The Longevity Project | Part 4: Colorado mountain towns struggle to accomodate a surge of seniors
February 26, 2018
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 http://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.
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."
“They’ve both been very helpful volunteer-wise with the center. They contributed a lot of time, and truly care about it. They’re amazing people.”Lorie Williams,Senior Center managerOn Anne and Ed Crane’s contributions to 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.
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.
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."
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.
"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."
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.
"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.