Struggling to provide support, how ready is state for its over-65 population?

SILVER CLIFF>> Colorado is struggling to support its elders, placing thousands on waiting lists for delivered meals and rides to doctors, slammed by a demographic shift that has turned rural communities such as Silver Cliff predominantly gray.

The latest population data prepared for state lawmakers this month shows a sustained multi-decade surge in Colorado’s over-65 population. By 2035, the number of over65s, now at about 928,029, will reach 1.3 million — 20% of Colorado’s projected 6.8 million population — and outnumber the under-18s through 2060, according to State Demography Office data.

This shift brings benefits of experience and wisdom in a state still slightly younger than the U.S. average but also intensifies challenges, ranging from dementia to wheelchair accessibility — as seen in Silver Cliff and surrounding Custer County at the base of the Sangre de Cristo mountains.

The average age here is 59, the oldest in Colorado and among the oldest in the nation.

Members of the Custer County Senior Citizens Center, as old as 90, gathered in the basement below the Town Hall on a recent frigid morning for one of three weekly meals. Handmade Valentine’s hearts hung on the walls around a library, pantry, pool table and bingo set-up with chocolates and teddy bears as prizes on display.

Most members regard Silver Cliff’s rural norms as healthy for senior living. They breathe clean air and see stars at night. “When you go into the stores, you know people,” said Janice Brunke, 81. Retired Xcel Energy accountant John Stevens, 74, savors his escape from the noisy congestion he navigated in west metro Denver. “By the time you pulled out of your driveway, you were in traffic,” he said. “It’s not like that here.”

Only one of the 20 in the center used a cane. Site manager and chef Darcy Rhodes, 37, watched them standing in line for her Sloppy Joes and scalloped potatoes. “Anything with meat, they love,” she said. Meals she prepares also are delivered by volunteers to a dozen or so members who can’t make it to the center off Main Street. When winds rage down from the mountains and temperatures plummet, deliveries include emergency “blizzard boxes” of canned goods and other items sufficient for three days.

But streets in Silver Cliff and neighboring Westcliffe remain mostly unpaved and lack sidewalks — nearly impassable for a wheelchair. There’s only one doctor living in the county and no urgent medical care. The Wet Mountain Valley Rotary Club’s transport van service is stretched.

Low-income seniors in Custer County increasingly seek help handling home chores, getting to dentists and eye doctors, and arranging breaks for their caregivers.

A waiting list of 50 for this county and three others is growing rapidly, said Tom Mcconaghy, director of the Salida-based Upper Arkansas Area Agency on Aging, one of the 16 agencies around Colorado that coordinates public-funded senior care. Looming budget cuts mean services cannot be increased and most likely will be reduced, said Mcconaghy, a former police officer who recently testified at the legislature.

“Having social connections is extremely important for an older population, and people tend to eat better when they’re not alone,” he said in an interview, warning against the “anonymity” in technologydriven cities.

“But we are behind the eight ball. We are behind in preparing for the larger number of elderly residents we will see in the next 25 years. Why does this matter? I don’t want to see people go without food or live in unsafe conditions. These are people who worked very hard in their lives. We owe it to them to help meet their needs. It is a moral issue. Are we discarding older adults because they are no longer any use to us?”

‘Struggling to handle what we have now’

At the Custer County Health Center, 60 to 80 new patients a month seek appointments, which typically aren’t available for three weeks. “We’ve had a huge influx of older people who moved from Texas and California,” manager Tammy Ahlers said in her office adjacent to a busy waiting room.

The clinic offers only general “family practice” care, but Ahlers said staffers face constant and increasing demands to handle emergencies. She has arranged for a bone specialist to visit the clinic once a week. Heart and lung doctors swing through the county every other week. “Telehealth” often proves insufficient.

For urgent stroke symptoms, chest pains, breathing problems, kidney dialysis, and radiation treatments, Custer County seniors must drive or seek emergency transport to medical facilities in Cañon City, Pueblo or Colorado Springs.

“Rural Colorado is not ready for a more elderly population. We’re struggling to handle what we have now. You would be taking a risk if you live in rural Colorado and have a health issue.”

When Janice Brunke’s husband needed radiation treatments to be cancerfree, the two of them made the two-hour back-andforth trip over the twisting Hardscrabble Pass to Pueblo 45 times, she said.

The nonprofit Valley Assisted Living facility in Westcliffe offers 14 beds. But seniors with medical needs typically must be transferred to facilities in Pueblo and Colorado Springs, said Sherry England, activities director. “A lot of them don’t want to leave. They have no choice,” England said. England said there’s a waiting list for space in the facility and survival depends on donations.

A microcosm of challenges statewide

Struggles in Custer County increasingly are replicated elsewhere.

Statewide, waiting lists for meal delivery and transport have ballooned into the thousands. Overseers of the area agencies on aging estimated clearing those lists would cost an additional $20 million in funding — above the current total budget of about $46 million using state and federal funds.

In the eight-county Denver area, more than 3,000 seniors are on waiting lists for meals, said Jayla Sanchez-warren, director of the Area Agency on Aging for metro Denver, run by the Denver Regional Council of Governments. Beyond that, more housebound seniors are asking for rides to medical appointments, an unmet need that reverberates because appointments often must be canceled, leading to seniors skipping necessary health care.

“Let’s say you just got out of the hospital and you cannot prepare your own food because you just had surgery. Normally, you could call and we would have a meal sent to you the next day. But right now in metro Denver, if you need a Meal on Wheels, you will be put on a waiting list,” Sanchezwarren said.

Metro Denver services providers also are anticipating an accelerating rate of residents suffering from Alzheimer’s disease (estimated 76,000 over-65s diagnosed in Colorado) and other forms of dementia, she said.

“This is going to be difficult. More people in nursing homes. More people living in isolation. More amber alerts for older adults. More ‘I’ve fallen and can’t get up’ calls to the fire departments. More people having a hard time just meeting their basic needs. Unless we understand this at a deeper level, it’s going to be about surviving, not about thriving. I am sure we have had people fall through the cracks. There will be more and more people who fall through the cracks.”

Home-bound elders await food

The Adams County Senior Hub on Dec. 31 suspended meal deliveries. Sanchez-warren and a colleague stepped in, drawing on county emergency funds the first week of February and rounding up frozen food supplies. They headed to the plains towns of Bennett, Deer Trail, Strasburg and Watkins. Thirty residents in this area were practically desperate.

“These folks really needed the food,” Sanchezwarren said. “They could not prepare meals for themselves. They could not drive. We saw a lot of people on walkers and in wheelchairs. Some could not come to the door. We saw poverty.”

American Association of Retired Persons officials are pressing for increased funding because reduced meals, transport and other services for seniors living in their homes could lead to shifting more elders into situations where they need skilled nursing medical care — likely in institutions, said Sara Schueneman, the AARP’S state director.

That’s ultimately more expensive for taxpayers, Schueneman said. And institutional living can increase disorientation and isolation. “We’re already struggling with the health care industry not having enough workers,” she said.

“How are we going to support these vulnerable populations?”