Okay, we're calling this meeting to order.

This is the Commission on Senior Living.

And tonight we have two agenda items.

And number one is Dr.

Joanne Burke is going to be speaking with us.

And then I am going to give you a summary on our conference that is going to be take place in October the 10th.

So I for the little bit of a delay.

We had some technical issues.

But I am so well, I am so happy to welcome Dr.

Burke here to our meeting.

I know that you're going to want to get to know her more after you hear her presentation.

You know, when Dr.

Burke pulled up to my house in a large pickup truck and dressed in a farm clothes, I knew she's my kind of a woman.

She's not only works with older adults, but she works with troubled teens and horses.

Many of these theories that she's going to present tonight.

She has learned from horses and their behavior.

So that'll be interesting to watch that develop.

Not only does she work with horses and mules, but she started her career as a nurse.

Sounds familiar to me as well.

Her passion for working with older adults started at the University of Cincinnati.

She also studied in the School of Social Work.

She has always advocated for older adults and now serves as chairman of the Indiana Commission on Aging.

She has written the Living Longer, Living Better Guide, which has been disseminated throughout our state.

I think you will enjoy this presentation and learn how we, as Carmel and our Commission, can make our community work for the people of all ages.

So, Dr.

Burke, it's up to you.

Well, thank you very much for this opportunity to be here.

Before I begin, I I just want to say a thank you to Carmel.

My oldest granddaughter has special needs, and we were so fortunate to be able to get her into one of the apartments at North End, and she works with the village of Marichi up there, and it has truly I could almost cry.

It is truly transformed her life.

She just turned 30.

She lived up in Tipton, and rural communities don't have the resources needed to support people with some special needs.

She just was kind of lost up there.

And she came down here her life.

She moved in a year ago in February.

And she's done really, really well.

She's so proud of herself.

And we got her a job across the street at Woodland Terrace.

She walks to work, works three days a week, and it's delightful to watch her just blossom and grow.

So thank you, Carmel.

So now with that said.

And Dr.

Burke, we just approved uh phase two to that north end project, the city did, and that will include a uh 55 plus over 200 uh 55 plus apartments there, too, as well.

Okay.

Great.

Now something happened.

Let's just find out.

Okay.

Small technical glitch again.

All right, we're back in business if I can make this work right.

Okay.

Well, a few weeks ago.

I didn't touch it.

They're adjusted.

Okay.

A few weeks ago, I was asked to uh talk over in Fisher's.

Uh, the Shepherd Center had asked me to talk, and that's where Carol and I had a little conversation after that meeting.

And they asked me to talk about population aging, urbanization, and public policy devolution.

I mean, that's what I took out of what they asked me to talk about, and I thought, boy, I better put a little levity in this, or I'll have everybody asleep in about 10 minutes.

So basically, that's woven into what we'll talk about today, but it's not going to be a dry professor's lecture.

I don't do that, although I taught for years.

Um, this is interactive, so if I'm saying something, you want more clarity, I want to be informal enough, just ask me.

What in the world are you talking about?

This really excites me, and it's something I think in community development, probably isn't talked about in this way.

So let's just see where you go with this and where we get with this.

Here's the most interesting thing with population aging.

Let's see if we can make this.

There we go.

More of us are living longer than ever before.

Our communities were developed for younger families.

And now we have a growing older population.

And basically, we don't know how to do it.

That's why I said we all need to be in the con in the conversation about it.

Because we have to learn together how to do this because we've not done it before.

This is some of the results from the last survey that was done in the county served by Sokoa, and Hamilton County being one of them, we just extracted some of the information out of the survey that was done that's particular to Hamilton County.

Now, this is Hamilton County as a whole.

This is not Carmel specifically.

But let's just go through this.

Only 4% of those who were surveyed, and these are people over 65, thought there was good ease of public transportation in the county.

Only 15% believed there was good availability of public places for older adults wanted to spend time.

Not knowing what services are available to older adults is a problem for 74%.

And that just kind of goes all across the United States.

We need to think on that one a bit.

Staying physically fit is a problem for 64%.

Feeling depressed is a problem for 61%.

Only 39% believed there was good availability of affordable housing in Hamilton County.

Only 47% believed there was good availability of accessible housing in Hamilton County.

And only 40% thought there was good availability of mixed-use neighborhoods where people can gather to eat, shop, work, and receive services.

So that led me to ask the question.

How is Carmel this community carmel adapting to population aging?

