they love is an essential contributor to overall health and longevity

Written By Lauren Glendenning
Brought to you by Vail-Summit Orthopaedics

Following orthopedic surgery, the majority of patients are interested in one specific outcome: returning to the activities they love doing.

People often think of overall health as boiling down to eating right and exercising, but there’s more to it.

“It means doing things that give you joy. These types of activities are invaluable to physical and mental health. And this can, in turn, lead to longer life expectancy,” said Dr. Bill Sterett, an orthopaedic surgeon at Vail-Summit Orthopaedics and the Head Team Physician for the U.S. Women’s Ski Team since 1997. “Too often people let activity slide for too long. Then they never get back to them, leading to a degradation of health.”

Too often, Sterett and his colleagues at Vail-Summit Orthopaedics hear patients say things like, “I gave up jogging five years ago,” or “Three years ago, I quit walking after dinner.” When the activities that were once part of a routine become long forgotten, it becomes harder to get the body back to where it used to be, Sterett said.

That’s why Vail-Summit Orthopaedics is focusing its overall and post-surgical care on activity preservation rather than simply returning patients to a baseline level of comfort.

“This is a new era. We’re starting to zero in on the fact that people don’t only want to be pain free,” Sterett said. “They want to be back doing the things they love. This fact can and should inform our approach when considering treatment options. … The art in this practice is to figure out the least amount of intervention needed to keep doing the activities we want to do.”

‘Not trying is failure’

In orthopaedic medicine, when people talk about preserving our joints as we age, what they’re really referring to is preserving and maintaining a person’s chosen activities. Injuries vary, as do the recovery processes for all patients, but Sterett said patience is key.

Patients must believe in their ability to work through the difficult recovery period, which is why Sterett said having a goal activity to return to is beneficial.

“The finish line goes from ‘when I’m pain free’ to ‘when I’m doing the things I love again.’ That can be very motivating,” Sterett said. “Of course, there will be instances when people are unable to perform at preinjury

levels. Based upon our initial evaluation, we can often predict this. In that case, we can be up front with the patient before surgery. Then we can help them understand what they can do to stay active post-surgery. But failing to get to our goal isn’t failure. Not trying is failure.”

Aging is a natural process that takes a toll on various parts of the body, but Vail-Summit Orthopaedics reminds patients that aging should never mean abandoning an active lifestyle. The physicians are helping patients who might not be able to push themselves as hard as they once could realize they can still do things they love and different levels. The main prescription, though, is to always keep moving.

“Health doesn’t happen to us, it needs a coordinated plan,” Sterett said. “After surgery, we lose muscle mass, energy and we hurt. It isn’t easy.”

Weight-bearing and load-bearing exercises have a huge beneficial effect on the heart and mind, as well as muscles. Sterett advises patients to exercise the heart by increasing their heart rate into their particular safe zone for 20 minutes, four times per week.

“Identifying the right exercises for your particular level of activity can be crucial. This is another factor that will vary from person to person,” he said. “My advice in this department is to focus on the quality of the exercise rather than the quantity. Find the balance that is right for your body.”

 

Regular massage therapy has long-term benefits

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The benefits of massage are linked to the same healthy habits practiced by the world’s longest living populations

Written By Lauren Glendenning
Brought to you by Simply Massage

While massage has typically been considered an alternative medicine, doctors are increasingly prescribing it as part of standard treatment for many different medical conditions.

That’s according to the Mayo Clinic, which cites the effectiveness of massage as a treatment for reducing stress, pain and muscle tension. The reduction of stress is an essential element of longevity based on the research of Blue Zones, areas in the world whose residents have the longest life expectancies. In these regions around the world, people share nine common lifestyle habits: Physical activity, a sense of belonging, eat a mostly plant-based diet, never overeat, put family first, enjoy a glass of wine or two per day, have purpose in life, have faith, unwind from stress and spend time with others who practice similar habits.

“We have so much stress worked up in our bodies — you can’t stay on top of it by just getting a massage every once in a while,” said Karen Taylor, owner of Simply Massage, with locations in Vail, Avon, Breckenridge and Glenwood Springs. “Continually working on the body gives it more of a chance to stay in shape.”

Here are some of the benefits that regular massages can have on overall health, wellness and longevity.

Focus and mental clarity

Research published in the International Journal of Neuroscience shows that massage therapy increases serotonin and dopamine in the brain. Dopamine is a neurotransmitter that helps control the brain’s reward and pleasure centers, while serotonin is a neurotransmitter that helps relay messages from one area of the brain to another — influencing mood, sexual desire and function, appetite, sleep, memory and learning. Massage therapy also decreases the stress hormone cortisol.

“Massages are excellent for clearing the mind and turning off that fight or flight response,” said Katherine Ford, manager at Simply Massage in Avon. “It helps cleanse those emotions.”

