Guest Opinion: We need a master plan to address the needs of our aging population | News | Palo Alto Online |


Guest Opinion: We need a master plan to address the needs of our aging population

Consultant calls for new survey on issues impacting older family caregivers

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In Palo Alto, we have a perfect storm on the horizon as the population ages and the cost of living continues to increase.

Palo Alto has one of the most rapidly aging populations in Santa Clara County. There are more adults turning 65 years old and living way past 85 than ever before. The Public Policy Institute of California has predicted that our state's elders will grow by 4 million by 2030. Thus, more of us will need care and more of us will become family caregivers.

In Palo Alto, many older adults can't — or will not be able to — afford the high cost of private home care, assisted living and health insurance co-pays for emergency room stays, ambulance transports, dental work, prescriptions ... The list goes on. And those who are house rich but cash poor will not be able afford to live or die in the place they have called home for more than 40 years.

I recently consulted with a staff member at a local suicide hot line who has worked the evening shift for more than 10 years. He confirms that he is receiving calls now from older adults who have suicidal thoughts due to the rising costs of rentals, the lack of affordable senior housing and difficulties accessing health care.

Family caregivers also face critical financial, emotional and physical health risks.

The Centers for Disease Control designates older family caregivers as an at-risk subgroup. They are at risk for social isolation, stroke, heart disease, autoimmune disorders, chronic pain and crippling anxiety.

My Palo Alto caregiver group members recently took a stress survey. Several members within our groups stated that they feel cut off from friends, fatigued, do not sleep well, have not had respite in months and feel scared about their financial futures.

One family caregiver, an adult daughter in her 60s, described her life as a "living hell." She is driving daily between two different households to assist frail, elderly relatives. One relative has had a series of strokes and is incontinent, and the other relative has diabetes and memory loss. She is on a medication regimen that includes 20 pills.

While there are some local efforts taking place to address the growing needs of our rapidly expanding aging population and their stressed family caregivers, there is no coordinated federal, state, county and city "master plan."

The city of Palo Alto, Avenidas and the Alzheimer's Association have partnered to create an Age Friendly and Dementia a Friendly City Initiative. Last March, 150 Palo Alto residents met with a panel of elder care providers to learn about dementia signs and symptoms and strategies for coping with challenging behaviors.

At Stanford University Hospital, medical professionals recently attended a seminar over a period of many months to bring hospital administrative staff in dialogue with quality-assurance staff and health providers to examine the gaps in care for frail elders.

For things to improve for family caregivers, we need a coordinated system and "road map" linking the entire region's elder care community and medical care networks.

I am suggesting that we conduct a new survey and or census on the issues that impact older family caregivers who reside in Palo Alto and Santa Clara County.

We need to know how many of you now 65-plus are care giving for a frail older loved one, a disabled adult child, grandchildren or perhaps some combined version in your household. How much of your budget is going toward the care of a loved one? Where do you obtain your health care? Are your urgent care needs met? What type of services do you need? Is there a delay for health care services? Were you instructed of your Medicare patient rights?

I am told by my caregiver group members that there are significant delays for scheduling a comprehensive cognitive status exam with a neurologist and for a first-home visit with a palliative care team. Most of my clients have had difficult experiences with a rushed discharge from a skilled facility or have not received Medicare policies forms required during the hospital admissions process and prior to discharge.

Until we have a master plan, learn to take control of what you can, when you can. Voice your concerns.

And finally, know your patient's rights:

— Become familiar with the Social Security and Medicare website If you are the legal decision maker for an incapacitated loved one, you have the right to file a Medicare appeal and or grievance concerning payment costs, prescription changes, discharge plans from a hospital, nursing home or home health service.

— Contact Medicare with any questions at 800-633-4227, or call 800-434-0222 to discuss your concerns with staff at the California Health Insurance Counseling Advocacy Program.

— Purchase a caregiver ID tag which states, "I am a caregiver. If I am found down, please call this number."