Well, I grew up up in Tipton, Bill and I, my husband and I grew up in Tipton and then left for about 50 years and came back.

So Carmel has really, I talked about urbanization, that has been carmel.

Lots of people moved in here rapidly in the last 50 years.

However, during the same time frame, population aging was occurring.

People who moved to Carmen 50 years ago, we did a little talking here a little bit ago with a few people.

They stayed, they're not 25 or 30 anymore.

They aged.

So the community also experienced is experiencing population aging as well as urbanization.

And now some older adults are moving here to be with their adult children.

Let's use a historical perspective to better understand what's happening now, not only in Carmel, it's across the whole country.

Let's go back to the 1800s.

Now, if I have my history right, and if I'm wrong, please correct me, anybody here.

I believe the count Hamilton County came into being in 1823.

Does that sound right?

Now let's think about 1823.

We didn't have a concept of childhood then.

That's really important to think about.

We didn't have a concept of it.

Working class families, children worked in mines, they worked on in fields, they worked in factories.

Communities didn't have schools.

There's no school in Carmel then.

Carmel didn't exist.

Didn't have parks with playgrounds, specialty pediatric care or immunizations for communicable diseases.

Water and milk and other foods were not tested for bacteria.

We had problems with our food and water back then.

Children without parents were placed in local almshouses, later called county homes, the poor home.

Here in Hamilton County, it was over on Cumberland Road.

I don't know if anybody ever saw it, remembered it, or knows about it.

I think there's a school there now, or there maybe that's where the jail is.

I'm not sure.

County land.

Think about it.

This county wasn't, you know, we didn't have, we didn't think about children then.

Local communities didn't have resources to care for children who were deaf or blind.

So mid-century, we ended up with schools for the deaf, schools for the blind, and state mental institutions were built.

Before then, it was all townships and counties, and their alms house or poor house where people were, and everybody who had a need ended up there.

Didn't matter, it was all mixed up.

They did the best they could, it was what they had.

Orphanages were developed in the 1800s.

The population over 65 was small.

Something to keep in mind.

All right, what happened in the 1900s?

The concept of childhood emerged.

All of a sudden, we began to get an understanding of what child development.

There were things children needed.

So schools were developed.

Child labor laws were enacted.

Pediatric health care emerged.

Child protective services were developed.

Children were then moved from orphanages to foster care because they didn't thrive in institutional care.

Social Security was passed in 1935, providing a public old age pension that reduced poverty for older adults.

Let's move to 1965.

Medicaid, Medicare, the older Americans Act was passed to provide health care for older adults who could not afford the high premiums charged by private commercial health insurance companies.

In the 1800s, there wasn't even health insurance.

We didn't have much health care didn't amount to too much then.

State mental institutions were closed in about in the 1960s, community mental health centers were developed.

We're still struggling with all of that.

Nursing homes, which is the institutional care model, and assisted living facilities were developed as a result of Medicare and Medicaid legislation and funding being available.

That whole industry grew on that program.

And something to keep in mind, the middle class uses Medicaid planning.

So the middle class as well as the poor use Medicaid now to fund nursing home care as well as home care.

This isn't just the lower class that's using that.

It's important to note.

Okay.

Okay.

Let's look at the 2000s.

Here we are.

Population aging and urbanization are happening rapidly.

This county continues to grow.

But we had the COVID pandemic in 2020.

We had we had one a hundred years before that had its issues.

But COVID, let's talk about that a little bit.

Social isolation, fear, and depression became prevalent.

And COVID spread quickly in nursing homes, causing death of residents.

That happened.

In 2024, I need to get in the right century here.

Voters elect an administration to shrink the health care and social safety net provided by federal and state programs through restricting funding and access to them.

That's still in process.

What that meant was this is public policy devolution.

We're moving in the 1800s.

Remember when I talked about the poor house and the county provided townships and counties.

Then we moved up to some state institutions.

Then in the in the 1900s, we got some federal legislation.

Now we're going backwards.

But what that's doing, and the reason I bring it up with local communities, this isn't all terrible.

I'm just we need to think about this.

We're bringing some of these issues back to the local communities.

But here's here's the hitch.

We don't have the infrastructure for it to deal with some of these things.

So we're beginning to kind of wonder how some of the service gaps may get met.

We're going to have first responders be called on more, pretty sure of that.

We will have some rural hospitals probably closing.

You are not in that situation, but some counties are.