Recent studies have shown that massage stimulates activity in the left side of the brain, which is the side that is most active when a person is pleased, happy, or excited. The right side of the brain, in contrast, is often activated when an individual is sad, stressed, or depressed. When feeling happy and motivated, individuals are more capable of producing their best work, as opposed to when they are sad and discouraged.

Tight neck and shoulder muscles often limit the circulation to the brain, which consequently does not support memory or concentration. Also, when massage relaxes tense muscles, it eases stress, which also benefits thinking and efficient work. Positive emotions typically are related to better thinking and memory, whereas negative emotions are associated with pessimistic thinking and less concentration.

Stress relief and relaxation

Massage can stimulate activity in the left side of the brain, which is associated with pleasure, happiness and excitement. For occupational stress — the main cause of stress for most Americans — massage therapy has been proven to reduce stress and promote mental health, according to research published by the National Institutes of Health.

Taylor said many clients come in as often as two or three times a week as part of their wellness routine. She finds that once a week works best for her.

“It varies for every person,” she said, adding that once a month isn’t really enough anyone seeking long-term benefits from massage.

Muscle tension relief

In mountain communities with such active residents and visitors, our muscles and joints often take a beating. Ford said it’s important to flush the joints and soft tissue to improve endurance, stability and competitiveness. The benefits of releasing this tension can positively affect the body and also the mind.

“We do hold trauma in our muscles and joints,” she said. “A lot of muscles and aches can be linked to emotional trauma.”

Without regular massages, Taylor said the knots and trigger points in the body might get worked out during one massage, but they’ll continue to come back.

Detoxification

Massage strokes and pressure release chemicals into the bloodstream that are then processed through the kidneys, which Ford said makes detoxification one of the top benefits of massage therapy.

She likes to incorporate breathing exercises into her massages as a way to increase oxygenation in the body, which also helps with focus and mental clarity, she said.

“Massage also increases circulation. As you’re pressing on these muscles, as soon as you release, they swell back up with blood to create a natural flushing process,” Ford said. “That flushing process is so beneficial — it cleanses the blood.”

Why giving up some independence helps aging people gain

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One of the keys to longevity is living a life with purpose

Written By Lauren Glendenning
Brought to you by Castle Peak Senior Care Community

As people age, everyday tasks such as cooking and cleaning start to require a lot more energy, leaving little left over for activities that actually boost quality of life.
Yet aging people often hate the idea of giving up those chores because they think it signifies giving up their independence, but that couldn’t be further from the truth.
“When you give up that little bit of independence, you gain a lot more back,” said Monica McCarroll, director of Marketing at Castle Peak Senior Care Community in Eagle. “If you allow someone else to do some of those basic things like preparing meals and keeping the house clean, it allows you to spend that energy on things you do enjoy.”
That’s important when you look at research on the longest living people around the world. Known as Blue Zones, the habits of these folks include a variety of meaningful activities, with socializing and quality family time among them.
“As your quality of life increases, your mental well being increases, which means you’re more resilient and you have more purpose in life — which leads to longevity,” McCarroll said.
The nine habits of people in Blue Zones include physical activity, never overeating, eating plenty of vegetables, having purpose, unwinding from stress, having a sense of belonging — often to some kind of faith, putting family first, enjoying a glass of wine or two per day, and socializing with folks who practice the same habits.
As Castle Peak, residents have the time and energy to practice all of these habits.
“Nobody says, ‘I had a great day, I watched TV all day,’” McCarroll said. “Whereas if you do volunteer, do an art project, spend time with family — it’s meaningful and it gives you purpose.”

Life enrichment
This ability to find purpose is what Castle Peak provides for its residents. The programming offered there is all centered around this theme.
“Having a purpose in life makes one feel important,” said Stephanie Sheridan, director of Life Enrichment and Volunteer Services at Castle Peak. “It provides an increase in happiness, decrease in stress, decrease in anxiety and depression, and so much more.”
Social interaction is something that often decreases for the elderly, which raises the risk of developing problems such as depression, anxiety and sickness due to isolation. By creating opportunities for social interaction, Castle Peak helps residents maintain or improve cognition and physical activity, she said.
Sheridan said the programs and activities aren’t just about keeping residents busy in order to fill the time — every activity incorporates a sense of purpose.
“We provide a sense of purpose for each person to meet their individual needs and wants. As therapeutic recreation specialists we are there to help guide and show them new ways in doing things or maintaining functioning,” she said. “We don’t just put a program on the calendar for the heck of it, we do it based on what residents want and will benefit from.”