— Have a team meeting with relatives, neighbors and friends: Delegate tasks; try to arrange for time-off coverage; and in case of an emergency, back-up support.

— Join a caregiver support group.

— If you are having thoughts of suicide, go to your local emergency room or call the suicide hotline at 800-273-8255.

Paula Wolfson, LCSW, manager of Avenidas Care Partners, provides elder care consultations, counseling, crisis intervention, and emotional support to older adults and their significant others. She can be reached at


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25 people like this
Posted by PA Grandma
a resident of Community Center
on Jun 25, 2018 at 11:18 am

I am an "aging" Palo Alto resident who shares her house with a child's family. We need more space for incipient teenagers. We can't afford to sell the house for a larger on - punitive capital gains, lack of affordable larger houses, lack of affordable senior housing, etc. etc. Pretty much our only solution is to move away, or convince the PA planning department that we need to add on space that exceeds the Palo Alto acreage limits. There are basically no good options for us here.

And I am not even addressing the issues discussed in this article. Yes, Palo Alto NEEDS A MASTER PLAN FOR SENIORS! It should include everything Paula mentions AND a plan to build one or two more Channing Houses. I would suggest utilizing the Cubberley land as a start. And in the process, combining the project with affordable housing and an art center.

Finally . . . I find it frustrating, if not infuriating, that Palo Alto and Bay Area government leaders - read City Councils - have not been able to get control over the rampant development that caused, and is still adding to, the current untenable situation. Consequently seniors who have lived in the area for a long time and have invested themselves in the community and contributed to the quality of life here are now being essentially written off. There is no excuse for the shoddy treatment of seniors described in this article.

10 people like this
Posted by @PA Grandma
a resident of another community
on Jun 25, 2018 at 11:41 am

That sounds about right. You used Prop 13 to wall yourself up in your house while protesting more housing development for others. Housing costs increased for everyone else while you were protected from it. Now that you apparently want a new house, you're shocked to find that everything is so expensive. You also want to sell your Prop 13 protected house while also not getting a capital gains hit on top of it (lol no).

I don't know what else you expected to happen?

31 people like this
Posted by @ resident of another community
a resident of Community Center
on Jun 25, 2018 at 12:17 pm

Let's see . . . what is objectionable about resident's response? Kind of bitter . . . and ignorant. Although I do not have to answer, here goes.

We bought the house with every bit of cash we had and a substantial mortgage before Prop 13. We raised children there, sent them to college and were employed in the community at government jobs (note - paid at the usual sub-private employer level), and eventually in the tech world. We paid taxes, engaged in the community and lived within our income. Our lifestyle did not include expensive cars, regular vacations to far-flung places, etc. etc. We watched as Palo Alto and Peninsula cities became increasingly controlled by developers, and as housing prices skyrocketed, we did NOT applaud. And we are not alone among others of our generation. The current landscape of greed and obsession with money among those who run the city and those developers who own the city is not something we chose or encouraged. We would have much preferred that Palo Alto had grown at a reasonable pace and that our children and the children of our friends could afford to live here and raise their children here as we did.

14 people like this
Posted by Naphtali
a resident of Crescent Park
on Jun 25, 2018 at 12:37 pm

@ resident of another community, only 1 in 3 Californians (I’m one of them) and only 3 counties (SF is one of them) voted against Prop 13. Better to blame the city councils who never ever look beyond four years. Recognizing the growing jobs and housing imbalance locally, implementation Program 6 in the draft of PA’s 1st Comprehensive Plan in 1976 would have REQUIRED “all new retail and office construction to provide some proportion of residential space on or near the same site.” The election that year flipped the city council from 5 residentialist-4 pro-business to 7-2 the other way, and the Comp Plan program was changed from “REQUIRE” to “PROVIDE INCENTIVES FOR” and then ignored. So the city piled on the jobs, didn't significantly add housing, and ignored transportation. And here we are.