Homeless shelters and jails are not good places to put impoverished older adults.

Roll up our sleeves and start talking to each other at the community, local level, because there's nowhere to kick the can.

So just to be aware, that's just an observation.

Now it's really important to work together in a local community.

As I said, I don't see this as all terrible, but we do need to work together.

Why?

Because human beings are social mammals.

And I talked about in COVID how we did not do well when we were wearing masks and locked up in our houses.

We didn't do well with that.

You know, as human beings, we're more attuned to our social environment than we realize.

And this is really important when you start to think about the community and what we may need in a community, what kind of community we want.

Dr.

Stefan Porgis, who is a psychologist at Indiana University, developed a theory based on how we are internally wired in our nervous system to connect with others.

And I learned this from horses.

Honest to God, I can tell you how I learned this.

I mean, horses mirror what's going on inside us.

And I am a volunteer at Agapi Therapeutic Writing Center up in uh Cicero.

I clicker train their many horses to go out and do visits with children, uh special needs in the schools, and we go to nursing homes and so forth.

Anyway, let me talk about this a little bit and then I'll tell you how the horses taught me.

I think this theory can help us understand why we need to live in communities that support us and what happens when our communities aren't we're not connected.

Dr.

Porgas calls this connection with one another, this social connection, neurosception, and this has been well studied, this is evidence-based, it's not something I just pulled out of the sky and throwing at you at all.

You can go look at all this.

The autonomic nervous system is our personal surveillance system.

Each one of us has that going on in this room right now.

We're not aware of it, but it protects us by sensing safety and risk in our environment.

It's always on our autonomic nervous system, has two pathways the parasympathetic and the sympathetic.

When we're connected, it's the ventral vagal pathway is active and we feel safe and connected.

If we feel like we're threatened in some way, the sympathetic pathway gets activated, and we can go into fight or flight.

We can go back, we go back to the dorsal vagal pathway and just shut down.

Now I know that sounds like how could that go on, but this chart, I've looked at it extensively.

This really impacts us in ways we don't think about physiologically, impacts us, our heart rates, our digestive system, how attentive we are to things, our immune system.

We get sick when we're isolated.

We really get sick.

This is amazing to me.

So this is just another discussion of neurosception and action.

I mean, people get frantic.

It makes can make us sick.

So we need a safe sense of safety if we're going to function well.

And if we feel supported and know some steps to get help and so forth, if we're struggling to find something to help us, we can self-regulate and bring ourselves back to a more calm thing.

But if we're out there and it just seems like we're disconnected and nothing's there to help us and no supports around us, we don't do well.

And you know, the problem with that is if we're around other people that are all upset and not feeling supported.

This emotional dysregulation can really go on.

I used to see this with college students getting ready for exams.

They could, if one was freaked out, they could get their anxiety transmitted to other people and get a whole bunch of people all upset.

So what we're doing in communities really, really, really matters.

This was also kind of interesting to me.

Most of us would know what a trigger is.

Triggers something that upsets us, makes us makes us really feel threatened in some way.

A glimmer, which you probably haven't heard much about, is something that brings us back into that ventral vagal state and makes us feel connected and alright.

All right, well, what does that have to do with anything?

That's isolation, being by yourself, lonely, anxiety.

I'm going to go back to the horse for a minute.

I remember one young man, he's about 16, came out of an alternative high school in Indianapolis and was up at Agape in a special class they were having for those students.

And this man, he was bigger than I am.

But uh, you know, you go stand by a horse that's 1,800 pounds, and if you've not ever been around those animals, it can be pretty intimidating.

So he just he was scared, but he didn't know how to tell me that.

And uh a horse senses, they they sense what's going on inside yourself even if you don't.

And so he went out and he stood by that horse, he terrified, stood by that horse, and everybody, the instructor was giving them instructions about how to go around the arena, and he just stood there, and all he could do is get angry because he didn't want to, he was scared, he didn't want to say he was scared.

And so she was telling, you know, giving them some instructions on how to get the horse to walk forward.

And he was so he just said walk, turned his head that way, didn't look at you know.

Do you think that horse moved?

No.

That horse was like uh he's not connected with me enough to be a trusted leader.

And if the horse doesn't trust the person that's handling the horse, the horse doesn't go anywhere.

And finally I got him to touch the horse, kind of begin to connect with the horse, and I said it's really scary.

Now that's very hard for a 16-year-old boy to say I'm scared, but he was.

Not ever been around horses.