Physical movement
Regardless of age, physical activity is essential to overall health and well being. Physical exercise helps in disease prevention, mobility, weight management and even mental health. In aging populations, physical activity becomes harder but never less important.
Matthew Mesibov, the Clinical Physical Therapy Specialist with Centrex Rehab, which works with Castle Peak, said the consequences for not remaining physically active can lead to functional declines such as increased hardship in doing daily tasks. It can also lead to health-related issues like diabetes, heart disease and cognitive decline. All of this can lead to increased costs to stay alive, as well as earlier mortality, he said.
“Our experience is that older adults would prefer to stay as independent as possible,” he said. “Maintaining one’s physical activity level is a large part of being able to maintain one’s independence.”
Every person is capable of varying levels of physical activity, which is why Mesibov recommends consulting with a physician or nurse before undertaking any new physical exercise.
“There are so many varieties of exercise that will help with strength, flexibility, balance and endurance — the key four components of a strong exercise program,” Mesibov said. “Once you are cleared for exercise, keep in mind or recognize what your motivation is. Seek out a professional or group program that meets your goals. Recognize that physical activity is like keeping gas — or for some, electricity — in your car and an engine which is kept in tip-top shape by servicing it regularly.”

The Longevity Project | Part 4: Colorado mountain towns struggle to accomodate a surge of seniors

Castle Peak Senior Life and Rehabilitation Center resident, Carole Litt, right, goes through strengthening exercises led by her physical therapist Erin Velpel during a session Wednesday, Feb. 21, at the assisted living facility in Eagle.

Editor’s note: This is the final installment in a four-part series from the Summit Daily News and the Vail Daily. Find previous articles at www.vaildaily.com/longevity.

Eighty-three-year-old Anne Crane sits in her Frisco home with her cat, Winnie.

“She was found in a Winnebago, so I named her Winnie,” Crane says while scratching the 3-year-old feline behind the ear. Winnie is Crane’s only regular company at home now that her husband, Ed, who is 94, had to move down to Arvada for long-term care.

Anna Crane at her home in Frisco Jan. 23.

Anne and Ed Crane have devoted countless hours to helping Summit’s senior community. In 1977, the Cranes were among the original 17 Summit residents to found Summit County Senior Citizens Inc. The nonprofit group has now grown to 2,000 members and, through its partnership with Summit County government, provides resources and services for seniors. In 2015, Summit County passed a resolution honoring and recognizing Anne “for her contribution to the betterment of Summit County.”

The Cranes were also a driving force behind the funding and opening of the Summit County Community and Senior Center in Frisco back in 2002, and Anne still spends a lot of time volunteering there.

“They’ve both been very helpful volunteer-wise within the center,” said Lorie Williams, manager of the Senior Center. “They contributed a lot of time and truly care about it. They’re amazing people.”

The Senior Center provides a wide variety of services and resources for Summit seniors, including social activities, medical assistance and the Mountain Meals on Wheels program for homebound seniors. Already strained for resources and staff, Williams said it’s just getting busier and busier.

“We have just under 2,000 members at the senior center,” she said, “and about 500 or 600 come around regularly. And we’re seeing more every year.”

Williams is on the frontline of an aging boom in the mountains. According to the U.S. Census, Eagle County’s population of residents 65 and older went from 5.6 percent of the total population (2,900 seniors) in 2010, to 9.3 percent (5,000 seniors) in 2016. In Summit, the senior population went from 7.7 percent (2,100 seniors) to 11.9 percent (3,600 seniors) in 2016. The median age in Eagle rose from 31.2 in 2000 to 35.9 in 2016, while Summit’s median age went from 33.3 to 38.2 over the same period.

Erin Fisher is director of the Alpine Area Agency on Aging, which helps seniors and caregiver access health services in the five mountain counties of Eagle, Grand, Jackson, Pitkin and Summit. She said mountain communities have some of the fastest growing senior populations in the state.

“Summit’s senior population is estimated to grow by 199 percent by 2050 and Eagle County by 274 percent in the same time frame,” she said.

For the past three weeks, this series has aimed to find out why mountain counties such as Eagle and Summit counties have the highest age expectancy in the country. In this installment, we will focus on the challenges created by that longevity, as mountain communities built for play contend with the needs of their aging residents.

Tricia Swenson talks with Eagle County Longevity Project nominee, Keith Countryman.

Silver rush

The aging issue is national in scope. U.S. Census issued a report predicting that by 2050, the population of Americans 65 and older will reach 83.7 million, roughly double the senior population in 2012. The growth rate of the senior population will eventually outpace the working-age population, leading to an increasing reliance on immigrants to bolster the American workforce, according to the census.

An older population also means more medical spending. The 65-and-older citizens only make up 14 percent of the total population but account for 34 percent of all health care spending, says the Center for Medicare and Medicaid. And according to the National Bureau of Economic Research, the cost of health care more than doubles between the ages of 70 and 90.

A physical therapy session at the Castle Peak Senior Life and Rehabilitation Center Wednesday, Feb. 21, in Eagle.

Seniors in the mountains face the same health issues as most others living at altitude, such as pulmonary hypertension, pulmonary edema and sleep apnea. However, seniors are also particularly susceptible to slip-and-fall accidents with the area’s long winters.