Like this comment
Posted by Green GAbles
a resident of Duveneck/St. Francis
on Jun 25, 2018 at 12:42 pm

If seniors own homes and do not have enough money to continue to live in them until their departure, there are reverse mortgages. No monthly payments are made. When death happens the reverse mortage gets their money back. Granted, it is a bit expensive but why not use it if it is needed.

24 people like this
Posted by Annette
a resident of College Terrace
on Jun 25, 2018 at 12:53 pm

Annette is a registered user.

Ms. Wolfson wrote an informative article and PA Grandma's response hardly warranted the sort of comment that followed by the next poster. The problems described are real and serious. It's absurd (shameful, even) that our leadership plans more assiduously for those who WANT to live or work than those who DO live and work here. Our development policies are slapping us upside the head and it is time that our CC and City Manager hear loud and clear that the status quo is dysfunctional. Their plans are failing us. Do they not realize that there are many people living here who do not have heaps of money? Or that this is not just about older citizens? One need only look at the President Hotel evictions/displacement for another example of the true cost of our development policies.

And yet the Council majority is preparing to do what they can to defeat the citizens' initiative to lower the development cap in the new comp plan. The initiative proposes that PA *only* grow at the rate we have been growing for most of the last 3 decades. The very rate that has resulted in our current untenable problem set. One could argue that even that is too much, but even grass roots movements involve compromise. CC has the latitude to simply amend the Comp Plan or at least not put a competing measure on the ballot (to confuse things). But we have a CC majority that is pro-development. Council has decided to spend time and money to defeat the initiative. In fact, many residents have already received a survey call that is riddled with misinformation.

Ask why CC (the majority)is doing this. Ask who donated to their campaigns. Ask who paid for the survey. Ask what the point is of exceeding the Office/R&D growth rate that has brought us to this sorry state. And then ask yourself if you want to see more of the same - and more of the problems Ms. Wolfson described. Personally, I think we can do better.

8 people like this
Posted by Me 2
a resident of Old Palo Alto
on Jun 25, 2018 at 3:35 pm

"@ resident of another community, only 1 in 3 Californians (I’m one of them) and only 3 counties (SF is one of them) voted against Prop 13. Better to blame the city councils who never ever look beyond four years. "

You want to blame city councils and not the 2 in 3 Californians that voted for Prop 13?

Responsibility for bad decisions doesn't work that way. When you're responsible, you're responsible. Shifting blame is magical thinking. It's all about incentives, and Prop 13 provided the incentives to promote commercial development over housing.

3 people like this
Posted by No Sympathy
a resident of another community
on Jun 25, 2018 at 4:11 pm

I'm not seeing a lot of "we advocated for new housing developments to keep up with housing demand and rising housing costs". Just a lot of people feeling that they personally are good, paid their taxes, and didn't buy expensive things, and therefore don't believe they did anything wrong and shouldn't have to endure the costs that come with keeping the "neighborhood character" i.e. fighting against housing development for decades. It's really hard to feel any sympathy, especially since you're sitting on a massively overpriced asset as a result while, on the flip side, everyone else gets to deal with crazy rents and see property ownership become ever more difficult to achieve.

5 people like this
Posted by Todd
a resident of Another Palo Alto neighborhood
on Jun 25, 2018 at 4:27 pm

Whatever happened to "move where you can afford" "not everyone deserves to live in Palo Alto" etc? Or is that attitude only meant to be directed at millenials?

12 people like this
Posted by Resident
a resident of Another Palo Alto neighborhood
on Jun 25, 2018 at 5:22 pm

PA Grandma's comments are valid because she is in a situation where most of us will be one day. Perhaps we will not aspire to be living with our children and their family, but we will aspire to live close enough to be part of their lives.

If those of us who have lived here long enough to have the benefit of a lower property tax than those of our newer neighbors living in similar homes are forced to move due to taxation how can that possibly help Millenials. The house prices will not fall due to the fact that so many overseas cash investors are buying here. The rental market will not fall due to these millenials renting and putting four or five single adults in each house where there isn't enough parking. The neighborhoods will decline as there won't be pride in community as these packed in Millenials will aspire to live in a family orientated community when they eventually get to the stage in life where they become parents who will want a single family home for their young children.