By the time that 12 weeks was over out there, he and that horse were the best friends.

He would not even have had to have the reins in his hand, and he could have stood by the horse, and the horse would have gone forward when he said walk on.

They had a partnership.

But he didn't trust being in relationships because he'd had some really unfortunate experiences in life to trust people.

And so it was a matter of really working together.

The more we can build trust and help people and you know be together in community, the better it is, is kind of the whole thing.

So we know what triggers are.

Triggers are when you just feel disconnected and scared and withdrawn, and nobody's around to help you.

Well, then we have glimmers.

A community that has some things in it that make us feel safe.

Parks, housing, neighborhoods, neighbors, supportive services, pets, people that are there, schools, food, and you're part of it.

Glimmers.

Glimmers.

Glimmers don't always cost a lot.

Glimmers.

That's important.

And community planning and development.

I think keeping the idea of glimmers is a real good one.

Came out of working with horses.

Who would have known that?

Let's revisit some of the issues raised in the community study.

That was the findings from Hamilton County.

Well, I don't know.

I mean, all of you have worked on a number of things here.

Transportation.

This community, I think, was developed with younger people who could drive.

Kind of in mind.

The way it was kind of developed.

But now we've got a number of older people who probably would need some other form of transportation to safely get around for some people.

It just happened.

I'm not blaming anybody.

It's just kind of happened.

We got that all over the place.

Look at rural areas.

They're even worse.

Access to care.

I got a lot of words on this one.

My granddaughter said, Nana, you don't do PowerPoints, right?

And I said, Well, people can read them over if they've printed out for them later.

But we have so many things.

We can just kind of begin as it is it's kind of back down toward the local level.

Have good discussions with one another.

People don't understand how health care is funded in the United States.

I don't think too many people could tell you the difference between Medicare and Medicaid.

Can we do something in local communities to help people understand that better?

It's pretty basic.

And it's going to impact our local communities pretty hard if we don't have people who understand it better.

It is it can be made more simplified than they most people can access to read.

But we need to understand that.

I don't know.

I'm not saying we should or shouldn't.

I'm just raising questions.

If we diminish some things, like I said, at the local level, there's nowhere else to kick the can down the road.

We're sort of here with it.

We're still using the English poor laws of the 1600s to vet people for public assistance.

We're the only wealthy.

We're the only country in the world doing that who has access.

Do we is that working for us?

I don't know.

It's kind of I'm not making that up.

Somebody can go go fact checking.

But again, it's just a good way to sit down and begin to talk to people.

I think people need more information, need to understand what how we fund things.

And what does it mean?

I mean, I'm asking the question: do we need to strengthen change or stop Medicaid and Medicare?

And if we did that, what would we do at the local level?

Every community would have people who couldn't privately pay for things.

Just saying.

Lots of public parks and trails and so forth here.

I don't know.

Um things working as well as they could be.

I don't know.

There's some fast bikes on the Monon.

A little scary to walk down there sometimes with them.

Maybe it's working.

I don't know.

Just asking questions.

Physical activity.

One would think there'd be a lot of amenities here.

I think you have a senior center here in Karma with physical equipment, right?

For it's like a fitness center.

I don't know.

I'm just it was in the it was in the uh survey, so I'm bringing it up.

How are we doing here?

Now this one.

Brain health and depression in older adults.

You have a number of excellent health care providers in Hamilton County.

It kind of and it doesn't matter whether you're wealthy and can private pay or whether you're needing assistance.

This is a hard one for all socioeconomic levels kind of people everywhere.

This is very hard.

We you know, older adults with issues involving dementias and depression often go to primary care providers and hospital emergency departments when they're having difficulty.

Then what?

Look at all those question marks.

The Indiana State Medical Association currently is considering a resolution to identify dementia as a public health crisis.

Dementias and depressions, as I said, impact all peep people of all socioeconomic groups.

And yet even those with adequate resources struggle to get what we need.

You remember back when I said pediatric, there was no pediatric care in the 1800s.

We're in an era now where we have more people living longer than ever before.

We probably need to take a look at what we may need to do now in health care to be sure that we have people cared for in our health systems and other providers that can actually address the issues involved with older people with brain health and depression.

I think that's a reasonable thing to start thinking about in our communities.

I mean, people that's why you end up with people saying 74% of us don't even know what's available.

So maybe it's time to look at some of that and see what we have here.

Housing, you've got a lot of housing choices down here.

