AGE AND AND HEALTHCARE A KET SPECIAL REPORT IS FUNDED BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

[♪♪] >> Renee: WELCOME TO AGING AND HEALTHCARE A KET SPECIAL REPORT.

I'M RENEE SHAW.

THANK YOU SO MUCH FOR JOINING US.

HEALTHCARE IN OUR GOLDEN YEARS, IF WE'RE LUCKY ENOUGH, IT'S SOMETHING WE'LL ALL NEED.

BUT SENIOR MEDICAL CARE IS NOT ONE-SIZE-FITS-ALL.

IT'S UNIQUE, COMPLEX, SOMETIMES CONFUSING AND OFTEN EXPENSIVE.

ACCORDING TO THE ANNUAL REPORT FOR AMERICA'S HEALTH RANKINGS KENTUCKY RANKS AMONGST THE WORST STATES FOR OVERALL SENIOR HEALTH COMING IN 47 OUT OF THE 50 STATES.

UNFORTUNATELY MANY KENTUCKY SENIORS FACE BARRIERS FROM PREVENTING THEM FROM GETTING THE CARE THEY NEED.

SOME BARRIERS INCLUDE THE HIGH COST OF MEDICAL CARE AND PRESCRIPTIONS.

LACK OF TRANSPORTATION AND LIMITED ACCESS TO SENIOR CARE PROVIDERS.

WE SPOKE TO SENIORS AND CAREGIVERS ACROSS THE STATE, MANY OF THEM FACING THESE COMMON CHALLENGES.

HERE ARE SOME OF THE VOICES YOU WILL HEAR FROM TONIGHT.

>> I USED TO GO WITHOUT SOME OF MY INHALERS.

BECAUSE SOMETIMES SOMEWHATS LIKE $50 AND $75.

THEY NEED MORE ACCESS TO AFFORDABLE HEALTHCARE.

>> DIGNITY LACKS WHEN YOU ARE IN THIS POSITION.

>> I'VE HAD CLIENTS BEFORE THAT HAD A HEART ATTACK AND STANDING AT MY DOOR.

>> SITTING AT HOME I GET DEPRESSED.

>> SOCIAL ISOLATION IS A KILLER.

>> WE'LL ALSO HEAR FROM A PANEL OF EXPERTS WHO ADVOCATE FOR BETTER ACCESS TO AFFORDABLE AND QUALITY HEALTHCARE FOR OLDER KENTUCKIANS AND THROUGHOUT THIS PROGRAM, WE'LL HIGHLIGHT INNOVATIVE SOLUTIONS THAT ARE HELPING KENTUCKY SENIORS LIVE BETTER, LONGER LIVES.

WE'LL BEGIN WITH ACCESS TO AFFORDABLE HEALTHCARE.

AS WE AGE, HEALTHCARE EXPENSES TEND TO RISE.

EVEN WITH PROGRAMS SUCH AS MEDICARE AND MEDICAID, OUT OF POCKET MEDICAL EXPENSES ARE NEARLY TWICE AS HIGH FOR THOSE 65 AND OLDER COMPARED TO ADULTS AGED 45-54.

ACCORDING TO AMERICA'S HEALTH RANKINGS.

THE RISING COST OF MEDICAL CARE, FOOD AND HOUSING CONTINUES TO PUT AN ECONOMIC STRAIN ON SENIORS.

THE PERCENTAGE OF KENTUCKY SENIORS LIVING BELOW THE POVERTY LINE HAS BEEN INCREASING OVER THE LAST FIVE YEARS.

LEAVING MANY WITH LESS RESOURCES FOR NEEDED HEALTHCARE.

ACCORDING TO THE C.D.C.

NEARLY 5% OF KENTUCKY SENIORS HAVE AVOIDED A VISIT TO THE DOCTOR IN THE LAST YEAR BECAUSE OF COST.

EVEN MORE, REPORTS SKIPPING OR DELAYING MEDICATION DUE TO COST.

OUR LAURA MORTON INTRODUCES US TO A LOGAN COUNTY WOMAN WHO HAS RATIONED HER PRESCRIPTIONS JUST TO GET BY.

>> YOU WANT TO BREATHE THAT IS ONE THING IT'S SCARY WHEN YOU CANNOT BREATHE.

>> TERESA HUDSON IN HER 60s, STRUGGLES WITH SEVERAL HEALTH CONDITIONS.