Think it through before you start getting rid of those of us who have been here longer than many of you have been alive.

23 people like this
Posted by Nayeli
a resident of Midtown
on Jun 25, 2018 at 5:45 pm

I was watching a series of street interviews in South Korea about how age and maturity is perceived there. Interestingly, age is valued much more because of the wisdom that it most often can bring. Young college graduates were mindful that companies often would prefer the older worker over a younger counterpart because of the perception that they might be able to offer more wisdom from age.

This struck me as being very different from the mindset in the Silicon Valley. I read an article a couple of years ago about how tech workers are spending a great deal of money to look younger (because it helps them when interviewing with prospective employers).

I think that there is something interesting to note in how society perceives and cares for our elders. Our taxes are considered "progressive" because they don't want to hurt people who cannot afford to pay them (or would be hit adversely by them). I think that property taxes should be progressive too. Property taxes were never designed to force a person, couple or family to lose a home that they've already paid for (or are in the process of paying for).

We should always be sympathetic with those who are much older than us. With proper diet, exercise and some good, old-fashioned genetic luck, we will all grow old one day. I hope that society doesn't make it impossible for people to care for themselves or make it difficult for children and loved ones to assist in the care for the older members of their family.

6 people like this
Posted by Webster Street
a resident of Another Palo Alto neighborhood
on Jun 25, 2018 at 5:57 pm

Civility, people, civility. Don't dump on us because we're ones who stretcccccched our pennies literally, saved, saved saved and saved to buy a modest house with 1300 sq. ft. Have stayed in our same home for 43 years rather than move up with the Jones. Now we'd like to enjoy it. At least while we can. Channing House is expensive; the Vi out of sight. Stevenson House requires that you have exhausted all of your money, if you had any, as does Lytton Gardens. Where are the group residences for the rest of us? Rich enough to have some money, but not enough for the Vi.

1 person likes this
Posted by @Resident
a resident of another community
on Jun 25, 2018 at 6:24 pm

Do you think millennials are cramming themselves into those single-family homes for fun? Or is it indicative of how just how bad the housing crisis has become? There is clearly a need for more apartments around here, and until then, you're never going to see a young couple with young children buy a single-family home in Palo Alto unless it's inherited or they're massively wealthy, because the only way to afford the mortgage on single-family homes now is to rent every inch out to as many warm bodies as possible.

12 people like this
Posted by Annette
a resident of College Terrace
on Jun 25, 2018 at 6:37 pm

Annette is a registered user.

@Resident makes some very good points. Perhaps the "Welcome to Palo Alto " signs should be amended to include something along the lines of "Until You Grow Old". It boggles my mind that there appears to be an assumption that one is entitled to own a home here simply because one wants to own here for whatever reason (school, work, to be near Stanford, to be near family, as an investment, just because). I can think of numerous lovely places that I would like to live but cannot afford. Or they are full-up. It never occurred to me that those communities are obliged to turn my wishes into possibilities. And yet that seems to be the expectation of many, including some members of our City Council. Do they not know that things cycle?

1 person likes this
Posted by @Resident
a resident of another community
on Jun 25, 2018 at 6:46 pm

Better article title: Boomers seek ways to continue externalizing negative outcomes of their actions onto others.

Being old doesn't in and of itself entitle one to respect. And when you've basically done everything you can to pull the ladder up with you and ensure hardship for the generations following yours, you may find that people don't respect you that much.

2 people like this
Posted by Fred D (no... T)
a resident of Greenmeadow
on Jun 25, 2018 at 6:51 pm

Y'all got bigger fish to fry... losing chunks of your Medicare and Social Security.