You've looked at housing down here.

What are the needs in housing?

Are people integrated into the community?

Or please don't stick spears in me, but I'm going to ask this.

Or are we age segregating people into certain enclaves?

And how could we be sure that we've got enough going on in the community so people are out and about and feel included so they get those glimmers, not be sitting somewhere isolated?

That's my only point.

So voters just move population aging issues to the local community, and it gives us an opportunity to modernize our communities to better fit the lifestyles and needs of people of all ages and abilities, or not.

But it's kind of like we picked up on the concept of childhood in the 1900s, and look at what this community has done for children.

You have lots of things.

What do we need to do in this community?

You need to do.

And I developed their gerontology program up there and taught in social work and nursing.

And I went to national conferences on gerontology and heard a lot of speakers.

And one of those speakers I that really drew my attention was from the Netherlands.

And they took a traditional nursing home.

Now remember I told you nursing homes were built or developed, they kind of built the nursing home industry on Medicare and Medicaid legislation that funded them.

We did the best we could.

I've worked in those all my life.

I've been in and out and nursing social work and everything in them.

But we used the old hospital model.

And you look at a lot of the nursing homes today that were built in the 70s, the 80s and the 90s, and you still have the long hall in the rooms off to the side.

We don't do too well in those.

It's just not a normative living situation for us.

And we sort of are struggling because we have the same problems with older people in that kind of an institutionalized setting as we had with children and orphanages.

Children didn't thrive in orphanages.

These were people, most of them at that point had dementia, and they had dedicated caregivers in there.

So the people, the caregivers got to know the people, the people got to know the caregivers.

Remember what I said about the trust?

How important that is.

If you have somebody different coming in every every day, and you never know who's coming in because it's hard to get staff in places.

That's hard on people.

It's stressful.

And then you try to hurry them up because you got a bunch of people to take care of.

Well, that's all right.

We're done with that.

That's that's hard on everybody, and it doesn't make one of those safe, people don't feel safe, there's anxiety, and they just doesn't work too well.

So anyway, there's dedicated caregivers, and then they so I mean it's I don't I can't tell you how many cottages they have, it's a number.

And then it's in there's a wall around it.

That you can't tell it's a wall because of the plannings they have and so forth.

But anyway, it's an enclosed safe environment for people.

But in each of these cottages are also they try to do culturally a cultural fit.

If someone was used to living in the city, it was more adapted to that.

If it they were rural, they had more rural uh things in the in the just culturally kind of fit.

And the people can walk around the little village, and they've got um a they've got a grocery store, they've got a restaurant, they've got a movie theater, and as you walk down, you can see all the things that used to be in most of the Dutch villages.

They got little storefronts, there's nothing in them, but the you know, you feel like you're walking around in the community.

And the people you see, you you they've got a hairdresser and a barber in there, and you go down and you get your, you know, you sit in the line, you get your it feels like a village.

These people can't go out into the village.

They brought the community into them.

It cut down on their use of medications.

They're getting exercise.

They stay there for the rest of their lives, they are not hospitalized, end of life care is provided there.

Eat in each cottage, people have their own bedroom and bathroom, and there's a common area for the living room and the kitchen.

You can go out and get something to eat at one o'clock in the morning if you want to.

It's normative, a normalized kind of thing, not the institutionalized kind of setting.

Now, so we met with the person who founded the dementia village and spent a day there.

Bill said, You have got to go see that when we went to Europe, and so we did.

And came back, I was teaching up in South Bend, and I was on the board of the area agency on aging, and I came back and I said, and they had also taken over, absorbed the Northern Indiana Alzheimer's and Dementia Services, and we're working with uh at a daycare center.

And I said, that is a model that we need to pay attention to because it connects people and calms them down and makes them feel safe.

All the things I talked about.

And so the board worked with a hospice organization up there, and we ended up, they raised six million dollars and built the first adult day service in the world based on the dementia village model.

So people with dementias come in there, they've got they can walk around, they've got beautiful gardens, there's all kinds of you know things they can do.

They can go get something to eat, they got their restaurant, they're all it's it works, and it's too small, and it opened, I believe, in 21 or 22.

22, 21, 22.

It's too small already.

Now, Carmel.

I think you have an opportunity.

They also have an investor who is looking at putting a residential dementia village up there.

Carmel, this would be a way to bring community to a population of people who can't go out and walk around in your community.

You know, I'm at the top of the baby boomers.

We have not been the silent generation.