“As people get older, the risk of serious injury from falls and deaths far surpasses the risk of car accidents,” said Dr. Jules Rosen, chief medical officer at Mind Springs Health in Frisco and former chief of geriatric psychiatry at the University of Pittsburgh. “Once you pass the age of 60, your risk of serious injury or death goes up exponentially compared to car accidents.”

Rosen explained that the risks of falls are magnified with osteoporosis, which is caused by bone loss later in life. Osteoporosis results in weak and brittle bones that are more susceptible to fractures and breaks. Rosen said seniors often mistakenly believe that their active lifestyles reduce their risk of serious injury from falls on the sidewalk or on the slopes.

“While being active is a protective factor, it does not prevent bone loss,” Rosen said.

Paul Chodkowski, CEO of St. Anthony Summit Medical Center in Frisco, said the hospital recognized that injuries from falls were a significant risk to seniors in high-alpine environments and accordingly instituted a “Stepping On” education workshop to help seniors avoid those injuries. The program trains seniors to recognize and address common tripping hazards at home, as well as what it takes to navigate safely in icy, wintry conditions.

(Video by Hugh Carey)

“It’s been a very positive program,” Chodkowski said. “Seniors build strength and confidence, and (it) helps ensure that they can stick around in the mountains long-term.”

While there has been some progress addressing seniors’ needs, there is still a long way to go. Lorie Williams often facilitates medical transport for seniors who need to see specialists down in Denver because they can’t find the same specialists in mountain towns.

“We don’t have gerontologists, rheumatologists and other specialists seniors need to keep living up here,” Williams said. “We help them get to their specialists so they can keep living here as long as they possibly can, but sometimes they go down for treatment or rehab and don’t come back.”

Rosen added that in the region there is a lack of specialists for geriatric cognitive conditions such as Alzheimer’s and Parkinson’s. He has also seen seniors who develop dementia due to multiple brain injuries suffered during their active lifestyle. However, there is a lack of knowledge about these conditions and how they affect seniors at altitude, which Rosen attributes to a lack of emphasis on senior issues.

“We have a very caring, generous community here, but senior care just has not been part of the discussion,” Rosen said.

Rosen added that the lack of motivation to increase care for seniors is partially one of perception, as active folks in Summit may have a different view of what is considered a “disability.”

“The concept of disability is not what is happening to me as an individual; it’s happening to me as an individual in the context of my environment,” Rosen said. “If I get diabetes and develop a foot ulcer, I can live with it. But if I don’t have adequate support to deal with it day to day, that’s a disability.”

Finding Solutions

Eagle is home to one of the only assisted living facility for seniors in the mountains with the Castle Peak Senior Life and Rehabilitation Center. The facility, which opened in late 2015 and was built on land donated by Eagle County, is managed by Augustana Care, a nonprofit based in Minnesota that manages senior-care facilities across the country and includes 44 skilled nursing units, 20 assisted-living apartments and 10 transitional-care units. Castle Peak marketing director Monica McCarroll said a memory care wing with 12 beds could open as soon as this spring. At the moment, 28 skilled nursing units and 15 assisted living apartments are occupied.

McCarroll said the facility came about because of strong local support and collaboration.

Castle Peak Senior Life and Rehabilitation Center residents interact with employee Stephanie Sheridan, middle, who is the Volunteer Services Director, inside the dining room Wednesday, Feb. 21, at the assisted living facility in Eagle.

“Elected officials, community groups and residents came together to really push for a facility here, and it is because of that collaboration that seniors are able to get the care they need in Eagle,” she said.

Augustana Care also considered building a facility in Frisco to serve Summit County residents back in 2015. At the time, the plan was to create a senior housing and care facility on a 4.5-acre site called “Hillside Parcel” near St. Anthony and overlooking the Summit Fire Authority training center. However, Summit County manager Scott Vargo said the plans fell through for financial and logistical reasons.

“At the end of the day, it just didn’t feel like an appropriate site,” Vargo said. “The developer felt that the infrastructure costs to get water and sewer to that site were too steep. There were also concerns about placing a residential facility right above the fire training facility, as well as noise concerns from a sand and salt facility that is planned near the site.”

With the high cost of real estate in the mountains, Vargo said finding another site for a senior facility is going to be challenging. He is not aware of any other plans for a senior facility Summit.

“We certainly recognize the need for such a facility,” he said, “and the county is open to working with seniors and developers to find an appropriate site.”

Chodkowski said another important reason the plans fell through was because there aren’t enough seniors who need those services in Summit.

“In order to run a long-term care facility, it requires certain critical mass of numbers for the care provider to justify the cost involved,” Chodkowski said. “Augustana looked at the marketplace here and realized here the senior population didn’t quite reach the threshold for opening a facility in Summit.”

Williams also noted that the problem of workforce housing comes into play, as workers at a new facility will need somewhere to live.

“It’s so very expensive to live here,” she said, “and their doctors, specialists and staff would need to find an affordable place to live. We have enough problems with affordable housing as it is.”