The Associated Press
June 20, 2018
Web Link

House GOP plan would cut Medicare, Social Security to balance budget
The budget would transform Medicaid, the federal-state health-care program for the poor, by limiting per-capita payments or allowing states to turn it into a block-grant program

"House Republicans released a budget proposal Tuesday that would... making large cuts to entitlement programs, including Medicare and Social Security, that President Donald Trump has vowed not to touch."

Well, good thing Trump made a promise. Eh, wot?

3 people like this
Posted by @Annette
a resident of another community
on Jun 25, 2018 at 6:54 pm

If no one is entitled to live in Palo Alto, then neither are you. You aren't entitled to a plan that keeps you around here in old age,
and if you can't afford to sell and still live in the area, then that's too bad. Surprise, it works both ways.

13 people like this
Posted by Annette
a resident of College Terrace
on Jun 25, 2018 at 7:03 pm

Annette is a registered user.

Just to be clear, the "@Resident" I was referring to is the one who wrote "PA Grandma's comments are valid because . . ."

I think it is the unsustainable Office/R&D development, not home ownership by baby boomers, that is the single biggest contributor to the housing conundrum. As long as that continues we will be creating more and more demand that we cannot possibly meet. That's akin to nurturing anger and frustration.

1 person likes this
Posted by @Annette
a resident of another community
on Jun 25, 2018 at 7:31 pm

Nice strawman. No one is saying that Boomers owning homes is the cause of the housing crisis. Boomers preventing further housing construction is what's causing it.

9 people like this
Posted by Webster Street
a resident of Another Palo Alto neighborhood
on Jun 25, 2018 at 8:15 pm

Paula Wolfson, the Opinion's author, must be amused, saddened or astonished by the comments so far. She talks about a master plan yet none of us has really addressed that.
What is a master plan? It means addressing the broad needs of the local aging population - whatever the age group, income level, desire to retain independence even through physical and mental abilities may change significantly. Etc. etc. Those of you at the beginning or in the middle of your careers, all have parents and grandparents. Do you know the issues that they will, or currently, face? Probably not. Do you care? You answer that one. Eventually, these issues will become personal for you. Yes, you could put 'em and their belongings on a bus for Chico where it's cheaper to live. Some of you have alluded to that. Paula spoke largely about care givers which is just one component. Aging in place is a dynamic that has spread across the nation today, so get used to it. Learn what it means. Just don't say, "Get out if you can't afford to stay." Instead, think of how we can facilitate the process through local, regional etc. resources. both private and public. Some of you are really upset because the houses don't turn over. Well then, wrap your head around workable options. Chico isn't for everyone. Finally, I ask Avenidas and its leadership - that means director, president of the board of directors, and directors, - to lead. You regard yourself at the forefront of Palo Alto's senior issues. Then do something beside build a new center in north Palo Alto. Palo Alto is a big, beautiful town, and the aging populaton lives on most every street from San Francisquito Creek in the north to San Antonio in the south.

6 people like this
Posted by Anonymous
a resident of Duveneck/St. Francis
on Jun 25, 2018 at 9:46 pm

I suggest a project (that would hopefully spread to more areas) in our local PAUSD school district, wherein children formally assist seniors (age 70+) on the basis of school catchment area. Nobody travels far, but the energy of youth would be directed to assist others nearby.
Elementary, middle, high school and our junior colleges would have an activity each term. Call it Community Service, if you like. Nothing arranged or paid for by Mom and Dad. This would be PART of the experience of being a public school student here, a routine.
The seniors would be invited to sign up for several categories of services. These might be decided to include: (?) things like social, yard cleaning, gardening, planting inexpensive decorative flowers, taking an oral history, transportation, attending a seasonal lunch such as the ones (that used to be done by mom volunteers) at the high schools for teachers and administrators. Tiny kids can make seasonal art on paper placemats (our private elem school,in another cuty did this for a prison program....)
Nothing would be one on one, and everything would be with at least one adult working at the institutions listed. It would not be ongoing, rather it would be periodic. It might make a bit of a difference, though limited concrete actions/activities.

4 people like this
Posted by Resident
a resident of Another Palo Alto neighborhood
on Jun 26, 2018 at 2:30 pm

How about some restaurants that seniors can enjoy?