We're going to be asking for something a little different as we go forward, probably.

The institutional model is probably not going to work very well with us.

I just bring this forward, Carol said, come up with an idea.

Here's my idea, Carmel.

If you want to work on something like this, this isn't going to compete with anything else.

You've got there's one one group going down here, however, that is close to it, and that's story cottages.

And you've got, is it one in Carmel?

I've had about three in Carmel.

Three in Karma.

Those are contained houses and people live in them.

They got dedicated caregivers, etc.

What I'm talking about would be cottages, several cottages enclosed, a uh something inside that that's a replica of some things in this community so that the people can walk around freely and feel a part of the community.

And also would suggest you put an adult day service in it.

They can be part of the model you've got there, because we've got to, right now, we're going to have to have people staying at home as long as they can and then come in.

Now, this could be private pay, and it also could be, I would think some of the commercial health insurance companies might get interested in this, and I would think the in the PACE programs might get interested in this.

And I will tell you, if people had a choice, I think a whole lot of people would rather be in the small cottages than in the larger institutions.

Now, I don't know.

Carol said, come up with an idea.

You could choose house, other kinds of housing, you could choose transportation, you could choose parks and rec any of these things, because there's needs all over the place.

I went to a group that needs, they need they need care, and we need to find a way to keep people connected with community.

So that is my presentation.

I hope I gave people some things to think about.

Again, Carmel, go.

I think you are in a sweet spot to pull something like this off.

That's just that working with older adults that don't have dementia, or could that concept or what in that concept could we use for just our aging population?

Well, I I mean you can modify it somewhat, the but I again you probably you've got so much dementia within a lot of the population.

Not everybody has dementia that's older.

You know, no, no, no, no, no.

Don't misunderstand me.

Um you can still have kind of a safe area that people could go around, but again, to be able to have a more normative kind of lifestyle and be able to freely move around.

That could be adapted.

And I will tell you, Eloy Van Van Hall in the Netherlands came over and did the consultation with the people in South Bend to put this together.

He has a consulting service that's available.

They've got they're doing this worldwide.

So that's available.

You've got assistance to do this that would be available to do it, and it can be adapted.

A question on the one either there or in South Bend.

Was it husband and wife or just a single person that would enter into that facility?

Well, that's if one of them had dementia and the other one didn't, but they wanted to remain together.

Well, the one in South Bend is just an adult day service now.

They are planning this residential, and they it will have the ability for a husband and wife to go in together, whether or not, and they don't have to both have dementia.

Okay, thank you.

Joanne, our committee is, you know, we're we are struggling with a lot of the issues that you've brought out.

How do we as a committee build trust with our with our senior population?

Or what what could we do, or what could we start out doing that would help build the trust and the involvement of our seniors in in this process?

Well, let me throw an idea out, and then somebody can challenge me.

That's fine.

Like I said, none of us quite know how to do this, but they didn't in Carmel or in the Hamilton county.

It wasn't even Carmel, I don't know.

When was Carmel Incorporated?

It's caramel clay.

We take the whole township.

Okay.

When when okay, all right.

In the beginning, in its early days, how did people get schools?

How'd they get together to do that?

And they had to fund them.

How do they get together to do a lot of things?

I think you pull people together and start asking questions.

They didn't know what to do with children for a while.

Now we have the same issues with what to do with a larger older population.

And that's why I said we're just going to have to roll up our seats and get together.

Let's say you have an idea and you put it out there and let people come in here.

Start talking to each other.

Does this make sense?

Would this work?

Is this what you want?

Is this not what you want?

What do we want?

They had to do that with children's things.

You don't always have them.

I'm not wrong.

I think that's how.

I mean, that's why you asked me to throw something out.

I threw an idea out.

Put some ideas out there and let people come in.

I mean it a lot of what I'm talking about, we are down to the local level figuring this out.

And so what will work down here won't work out in some of those rural counties.

So we have to do this local community by local community, I think.

And we've gotten a little complacent thinking what we had was going to work.

I don't think it's so bad that we've got a lot of changes coming now.

Give us an opportunity to rework some things.

I'm not doom and gloom in case you couldn't tell.

But we don't have to do anything, but what would have happened if Hamilton County had decided not to develop anything for children?

They didn't have to.

But if people wanted to live here, they wanted something for their children after they started seeing what was going on.

I don't know.

Maybe that wasn't a good good response.

I don't know.

Joy, I was charged with looking at transportation.