Rosen said even while recognizing the need for more senior services, altruism won’t be enough to attract them and medical research for senior health needs in the mountains.

“In order for science to spread, it has to have an economic anchor,” he said. “People won’t do something just because it’s good for community health or the right thing to do. It’ll have to be beneficial economically, as well.”

Rosen offers some solutions to the medical needs for seniors in the mountains, such as collaborating with institutions on the Front Range.

“The University of Colorado School of Medicine has an amazing program for geriatric medicine,” Rosen said. “We should try to tap into that resource and bring in a team including specialists in geriatric mental health, geriatric social work and geriatric medicine. Maybe we can do a once-a-month clinic.”

Castle Peak Senior Life and Rehabilitation Center resident Larry Youse, 69, who’s left arm is paralyzed, gets help with putting on a bib during lunch break inside the dining room Wednesday, Feb. 21, in Eagle.

Looking forward

Anne and Ed Crane, who spent much of their adult lives trying to bring joy and purpose to Summit’s senior community, find themselves separated because Summit doesn’t have the services they need. Eventually, Anne may leave Summit when she is no longer able to live independently, and the county will lose another one of its upstanding citizens.

Erin Fisher, director of the Alpine Area Agency on Aging, believes that more affordable, accessible senior facilities are urgently needed in the mountains to make sure people like the Cranes can live here as long as they want.

“Summit doesn’t have any senior housing or long-term care facilities,” she said, “so if aging in your own home isn’t an option, you’re forced to leave the community. Interestingly, our senior gap analysis showed that while people overwhelmingly think this is a good place to live with a good quality of life, they are much less likely to recommend retiring here due to the high cost of living and housing costs.”

Fisher added that she has hope for the future based on rising local political support for senior care.

Castle Peak Senior Life and Rehabilitation Center residents share a table during lunch break inside the dining room Wednesday, Feb. 21, in Eagle.

“I’m encouraged that the state produced and continues to update a Strategic Action Plan on Aging and Gov. John Hickenlooper recently appointed the state’s first senior advisor on aging. While we need a comprehensive vision to help guide the state legislators and planners, we also need to make sure our local officials understand the complexities and opportunities of our local aging population.”

Fisher added that seniors have the power to bring about change, but she does not want to see an intergenerational struggle take place over resources.

“Seniors are a very vocal group, and they are very involved,” she said. “They have the political and financial clout to see things happen. And this is a problem faced all across America. You’ll see these issues coming to the forefront. But I don’t want to see a situation where we’re pitting communities against each other, such as a fight for resources between seniors and children. What can serve one community can benefit everyone.”

The Longevity Project | Part 3: Despite nation-leading longevity, Colorado mountain communities face significant health challenges

Editor’s note: This is the third installment in a four-part series from the Summit Daily News and the Vail Daily. The final part of the series will appear in print on Tuesday, Feb. 27. If you missed it, read The Longevity Project | Part 2: How do Colorado’s long-lived mountain towns stack up to the rest of the world?

Frisco resident Gretchen Tilden is 85 years old, and she spends much of her time these days painting. Tilden is engaging in art therapy to cope with the lingering effects of a serious brain injury she suffered back in 2013. Before the injury, Tilden was a physical force of nature. She was a ski instructor in Keystone for 15 years after moving to Summit in 1990 and never had any noticeable health issues.

But then came the fateful day in 2013 when she was hit by an out-of-control snowboarder at Copper Mountain Resort.

“I went flying in the air and came down directly on my head,” Tilden said. “I had an internal brain hemorrhage. They took me to Denver on Flight for Life, and the doctors didn’t think I would survive the night.”

However, Tilden beat the odds and survived.

“The doctors kept saying, ‘I can’t believe she’s alive, she’s 80!’”

Unfortunately, Tilden’s survival came at a sharp cost.

“I lost my sense of smell and taste, and I have constant vertigo. It’s cost me a lot,” she said.

Brain injuries are one significant risk factor for the high country’s fearless, active seniors, but there are other concerns, as well.

At first glance, Colorado’s central mountain towns seem to have most of the ingredients for a long, happy life: breathtaking scenery, clean air, healthy people and a bounty of outdoor recreational activity that draws hundreds of thousands of people from around the world. It’s no wonder we have the highest life expectancy in the country.

Dig below the surface, though, and you’re likely to find some sobering truths.

Gretchen Tilden at her home Thursday, Jan. 25, in Frisco.

According to the Robert Wood Johnson Foundation’s Annual Report, the mountain counties of Eagle, Pitkin, Routt and Summit ranked in the top 10 among all Colorado counties in health outcomes. However, Eagle and Summit also tied for having the highest rate of excessive drinking in the state. Mountain counties also scored poorly when it came to physical environment because of a severe housing shortage.