FROM COPD AND ASTHMA TO DIABETES.

>> I WAS DOING WITHOUT MY INSULIN BECAUSE IT WAS SO HIGH.

>> THERE WAS A TIME WHEN HUDSON COULD NOT AFFORD ALL OF HER MEDICATIONS.

>> I USED TO GO WITHOUT SOME OF MY INHALERS BECAUSE SOMETIMES SOMEWHATS LIKE $50 AND $75 AND THAT WAS AFTER INSURANCE YOU GO WITHOUT THEM.

>> SHE WOULD FIND HERSELF RATIONING HER MENTAL HEALTH SUPPLIES.

>> I TRY TO GO EASY ON AN INHALER AND I WOULD BUY ONE LIKE EVERY OTHER MONTH.

>> THREE YEARS AGO SHE HAD HALF OF EACH LUNG REMOVED CALLED LUNG VOLUME REDUCTION PROLONGING WHAT MIGHT BECOME A LUNG TRANSPLANT.

>> I WALK TO THE BATHROOM I GET OUT OF BREATH.

>> LIVING IN RURAL LOGAN COUNTY, HUDSON HAS TO TRAVEL AN HOUR-AND-A-HALF EACH WAY TO A HEART AND LUNG DOCTOR IN NASHVILLE.

>> I DON'T LIKE THE DRIVE.

AND UNFORTUNATELY HAD THEY DON'T -- I CAN GET RIDES TO DOCTORS BUT IN MY AREA THEY DO NOT HAVE ONE THAT WILL TAKE YOU TO NASHVILLE.

>> SHE HAS AN ADULT SON THAT CAN DRIVE HER THERE BUT SHE DOESN'T LIKE ASKING FOR HELP.

>> I ALWAYS DID FOR MYSELF.

AND I WAS VERY ACTIVE.

VERY ACTIVE PERSON AND DID FOR MYSELF ALL THE TIME AND DIDN'T ASK FOR HELP.

AND NOW I HAVE TO ASK FOR HELP SOMETIMES.

AND THAT'S HARD WHEN YOU ARE NOT USED TO ASKING FOR HELP.

>> THEY NEED MORE ACCESS TO HEALTHCARE, AFFORDABLE HEALTHCARE.

AND THEY NEED BETTER WAYS FOR TRANSPORTATION TO GET TO THEIR HEALTHCARE.

>> TERESA JONES MANAGES THE SENIOR CENTER AT COMMUNITY ACTION OF SOUTHERN KENTUCKY IN HART COUNTY.

>> SOME WE HAVE FOUND DON'T HAVE FAMILY MEMBERS THAT LIVE IN THE STATE OR FAMILY MEMBERS AT ALL AND THEY GET LEFT BEHIND.

>> JONES MEETS A LOT OF OLDER KENTUCKIANS WHO STRUGGLE TO AFFORD THEIR BASIC NEEDS.

>> WE HAVE SOME THAT THEIR NUTRITION COMES FROM US.

WE HAVE SOME THAT THIS IS THE ONLY MEAL THEY GET.

>> FOR OTHERS THE SENIOR CENTER IS A PLACE TO GATHER AND SOCIALIZE TO COPE WITH ISOLATION AND LONELINESS.

>> COMING HERE REALLY HELPS ME BECAUSE SITTING AT HOME, I GET DEPRESSED.

>> MARY ALICE SHIRLEY HAS BEEN COMING TO COMMUNITY ACTION FOR THE PAST 20 YEARS.

ON THE ADVICE OF HER DOCTOR.

>> HE TOLD ME THAT I NEED TO VENTURE OUT AND BE WITH PEOPLE.

I CALL THEM MY SISTERS AND MY BROTHERS.

>> NANCY HAYCRAFT WIDOWED A COUPLE DECADES AGO, HAS A HOST OF HEALTH ISSUES.

>> I AM A DIABETIC TYPE 2.

I'VE HAD THREE HEART ATTACKS.

>> SHE IS ONLY ABLE TO AFFORD HER MEDICATIONS BECAUSE OF MEDICARE AND MEDICAID COVERAGE.

>> THEY PUT ME ON MEDICINE THAT COSTS ONE BOTTLE $50.

AND THEN I'VE GOT THIS THAT I CAN GET THAT BOTTLE MEDICINE.