And when I began to look at transportation, and you look at all the facilities that are blossoming here in the area, there are a number of senior housing that's being built, you know, apartments and so forth.

We also have other facilities, they have transportation.

The thing that we have not are trying to, or how do you reach into and pull out the people like me who are still in our own home, and how do we facilitate and help them with transportation?

I'm not ready to give up my home.

I have transportation of my own.

But the more I think about it, uh, we have talked to the school who's willing to stand up and help with transportation.

We've taught to Hamilton County Express, and those two are talking about getting together, but it's reaching inside of these different individual homes and communities to make them aware of what we're trying to develop, and I think that's one of the problems we're struggling with right now.

Well, I mean, we kind of created our own problem, I think.

We built the community for driving.

We didn't drive, we didn't we didn't have dense housing around the community square.

Uh suburbs are great when you can drive and get get out and your kids can, you know, you guys you got a lot of driving with kids too.

But uh we didn't we didn't sit down and plan the community for for older adults who who couldn't couldn't, you know, were driving was difficult.

So we kind of created our own problem, and now we're trying to find ways to fix some of that.

And that's going to take us some time.

I mean, and and we've got people that get isolated at home because they can't get out.

That doesn't help health.

But uh these aren't easy, but you know, you're asking good questions, and you know, bring people out and ask them, but no, people don't want to give up their independence.

They don't want to go into, oh boy, I'm probably going to get a spear on this one.

They probably don't want to go into some kind of less normative life style like institutional that appears institutional.

They like their houses.

I don't blame them.

I like my house too.

I think my cats in there.

So it's that kind of thing.

So we kind of have to work out of some of what we created our own issues sometimes.

I know I'm really concerned about the cost of health care.

And the availability of health care.

So we may be forced to stay in our homes for longer period of time because there's not going to be those funds and those facilities to take care of us.

That is why I am encouraging, and we haven't done very much in the state at a state level to incentivize adult day services, but we need them.

We we have some, but we don't have very many.

When you say adult day services, could you tell me what that entails?

Okay.

Well, I'm thinking um they usually are open 6 a.m.

to 6 p.m.

and someone that's working and maybe have their parents living with them.

The parents can go there during the day, and they provide meals, bathing, food, medicine.

In some cases, there can be wraparound health care services there.

Nurse practitioners come in, take care of people during the day, see them, and in the evening, the family can pick them up and they go home, and there's a place they can rest during the day.

It costs lots less than personal care at home 24 hours a day.

Gets real expensive real fast.

But there's you know, some things we can begin to plan into communities to make things work better.

Does that answer your question?

We didn't always have child care either.

Well, thank you very much, Dr.

Burke.

You've given us a lot to think about.

Um it's hard for us, I think, to be able to solve these problems in a short period of time.

They're going to take us some time, but I'm very grateful that the the mayor has been, you know, open to starting this commission and it's and working on some of these issues within our committee.

Community.

I think somebody had a question.

Did you have a question?

Very quickly.

Uh ma'am, have you ever I read this book some years back and it sort of set me on a path right when I retired?

It's called Beating Mortal.

It's by a doctor Atul Gawandi.

He's a neurosurgeon in the Boston area, and primarily was about his father, who was uh uh had had either cancer or uh an illness that was was life threatening.

And primarily was about his father, who was uh uh had had either cancer or uh uh an illness that was was life-threatening, and it it talked a lot about these things and that concept as he knew them back in uh in terms of the whole appearances of senior living and the the nursing home concept as opposed to the uh concept or in the Netherlands, and um one of the things that I recall is he conceptualized a lot of this this book about asking his father, what do you want?

And the more I hear I really appreciate your comments, but uh and I think you said this well, Carol.

How do we get our population to tell us what they want?

And I I hope that you know your material uh and I I've got your paper that came out in 2020, and it really is gonna help us a lot.

Thank you.

Well, there's a lot of resources out there for communities.

I think AARP has a lot of things out that can be very, very helpful.

But I think we again let's bring let's invite people in, get an idea, let them critique it, say what they think would work, won't work, what else would they recommend, and get them thinking about the idea of this really is a new day because we've never had this many people live this long before.

No wonder this community doesn't know what to do.

None of us do.

But whatever you do, make it fit caramel.

And unless we hear from people, we won't know what they need.

I'm sure when they were starting to tax people for public schools, there were a lot of lot of uh meetings.

And it was hard in Indiana.