For the working people in our mountain communities, those truths are evident every day. Some residents rely on free community dinners because they spend what little they have on rent. They might not be able to afford health insurance or afford the specialist who can diagnose and treat their hidden heart condition. To pay for a roof overhead, one might need to hold two or three jobs. To cope with the stress, they might turn to heavy drinking or other self-destructive vices. During the shoulder seasons, when most homes sit empty and when friends move away, they get lonely.

These are people whose quiet suffering is rarely reflected in the cheery statistics about mountain life.

In the past two installments of The Longevity Project, the Vail Daily explored reasons why Summit and Eagle counties have the highest life expectancy in the country. In this installment, we look at the areas where we fall short.

High living, high costs

An obvious bit of news for anyone who has tried to find a place to live or gone grocery shopping in the mountains: It’s really expensive to live up here.

Just ask Dillon Mayor Kevin Burns. Back in December, he announced he would not seek another four-year term as mayor this April, citing the high cost of living.

“Dillon is a very tough place for young professionals and young married couples trying to establish their lives, and that certainly affects me,” Burns said at the time. “The chances of me staying in Dillon are pretty remote, and I think it’s only fair to give someone who is more confident they can serve an entire term a chance.”

To understand the housing problem, take a look at home sale listings on Zillow or any other real estate listing page. The median price for a single-family home currently on the market is $789,000. Only 12 apartments or condos are currently available for rent on Zillow, with the average rent at $1,900 per month.

A person earning $40,000 a year may wind up spending half of his or her paycheck on rent alone. A household is considered “cost-burdened” by spending just more than 30 percent of gross income on rent. The 2015 Self Sufficiency Standard for Colorado report issued by the Colorado Center on Law & Policy found that families in our area have to make much more to afford basic necessities such as housing, child care and food.

“A Summit County family with one adult and one preschooler, for example, needs an annual income of $59,595 to make ends meet, more than three and a half times the federal benchmark (for poverty),” the report concluded.

Craig “Corky” Woodring, a local artist and former construction company owner who spent much of the past three decades living in Summit, doesn’t see the county doing enough to support the people who actually live there.

Summit County resident since 1987, Craig Woodring, 66, is bi-polar has not worked in many years due to his disability. “When I moved here, I made this my home. I don’t think I have to move and live somewhere else because I can’t afford to live in my home, just because I am disabled and old,” says Woodring, who chose to live close to family living in Summit County.

“People can’t afford to live here,” Woodring said. “They come to work here, but when they start a family, they need to move away to buy a house. You have to work three jobs to survive. The employers don’t want to pay a living wage.”

Woodring also believes that the bedrock of a stable community — a foundation made up of longtime residents and middle-class families — doesn’t really exist in Summit. And the same could be said of Eagle County, as well.

“Summit doesn’t have the solid base. The jobs are seasonal, the pay is (low), you can’t afford insurance to carry yourself through. There’s a whole segment of society that is missing,” Woodring said.

Tamara Drangstveit, executive director of the Family and Intercultural Resource Center in Silverthorne, regularly helps people who struggle to afford living in the mountains.

“It doesn’t matter if you’re looking at housing, health care or child care, costs are higher in Summit County,” Drangstveit said. Her clients often pay 40 percent to 50 percent of their income on housing, and 15 percent to 20 percent each on health care and child care.

“That doesn’t leave a lot of money at the end for things like food, clothing and other necessities.”

Dr. Ali Mokdad is a co-author of the study by the Institute of Health Metrics of Evaluation that placed Summit and Eagle counties at the top for life expectancy. He said that while socioeconomic factors do have a large impact on life expectancy, they aren’t necessarily the most important.

“While health is correlated to socioeconomic issues primarily, you can be poor and still be healthy if you engage in the right behaviors.” Mokdad points to places such as Yuma County, Arizona, which has a relatively low average income but managed to raise its life expectancy by eight years since the last study. Poor life expectancy, Mokdad explained, is primarily driven by behavioral issues, such as obesity, poor nutrition and excess drinking.

The Human Environment

But part of the problem for making those lifestyle changes is living in an environment that does not encourage them. In his Blue Zones books, author and explorer Dan Buettner proposed that the most sustainable way to improve a community’s life expectancy is to “reshape the environment” to steer people toward better habits and better lifestyles.

He identified one key common trait across all Blue Zones communities: walkability. While Eagle and Summit counties have exceptional trail and recreation path networks, they don’t necessarily link to all the places people need to go. Many of those places are only accessible by car.

“Parts of Summit County are walkable,” Drangstveit said, “but places like the Dillon Valley are not. The county has done walkability studies, and there’s been a lot of work done, but there’s a long way to go. There needs to be better linking of middle-class neighborhoods to the trail and path network, as well as to the needed services like grocery stores and health care.”

Another issue in Summit is a relative lack of food accessibility. The public can look up local food accessibility statistics through the Food Research Atlas, an interactive map tool provided by the U.S. Department of Agriculture to find areas that are considered “food deserts” because of their lack of access to a variety of healthy food.