>> THERE ARE CRUCIAL TREATMENTS NOT ALL HEALTH PLANS WILL COVER.

>> THERE'S PLACES WHERE THEY CAN GO TO GET MENTAL HEALTH.

THEY HAVE TO PAY EVERY VISIT THEY GO.

AND WHEN YOU LIVE ON A LIMITED INCOME AND YOU STILL HAVE TO PAY FOR SOME OF YOUR MEDICINE, YOU DON'T HAVE THE EXTRA MONEY TO GET THINGS LIKE THAT.

>> I NEED MORE HELP.

SOME OF THEM DRAW SMALL CHECKS AND TIME THEY PAY THEIR RENT OR WHATEVER THEY AT, YOU KNOW, IT TAKES IT UP.

>> TERESA HUDSON AGREES SHE SAYS MOST OF THE RESOURCES SHE FOUND TO MAKE HER LIFE MORE AFFORDABLE SHE HAS HAD TO SCRAMBLE TO FIND ON HER OWN.

>> YOU HAVE TO DIG INTO FIND HELP WHAT TO DO BECAUSE YOU ARE READY TO DO WITHOUT YOUR MEDICINE.

>> TERESA HUDSON SAYS THE BARON RIVER AREA AGENCY ON AGING AND INDEPENDENT LIVING HAS HELPED HER WITH SERVICES.

EACH REGION IN KENTUCKY HAS A STAFF DEDICATED TO HELP OLDER ADULTS.

THESE AREA AGENCIES ON AGING AND INDEPENDENT LIVING ARE IN EACH AREA DISTRICT THROUGHOUT THE STATE THEY AIM TO BE A ONE-STOP SHOP FOR SENIOR INFORMATION AND RESOURCES.

OUR CHRISTIE DUTTON SPOKE TO ANGELA ZEEK FROM THE BLUEGRASS AREA AGENCY ON AGING AND INDEPENDENT LIVE BEING A FEW RESOURCES THAT COULD HELP PAY FOR NEEDED CARE.

THAT YOU MAY NOT HAVE HEARD ABOUT.

>> WHAT ARE SOME OF THE CHALLENGES FOR AFFORDING HEALTHCARE IN THE GOLDEN YEARS?

>> WELL, THE FIRST CHALLENGE IS UNDERSTANDING THE INSURANCE THAT THEY CURRENTLY HAVE.

MEDICARE IS THE INSURANCE PROGRAM FOR INDIVIDUALS THAT ARE AGED 65 YEARS OLD OR OLDER OR FOR INDIVIDUALS THAT HAVE BEEN DECLARED DISABLED AND MIGHT BE YOUNGER THAN 65.

BUT IT IS A COMPLICATED BENEFIT.

>> WE HAVE THE SHIP PROGRAM OR STATE HEALTH INSURANCE ASSISTANCE PROGRAM IN EVERY COUNTY IN KENTUCKY IN EVERY STATE IN THE NATION.

AND OUR GOAL IS TO MAKE SURE THAT PEOPLE UNDERSTAND THEIR BENEFITS, HELP THEM GAIN ACCESS TO THEIR BENEFITTINGS AND HEALTHCARE.

>> THERE ARE ALSO CERTAIN PROGRAMS AND HELP FOR SENIORS WHO MAY HAVE SOME ISSUES TRYING TO AFFORD HEALTHCARE.

WHAT ARE SOME OF THE PROGRAMS AND THAT YOU OFTEN USE AS PART OF YOUR TOOLBOX?

>> SO ONE OF THE MOST IMPORTANT BENEFITS WE TRY TO HELP PEOPLE ACCESS IS SOMETHING CALLED EXTRA HELP OR MEDICARE EXTRA HELP.

MEDICATIONS ARE EXTREMELY EXPENSIVE.

MEDICARE EXTRA HELP CAN LOWER THOSE MEDICATION COSTS.

IT'S HELPING TO PAY THE MONTHLY PREMIUM FOR THEIR PART D PRESCRIPTION SON DRUG PLAN AND IT LOWERS THAT PHARMACY BILL EACH MONTH WHEN THEY ARE PURCHASING MEDICATIONS.

THAT IS A VERY IMPORTANT PROGRAM.

SAVES ABOUT $5,000 A YEAR OF MEDICATION COSTS.