Seniors are not really able to deal with some of the order at counter types of restaurant we seem to be getting lately. Even if the food is delivered to a table, the party has to look for seating after ordering. A senior is not as able to stand in line while reading a menu usually written on the wall. The senior may need to hold a walker, change glasses to read the menu, and perhaps dig deeper to find a wallet in which to pay at the counter before remembering all they may need in the way of silverware before seating themselves.

Most of the restaurants with table service are going, and the replacements do not suit seniors well.

And many seniors cannot walk as far as they used to, even if they do not need a disabled spot. Restaurants with their own parking lots with a couple of blue badge spots right outside are the types of places our seniors need and enjoy.

2 people like this
Posted by Webster Street
a resident of Another Palo Alto neighborhood
on Jun 26, 2018 at 6:01 pm

Thanks, anonymous, for some concrete ideas. And, for getting us back on the main topic.

There's a great article in the Mercury News' Business section on Sunday. "College students moonlight as 'grandkids' for hire." Started by an adult "grandkid" in Florida, he advertises to HS seniors and college students to do light housekeeping or driving chores. The company's real goal is in its slogan: "Grandkids on Demand." It also might build bridges between generations in the futur. This would improve understanding among both populations. However, "grandkids for hire" will only work where there's a market incentive. The job market in Florida isn't the same as the Bay area. Also, read the Mercury News article on hospitality businesses in Santa Cruz hiring 14 year-olds because the older ones don't want to work in kitchens, park cars, etc. Sure, why not go after jobs that pay more! Basic sense.

5 people like this
Posted by Another PA Resident
a resident of Leland Manor/Garland Drive
on Jun 26, 2018 at 6:53 pm

Those of you who think that long-time home owners in Palo Alto are the cause of the housing crisis should read this article by Brian Reynolds:

Who benefits most from Proposition 13? Hint: It’s not homeowners.
Web Link

According to one of my friends, about 4 or 5 people own most of the buildings in downtown Palo Alto and have for a long time, thus benefiting greatly from Prop. 13. (If you wanted to check that, I'm sure you can troll through Santa Clara County Property Tax rolls.) They are the ones pressuring the City Council to not enact any policies that would enforce or encourage developers to add housing to new structures or even turn some of the downtown buildings into retail/business on the lower floors with living space above. (In its rebirth, Detroit is doing that to great advantage.)

And in light of the recent articles in this paper calling for civility in discourse, it strikes me that given the tenor of some of the comments in this thread, we are facing a severe uphill battle.

1 person likes this
Posted by Webster Street
a resident of Another Palo Alto neighborhood
on Jun 27, 2018 at 6:38 pm

I would like to apologize to Avenidas for "flaming" as my husband accused me in my last comments. (Does anyone over 50 know what the term means?) Mea culpa. I have written them for years about having a satellite elsewhere in Palo Alto. As far as I know, they haven't acted in any way. Despite that shortcome, they are an outstanding organization with many programs for seniors. We're lucky to have them. Why do I keep pushing the satellite idea? Because the city is spread out and a program on Bryant does not serve the needs of many seniors who live at a distance. To me, that means beyond Oregon Expressway, especially if you have to depend upon public transportation.

We live on East Charleston. We drive now, but when we need it (and we haven't been banished to Chico), the bus stop is nearby. For many it isn't. For us, the trip is long, but it does reach downtown and Avenidas. Look up Or, call Avenidas at 289-5400 for information.

Avenidas is currently in Cubberley on Middlefield in southern Palo Alto. But, that will end once Avenidas is remodeled on Bryant Street. Will Cubberley continue to be used by Avenidas in some way? Will Comida, the lunch program, continue at Stevenson House on Charleston, or move elsewhere? The city council quickly approved money for remodeling. What's their commitment to funding a sattelite? ANY satellite? Finally, there are many advantages to using Avenidas. Read a about them at Am I forgiven?

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