While healthy fruits, vegetables, grains and beans are usually available at grocery stores, more than 1-in-20 Summit households are in a situation where they don’t have access to a vehicle and live more than half a mile from the nearest grocery source. That means they have to take long, burdensome trips by foot to the supermarket or rely on public transportation and be at the mercy of its schedule.

Physical Health Factors

Living at altitude isn’t for everybody, especially people who have difficulty breathing or other cardiovascular issues. Sometimes those issues are not readily apparent and pose serious threats to long-term health. Cardiac failure continues to be the leading cause of death nationwide.

Dr. Peter Lemis said that one of the biggest health concerns at altitude are hypoxia, a lack of oxygen reaching tissues and pulmonary edema — a cardiac condition that can cause fluid buildup in the lungs.

“We have 20 percent less oxygen up here,” Lemis said, “and for people with pre-existing cardiovascular issues, those are exacerbated. People who have pre-existing medical conditions don’t usually move here.”

Lemis added that people with those conditions who do move up here often have to move away, as do people who have to move away due to other serious illnesses or injuries. That, he believes, is part of the reason life expectancy is so high in the mountains.

“When people get critically ill, and in danger of dying, they often need to move to a tertiary care center down in Denver. That’s why we don’t have many people die here,” he said.

Dr. Jules Rosen in his office at the Summit County Care Clinic Thursday, Feb. 15, in Breckenridge.

Dr. Jules Rosen, chief medical officer at Mind Springs Health in Frisco and former chief of geriatric psychology at the University of Pittsburgh, added that because most people living in the Colorado high country weren’t born here, they aren’t acclimated to the conditions.

“Take the Sherpas in the Himalayas,” Rosen offered as an example. “Some genetic studies show that Sherpas are genetically different from most of us.”

Rosen explained the body’s usual response to living in a place with less oxygen than what the organs need is to produce higher hematocrit levels, or red blood cells to carry that oxygen. The risks of having high hematocrit levels include blood clots and other serious conditions.

However, despite the lack of oxygen in the Himalayas, those Sherpas test for lower hematocrit levels.

“People who live in the Himalayas, whose genetic line stretches hundreds of thousands of years, have become genetically attuned to the conditions,” Rosen said, “but most who come to live here are not genetically selected to live here.”

Rosen added that there are significant risk factors for seniors, such as bone change. Being healthy and active doesn’t slow that down.

“Being active is a protective factor, but it doesn’t prevent bone degeneration,” Rosen said. “Even if they are active, they may have osteoporosis. If you slip on ice and break a hip, you have the same risks and complications as everyone else does.”

Rosen also said that falls are one of the biggest safety concerns for seniors.

“As people get older, the risk of serious injury from falls and deaths far surpasses the risk of car accidents. Once you pass the age of 60 your risk of serious injury or death goes up exponentially compared to car accidents.”

Paul Chodkowski is CEO of St. Anthony Summit Medical Center in Frisco, a Level III trauma center and the largest health services provider in Summit County. Early in his tenure, Chodkowski recognized the need for more study about health effects at altitude, especially as we age.

“For every 1,000 feet, there’s an exponential effect on the body,” Chodkowski said. “It’s much harder on the cardiovascular system to live at 9,000 feet than at 7,000 feet.”

Chodkowski found that there was a rising senior population in the area and realized the importance of addressing their needs. He wound up hiring Summit’s first local full-time cardiologist, Dr. Warren Johnson.

“Dr. Johnson started seeing patients who had cardiology issues, and they are significant at altitude,” Chodkowski said. “He began to see that there is a higher prevalence of pulmonary hypertension in our population.”

Though little research exists about the physical health effects of living at altitude, Chodkowski said Johnson’s work produced positive developments.

“Dr. Johnson started collecting patient information and data, and eventually that led to the development of a High Altitude Research Center that we’re in the process of working on.”

Chodkowski said he hopes the research will help find better solutions and care for altitude-related illnesses and chronic diseases.

Mental health

In 2017, Eagle County recorded 13 suicides, the most anyone in the county can remember for a single year. In 2016, Summit County also had a near-record number of suicides, but in 2017, that number dropped significantly, a dose of good news that underscores the strides that mental health advocates have made in Summit County in the past year.

However, the struggle to bolster mental wellness in the mountains is far from over.

In working with her clients at FIRC, Drangstveit believes stress continues to be major contributing factor.

“When regular people are struggling to keep three jobs while trying to support their family, it builds up a lot of toxic stress — stress that you can’t really get rid of. It leads to depression, anxiety and general unhappiness.”

Woodring had his life shattered by mental illness. He once had a family, his own construction company and a relatively comfortable life in Summit. But depression and bipolar disorder made him lose it all, and he was forced to move to Pennsylvania for a time. There, he was briefly institutionalized to treat his mental illness.

“In Pennsylvania, I started to get better. They have a much better mental health support system out there. But back then, there was nothing for mental health in Summit,” he said.