>> FOR THE EXTRA HELP, GIVE ME AN EXAMPLE HOW THAT HAS HELPED SOMEBODY INDIVIDUALLY?

>> OH, YES.

SO WE HAD A CLIENT THIS WAS EARLY ON IN THE BENEFIT WE HELP PEOPLE EVERYDAY, BUT THIS INDIVIDUAL STUCK WITH ME, BECAUSE SHE WAS ONE OF THE FIRST PEOPLE I WAS ABLE TO GET CONNECTED TO THE PROGRAM.

SHE RECEIVED -- SHE HAD MANY MEDICATIONS SHE WAS ON EACH MONTH.

SHE DID NOT FILL TWO OF HER MEDICATIONS BECAUSE SHE COULDN'T AFFORD THEM.

AND ALTHOUGH HER OUT OF POCKET COST IS RELATIVELY LOW IN A SENSE BECAUSE WE'VE SEEN MEDICATION COSTS INTO THE THOUSANDS OF DOLLARS EACH YEAR, HER MEDICINES RAN HER ABOUT $345 A MONTH.

AND, AGAIN, SHE DIDN'T PICK UP THE OTHER TWO MEDICINES BECAUSE SHE COULDN'T AFFORD IT.

AND WE GOT HER CONNECTED TO EXTRA HELP AND HER PHARMACY BILL WENT TO $27.

>> THERE IS ANOTHER PROGRAM CALLED MEDICARE SAVINGS PROGRAM.

THAT BENEFIT LOWERS OR ACTUALLY PAYS FOR THE MEDICARE PART B PREMIUM WHICH IS $174.70 A MONTH.

THAT'S TYPICALLY DEDUCTED FROM THE SOCIAL SECURITY CHECK BEFORE THEY RECEIVE IT IF THEY ARE RECEIVING SOCIAL SECURITY PAYMENTS.

AND IF WE CAN GET THEM ACCESS TO THAT PROGRAM, THEN THEY RETAIN THEIR ENTIRE SOCIAL SECURITY ALLOTMENT.

>> SO IF A SENIOR WANTS TO FIND OUT MORE ABOUT THESE PROGRAMS OR EVEN JUST ABOUT THEIR MEDICARE PLAN, WHAT IS STEP ONE FOR THEM?

>> SO THEY NEED TO REACH OUT TO THEIR SHIP PROGRAM.

MOST SHIPS IN KENTUCKY ARE LOCATED IN THE AREA AGENCIES ON AGING WHICH ARE INSIDE THE AREA DEVELOPMENT DISTRICTS.

I KNOW IT'S DIFFICULT TO FIND US.

BUT WE HAVE A STATE-WIDE SHIP PHONE NUMBER AS WELL.

AND THEY ARE REALLY GOOD AT GETTING PEOPLE DOWN TO US WHEN THERE IS AN ISSUE.

WHETHER IT'S GETTING CONNECTED TO PROGRAMS, EVALUATING THEIR MEDICARE PROGRAM OR IF THEY ARE HAVING AN ISSUE, MEDICARE REFUSED TO PAY FOR SOMETHING.

>> THAT'S GOOD TO HAVE SOMEBODY WHO CAN NAVIGATE THAT SOMEBODY ON YOUR SIDE.

>> RIGHT.

IT'S VERY COMPLICATED.

AND YOU KNOW, OUR GOAL IS TO JUST TO MAKE SURE THAT PEOPLE LEAVE US IN A BETTER SITUATION THAN THE WAY THEY WERE IN WHEN THEY FOUND US.

>> IF YOU'D LIKE TO KNOW IF YOU ARE ARE ELIGIBLE FOR EXTRA HELP OR THE MEDICARE SAVINGS PLAN OR HAVE QUESTION ABOUT YOUR MEDICARE OR MEDICAID PLAN CALL THE STATE HEALTH INSURANCE ASSISTANCE PROGRAM HOTLINE AT 877-293-7447.

UNDERSTANDING THE HEALTHCARE SYSTEM AND WHAT RESOURCES ARE AVAILABLE CAN BE A DIFFICULT, BUT NECESSARY, TASK TO GET AFFORDABLE MEDICAL CARE, ESPECIALLY FOR SENIORS IN RURAL COMMUNITIES.