Indiana was one of the later states that got public education.

So we'll probably have a lot of a lot of discussion, but we need to have it.

We're not waiting for federal and state programs to take care of us now.

Voters decided to bring it back here to the local level.

Well then, but see, people aren't used to that.

We've been kind of just going along, and now we've had this movement to change, but we gotta come up with something you can't just cut.

That would that's not enough.

That won't work.

And we're down here at the local level, and people are going, yikes, what are we gonna do?

But we have opportunities.

Well, thank you so much.

And if I miss the point, just let me know.

But if I've got you thinking, that was I used to tell students my job is not to tell you what to think or how to think.

My job is to get you thinking.

I hope I stimulated some thought.

Thank you, everyone.

You did, thank you, Vavor.

And so in trying to do some of the things that you have suggested to us, we're gonna have a conference in October, October the 10th.

Actually, instead of the 9th, Carol Kelly, there's been a change for that.

So October the 10th, um, we're gonna have a conference called Senior Resources, and we're hoping to get uh, I think if you remember, we had one last year and we had one the year before.

So our attendance is growing, but our challenge is to get more people there so they can understand and know what's going on in our community.

So um for our our uh conference, we're gonna have some local um resources for our seniors, and I'm just getting this sort of um organized and so forth, but right now we're gonna have the Carmel Fire Department's gonna talk about our fall prevention program because we know that when people fall, that starts the the downwards uh progression of our health.

So the fire department has a new program.

The Car Carmel Police Department is gonna be talking to us about senior scams.

And that's so common in our and amongst our seniors now and amongst everyone.

Um Dr.

Bustani is going to talk about his program that he has opened up.

Um I think there was an article in the current not too long ago, just a few weeks ago, about his program that he's starting for caregivers to be paid by Medicare.

So I think a lot of people should be very interested in seeing what that program is a lot about, and he's gonna be explaining that.

We're gonna have the Carmel City Library talk about programs that are that are wonderful library.

We have a wonderful library here, and I think they'll be telling us some programs for our seniors.

We've got a representative from Shepherd Center that's gonna talk about either part of their guardianship program and their counseling program.

And Dr.

Burke, you talked about depression in our seniors.

We have that so much of the time.

So they have a program to help our seniors through that.

Then I have a local physician, Dr.

Burr, who's going to talk about you know some of the new medical issues that seniors are facing as they're growing older.

And then I hope to have a little bit of date on our commission and the status of our survey that we're doing as well.

So seniors are welcome to come.

There's a free lunch that will be served to our seniors that day.

And in addition to speakers, we're going to have a room full of vendors.

And these vendors are going to have tables that will be able to display some of their resources that they are having for seniors.

And I've got Cardan is coming.

We've got uh Hass Hessen Donaldson coming for some legal advice.

I have Nancy Moore talking about Medicare fraud, Medicare fraud.

Got the Palladium coming to talk about their perfect harmony program.

And then I'm working on Joey's house to come about daycare for our seniors.

So we hope to have oh 15 tables so that our seniors can meet with those people at the table and ask questions and get information.

I'm very pleased to announce that we have gotten a sponsorship from Cardon.

They're giving us $3,000 for this program.

And I just heard from BHI today.

They're giving us $1,500 to help cost with the cost of this program.

I also have Hessen Hess Hess and Donaldson is donating some monies to cover the cost of some pastries for the morning.

I have the coffee being donated by Just Love Coffee.

And Jimmy Johns has been very helpful in the past three years, and they're donating half of the sandwiches for the lunch, and then we pay for the other half.

So we've got some really good.

Our biggest expenses are marketing, but I have had an interview today with the current to talk about this and have a story in the paper, so please watch for that.

And then there'll be some ads promoting this event.

Showed 74% of our seniors say they don't know what's what resources we have in this community.

So this is one of our ways that we can promote some of those our senior resources that they can use in this committee or this community and make it better.

So and so it's coming along, and I'll be finishing up some of this and getting it more organized, and there'll be a schedule of events and so forth coming out in the paper.

So is there any questions that any of the commission members want to ask me about?

I will be sending out some assignments for all of you because it takes a lot to get it set up, to get the food on the table, to get it cleaned up, and do all those little detail kinds of things.

So you'll be hearing from me very shortly.

Any questions from any of you on that?

Okay.

So our next meeting will probably have some committee reports from each committee.

That's what they've been working on, and we'll have more information.

If not, meeting adjourned.