Carlos Santos is an independent living coordinator and peer counselor at the Northwest Colorado Center for Independence, a nonprofit that helps persons with disabilities and others obtain the help and resources they need to live independently. He regularly comes across individuals with mental health concerns.

“What I’ve seen is that a lot of these folks come up to the mountains to get away from their problems, but obviously it doesn’t always work,” Santos said. “They look at it as a bit of escapism, but then reality sets in. They struggle to afford the cost of living, and they don’t know how to navigate the system out here to get the resources they need.”

Santos added that while Summit and Eagle counties have done a good job improving accessibility to mental health resources, there are a lot of people who work here but live in Park and Lake counties.

“Out in Park and Lake, the bedroom communities, there isn’t a lot of outreach to help them where they live,” he said. “They can’t always access the resources that are available in Eagle and Summit.”

The Building Hope initiative is a grassroots community mental health initiative that is trying to address gaps in Summit County’s support network. Program Manager Betsy Casey believes that along with cost of living, the very nature of mountain communities makes residents susceptible to depression.

“We have long, cold winters that are nine months long instead of six months,” Casey said, “and combined with the isolation for young people who come here without a support network, it creates a perfect storm.”

That isolation is compounded, Casey said, by the fact that mountain resort towns are transient communities, where people come and go and stable relationships are hard to maintain. Many turn to drinking or substance abuse to self-medicate as a result.

Rosen believes that there may also be some physical reasons for poor mental health in the mountains. One concern he highlights is “nocturnal oxygen desaturation,” or low oxygen levels during sleep because of conditions such as central sleep apnea. That lack of oxygen and poor sleep may lead to psychological issues down the line.

“Sleep apnea is a hidden danger and a real risk factor for people living at altitude,” Rosen said. “It causes fatigue, low energy levels and can also lead to depression, anxiety and other emotional problems. But we don’t know enough about it, and we really need to.”

Rosen added that those mental health issues, whether environmental or biological in nature, might lead to dangerous behaviors such as binge drinking.

“Alcohol is a depressogenic, it causes depression. Excess drinking alters your brain chemistry and hormone levels and might make existing mental health conditions worse.”

Rosen added that excess inebriation creates a secondary concern — falls.

“You’re more likely to die from a fall on ice or snow around here if you’re drunk than getting into a drunk driving accident. It can also seriously affect your sleep, which can cause issues with blood pressure and feeds into the cycle of stress and poor health.”

Rosen said he and Lemis have been hoping to do a serious study about sleep apnea at altitude. Chodkowski said St. Anthony Summit has also been looking into researching sleep apnea and oxygen desaturation.

Rosen maintains that the physical and mental health issues he mentioned eventually push people out of the mountains, and that is the real reason life expectancy is so high here.

“We have everything going for us here, except time,” Rosen said. “No matter how successfully you’re aging, time will still march on, and as time gets the better of us, we have to move out.”

Rosen concludes that the high life expectancy in Colorado’s high country is a bit of a mirage.

“People don’t live longer in Summit, they just don’t die in Summit,” he said. “They move to Denver.”

To greener pastures

Tilden’s brain injury cost her dearly. Because of the chronic vertigo, she had to give up downhill skiing, her true passion. She can’t even do cross-country anymore.

Now that she can’t do much of what she loves, Tilden said she is going to wind up moving to the Front Range.

“There’s not much more left for me to do up here,” she said. She believes she will be taken care of down in Denver, where senior care services are much more readily available.

Tilden managed to live to a ripe old age by avoiding excess drinking, staying active and healthy and keeping a positive mindset. However, the accident left her needing the kind of care she can’t get in the mountains. She is one of many seniors having to abandon their perch at 9,000 feet because of a lack of senior services. In our next installment, The Longevity Project will look at whether our mountain communities are doing enough to care for the burgeoning senior population, which has nearly doubled over the past decade.

Edwards ranks third in U.S. for growth in senior population, according to Newgeography analysis

Colorado’s mountains aren’t the only places showing more white on top. Residents of the resort towns below are graying at some of the fastest rates in the country.

Steamboat Springs, Edwards and Breckenridge ranked first, third and fourth, respectively, for the biggest gains in their senior populations this decade, while Glenwood Springs came in 13th, according to an analysis published in Newgeography.

“You have to recognize that not everybody wants to move to Florida. A lot of people enjoy those mountain communities,” said Wendell Cox, a principal with Demographia near St. Louis who did the analysis using U.S. Census Bureau numbers.

Cox looked at the change in the 65-plus population between 2010 and 2016 in 933 places across the country ranging from small communities to large metropolitan areas. Of the 15 locales with the biggest percentage gains in senior population, nine were in the Rocky Mountain region, including four in Colorado.

 Nationally, the nation’s senior population this decade rose 15.2 percent, a gain nearly five times faster than overall population growth. The entire country is getting older, but Colorado, with its heavy concentration of baby boomers, is aging faster than most.

Read the full story on The Denver Post website, click here.