COMMUNITY HEALTH WORKERS IN EASTERN KENTUCKY ARE WORKING TO BRIDGE THE GAP BETWEEN ACCESS AND AFFORDABILITY.

>> GETTING OLDER CAN BE DIFFICULT MANAGING YOUR HEALTH AND PAYING FOR PRESCRIPTION SONS AND NAVIGATING INSURANCE CAN BE OVERWHELMING.

THIS IS ESPECIALLY TRUE IN PARTS OF EASTERN KENTUCKY.

A REGION WITH UNUSUALLY HIGH LEVELS OF POVERTY AND ILLNESSES LIKE CANCER, HEART DISEASE AND DIABETES.

BUT FOR SENIORS IN EASTERN KENTUCKY, THERE IS HELP.

IT'S CALLED KENTUCKY HOME PLACE.

>> THERE ARE 22 CERTIFIED COMMUNITY HEALTH WORKERS THAT WORK WITH KENTUCKY HOME LAYS AND WE COVER 32 COUNTIES IN EASTERN KENTUCKY.

>> SAMANTHA BOWMAN IS A COMMUNITY HEALTH WORKER SHE HELPS PEOPLE IMPROVE THEIR QUALITY OF LIFE.

WHETHER THAT IS ASSISTING WITH A HOUSING APPLICATION OR DECREASING OUT OF POCKET COSTS FOR MEDICINE.

SHE SAYS SENIORS ARE STRUGGLING.

>> SO THE BIGGEST THING WITHIN THE LAST YEAR OR TWO THAT I'VE SEEN IS FOOD INSECURITY.

SO WE HELP THEM APPLY FOR FARMERS MARKET VOUCHERS WHERE THEY WILL RECEIVE FRESH FRUITS AND FRESH VEGETABLES.

WE HELP CONNECT THEM WITH COMMUNITY PANTRIES TO WHERE THEY CAN GO AND PICK UP SENIOR COMMODITIES.

AND NAVIGATING THROUGH HEALTH INSURANCE.

THERE ARE SO MANY DIFFERENT OPTIONS AVAILABLE TO THEM.

BUT A LOT OF THEM ARE UNAFFORDABLE.

WHEN THEY COME TO SEE US WE CAN REVIEW PLANS WITH THEM.

HELP ASSIST THEM WITH THE MEDICATIONS THAT ARE EXPENSIVE TO KEEP THEM OUT OF THE DOUGHNUT HOLE LONGER SO THEY CAN AFFORD THEIR LOWER COST MEDICATIONS THROUGHOUT THE YEAR.

AND JUST HELP THEM WITH MEDICAL SUPPLIES THAT THEY CAN'T AFFORD TO PURCHASE.

>> ONE OF HER CLIENTS IS FANNIE CALLAHAN.

SHE HAD EMERGENCY SURGERY IN 2013 JUST A FEW YEARS BEFORE SHE RETIRED.

SHE WAS IN THE HOSPITAL FOR A WEEK AND OUT OF WORK FOR OVER A MONTH.

WHEN THE MEDICAL BILLS SHOWED UP, SHE KNEW SHE NEEDED HELP.

>> I WAS EXPECTING TO WALK IN AND FEEL LIKE I WAS BEGGING.

BUT WHEN I WALKED IN FOR MY APPOINTMENT, I WALKED IN TO A WARM SMILE, A WARM WELCOME AND SHE ASSURED ME WE WILL TAKE CARE OF THE SITUATION.

SHE REACHED OUT TO THESE PEOPLE.

SOME OF THEM JUST DROPPED THE WHOLE AMOUNT THAT I OWED WITHIN A FEW MONTHS, I WAS DEBT FREE, HEALTHY, BACK TO WORK BUT STILL THERE'S LOTS OF THINGS SINCE THEN AND NOW THAT I STILL GO TO HER FOR.

>> FOR THOUSANDS OF KENTUCKIANS LIKE FANNY, COMMUNITY HEALTH WORKERS ARE A LIFELINE N SOME SITUATIONS THEY ARE LIFE SAVERS.

>> I'VE HAD CLIENTS ABOUT OF THAT HAD A HEART ATTACK AND STANDING AT MY DOOR.

HE WAS GRAY.

HE WAS SWEATING.

AND THE FIRST PLACE HE STOPPED AT WAS KENTUCKY HOME PLACE.

I CALLED HIS DOCTOR HIS DOCTOR GOT HIM IN HE WAS TAKEN BY AMBULANCE A LOCAL HOSPITAL AIRLIFTED HIM TO U.K.

WHEN PEOPLE SHOW UP HERE THEY NEED HELP.

>> MACE BAKER IS THE DIRECTOR OF KENTUCKY HOME PLACE AND TRUST IS A PART OF THE PROGRAM.

>> IT TAKES A LONGTIME TO BUILD SOMEONE'S TRUST IT'S IMPORTANT THAT OUR COMMUNITY HEALTH WORKERS GET OUT AND WORK IN THEIR COMMUNITIES AND GET TO KNOW PEOPLE.

AND BUILD PARTNERSHIPS.

BECAUSE THEY DEPEND ON THESE PARTNERSHIPS WHEN THEY ARE HELPING THEIR CLIENTS.

AND HAVING THOSE COMMUNICATIONS SKILLS AND BEING AN ENJOYABLE PERSON TO TALK TO, AND A HELPFUL PERSON, IS KEY TO BEING A COMMUNITY HEALTH WORKER.

YOU CAN TEACH FOLKS A LOT OF SKILLS BUT YOU CAN'T TEACH THEM COMPASSION.

>> I HEAR IT ALL THE TIME.

I WISHED I WOULD HAVE KNOWN YOU WERE HERE SOONER BECAUSE I'VE NEEDED THE HELP FOR SO LONG BUT DIDN'T KNOW WHERE TO TURN.

>> WHEN YOU COME TO HER, YOU FIND OUT THINGS THAT ARE OUT THERE THAT YOU DON'T KNOW EXIST.

AND THAT IS WHY KENTUCKY HOME PLACE IS SO HELPFUL TO THE COMMUNITY AND TO THE ELDERLY ESPECIALLY.

>> THE MOST FULFILLING PART OF MY JOB ARE MY CLIENTS.

THE THANK YOUS, THE I COULDN'T HAVE DONE IT WITHOUT YOU.

STOPPING IN SAYING I GOT MY LABS BACK MY A1C DROPPED TO GET THE HUGS.

IT'S MY CLIENTS.

>> IF YOU WILL ASK JUST ABOUT ANYBODY IN THIS TOWN WHERE CAN I GET HELP WITH THIS OR THIS, THEY WILL SAY KENTUCKY HOME PLACE.

>> FOR KET, I'M CLAYTON DALTON.

>> THE KENTUCKY LEGISLATURE PASSED A BILL TO ESTABLISH KENTUCKY HOME PLACE IN 1994.

SINCE THEN THESE COMMUNITY HEALTH WORKERS HAVE PROVEN TO BE AN INVALUABLE RESOURCE TO BETTER HEALTH OUTCOMES.

UNFORTUNATELY, JOBS THAT IMPROVE THE HEALTH OF SENIORS AND ALLOW THEM TO LIVE INDEPENDENTLY OFTEN GO UNFILLED.

THIS LIMITS ACCESS TO THESE VALUABLE HEALTHCARE PROVIDERS FOR SENIORS.

IN KENTUCKY WE HAVE A TROUBLING SHORTAGE OF HOME HEALTHCARE WORKERS AND PERSONAL CARE AIDES.

THESE WORKERS ENABLE OLDER ADULTS TO REMAIN IN THEIR HOMES AS THEY AGE A PREFERRED OPTION FOR MANY.

KENTUCKY HAS 29 HOME HEALTHCARE WORKERS FOR EVERY 1,000 ADULTS 65 AND OLDER.

THAT'S LESS THAN HALF OF THE NATIONAL AVERAGE WHICH IS 61.

AND A CONCERNING STATISTIC AS WE FACE AN INCREASE IN THE SENIOR POPULATION.

OUR CHRISTIE DUTTON TALKS TO AN EXPERT IN THE FIELD OF SENIOR CARE TO EXPLORE WHY THIS WORKFORCE STRUGGLES TO KEEP UP WITH DEMAND.

>> JOINING US IS Dr. SAM COTTON THE ASSISTANT PROFESSOR FOR FAMILY AND GERIATRIC MEDICINE AT THE UNIVERSITY IN LOUISVILLE.

HOME HEALTHCARE WORKERS THEY ARE A PART OF SENIOR CARE.

HEALTHCARE.

TELL US A LITTLE BIT ABOUT WHAT THEY DO AND WHY THEY ARE SO IMPORTANT?

>> I WOULD SAY HOME HEALTH WORKERS ARE REALLY ONE OF THOSE CRITICAL ASPECTS TO OLDER ADULT CARE HERE IN KENTUCKY.

IN TERMS OF INDIVIDUALS WHO PERHAPS WANT TO STAY AT HOME, AS THEY GET OLDER, BUT ALSO NEED ADDITIONAL CARE AND ADDITIONAL SUPPORT, HOME HEALTH WORKERS TEND TO COME IN THE HOME AND HELP WITH THINGS LIKE DAY-TO-DAY ACTIVITIES.

THINGS LIKE HELPING WITH MEAL PLANNING.

HELPING WITH CLEANING ASSISTANCE.

SOMETIMES DOING THINGS LIKE TRANSFERENCE FROM A BED TO A WHEELCHAIR OR HELPING WITH OTHER PERSONAL CARE TYPE THINGS THAT THAT PERSON MIGHT NEED TO STAY INDEPENDENT IN THEIR HOME.

SO I WOULD SAY IN GENERAL, THAT WORK IS JUST SO CRITICAL FOR THAT POPULATION OF INDIVIDUALS WHO WANT TO BE ABLE TO STAY IN THEIR OWN HOMES, STAY IN THE COMMUNITY AND STILL BE ABLE TO RECEIVE THAT LEVEL OF CARE THAT THEY NEED.

>> IT IS CRITICAL.

BUT THERE IS SUCH A SHORTAGE OF HOME HEALTHCARE WORKERS.

SO WHAT ARE SOME REASONS FOR THAT?

>> YEAH, SO IN KENTUCKY, WE'VE SEEN A HUGE GROWTH IN OUR 65 AND OLDER POPULATION.

SO WE KNOW HERE IN THE STATE THAT OUR POPULATION IN GENERAL IS JUST GETTING OLDER.

I THINK THE ESTIMATES ARE JUST A LITTLE UNDER 20% OF THE POPULATION OF KENTUCKY IS IN THAT 65 AND OLDER CATEGORY.

SO THAT'S TO CONTINUES TO GROW OVER TIME.

AND WE JUST DON'T HAVE THE INFRASTRUCTURE FOR THIS TYPE OF SUPPORT FOR INDIVIDUALS IN THEIR OWN HOME.

AND THAT IS UNFORTUNATE BECAUSE IT IS A CRITICAL ASPECT OF THEIR CARE.

I WOULD ALSO SAY AS WELL WE HAVE NOT DONE A GREAT JOB OF HIGHLIGHTING HOW NEEDED HOME HEALTH AIDES ARE AND HOME HEALTH WORKERS ARE.

A LOT OF TIMES THERE'S OFTEN A STIGMA ATTACHED WITH THOSE CAREERS.

WE HAVE NOT DONE ENOUGH IN TERMS OF CREATING CAREER LADDERS FOR INDIVIDUALS FOR THEM TO BE ABLE TO MOVE UP IN THAT PROFESSION.

AND SO A LOT OF INDIVIDUALS END UP LEAVING THE FIELD.

SO BASELINE WE DON'T HAVE ENOUGH INDIVIDUALS GOING INTO THOSE TYPES OF JOBS.

AND AT THE END OF THE DAY WE ARE NOT RETAINING THAT WORKFORCE AS WELL.

>> AND IT'S NOT EASY WORK, EITHER.

AND SOME SAY EVEN REIMBURSEMENT FOR THAT KIND OF WORK IS NOT AT THE LEVEL IT NEEDS TO BE.

>> YEAH.

I WOULD TOTALLY AGREE WITH THAT.

AND NOT JUST THE REIMBURSEMENT TO THE HOME AIDE HEALTH AGENCIES WHO ARE PROVIDING THAT SERVICE AND PAYING WORKERS, I WOULD SAY THAT THE COMPENSATION FOR THE ACTUAL WORKER IS NOT SUFFICIENT FOR THE BOTH PHYSICAL AND SOMETIMES EMOTIONALLY DRAINING ASPECTS OF THE CARE.

IN KENTUCKY I WOULD LOVE TO SEE US FOCUS MORE ON JOBS LIKE HOME HEALTH AIDES AND CREATING CAREER TRACKS FOR INDIVIDUALS SO WE RETAIN THAT WORKFORCE.

OFTEN WHAT HAPPENS IS INDIVIDUALS GO INTO THIS LINE OF WORK, AND BECAUSE THERE'S NO UPWARD MOBILITY FOR THEM THEY END UP GOING BACK TO SCHOOL TO GET A DIFFERENT DEGREE IN A DIFFERENT FIELD OR MAYBE THEY END UP IN A TOTALLY DIFFERENT AREA AND LEAVING HEALTHCARE IN GENERAL BECAUSE THERE'S NOT ENOUGH PROMOTION FOR THEM IN THAT AREA.

BUILDING UP A SUSTAINABLE WORKFORCE WOULD INCLUDE HAVING DIFFERENT TRAINING OPTION, CERTIFICATION PROGRAMS THAT AN INDIVIDUAL CAN GO THROUGH.

NOT JUST SO THEY HAVE THAT CERTIFICATION BUT ALSO THEY CAN POTENTIALLY MAKE MORE MONEY LONG-TERM.

WHAT WE OFTEN SEE IS INDIVIDUALS ARE NOT GETTING AID PAID WHAT THEY NEED TO BE TO REALLY FEEL LIKE THEY CAN HAVE A CAREER IN THIS FIELD.

>> Renee: THE DEMAND FORETHIS WORKFORCE IS EXPECTED TO SOAR AS THE AGING POPULATION INCREASES.

WITHOUT THE WORKERS TO FILL THESE POSITIONS, SOME SENIORS ARE TURNING TO EACH OTHER FOR A SOLUTION.

OUR KELSEY STARKS TAKES US TO BRECKINRIDGE COUNTY WHERE THE COMMUNITY ACTION SENIOR COMMON COMPANION PROGRAM IS FILLING THAT GAP WITH SENIORS HELPING SENIORS.

>> I'M 75.

>> I'M 86 IN DECEMBER.

>> LIKE HAVING A BIG SISTER.

>> ANOT QUITE A BIG SISTER BUT A SENIOR COMPANION.

SENIORS HELPING SENIORS.

IT'S PART OF THE CENTRAL KENTUCKY COMMUNITY ACTION PARTNERSHIP FUNDED BY AMERI CORE.

>> OUR COMPANIONS GO OUT AND OFFER COMPANIONSHIP AND ASSISTANCE TO THE OLDER ADULTS WHO NEED A LITTLE HELP SOMEBODY CHECKING IN ON THEM WITH THE DAY-TO-DAY TASKS THAT HAVE BECOME A LITTLE DIFFICULT.

>> GAYLE STURGEON PRIDED HERSELF ON BEING INDEPENDENT LIVING HOME ALONE SINCE 1969 UNTIL SHE LOST THE BETTER PART OF HER VISION WHICH MADE IT IMPOSSIBLE FOR HER TO DRIVE.

THAT'S WHERE LYNN CAME IN.

>> THIS IS A FLOWER SHOP.

>> A LOT OF TIMES SHE IS TAKING ME TO THE BANK AND TAKE ME TO VISIT HOMESTEAD OUT HERE WHICH IS A NURSING HOME.

WE DID THAT.

AND WE GO TO TAYLOR PHARMACY.

>> WALMART.

>> WALMART.

BASICALLY ANYWHERE TWO OLD LADIES MIGHT GO.

>> THEY LOVE TO GO THRIFT SHOPPING AND THEY SPEND TIME WITH FRIENDS AT THE SENIOR CENTER AND GOING ON DOCTOR'S APPOINTMENTS.

>> I GOT TO WHERE I GO INTO THE DOCTOR WITH HER AND TAKE NOTES SO THAT WE ALL KNOW WHAT SHE'S BEING TOLD.

>> BECAUSE AS I SAY I HAVE CASE OF DEMENTIA AND I FORGET.

>> IT'S THOSE LITTLE TASKS THAT CAN BECOME BIG HURDLES AS WE AGE.

AND OPTIONS LIKE IN-HOME HEALTHCARE OR ASSISTED LIVING ARE OUT OF REACH FOR MOST PEOPLE.

>> COST.

WAITING LISTS.

THERE'S SO MANY BARRIERS TO GETTING INTO ASSISTED LIVING.

AND THERE ARE SO MANY PEOPLE WHO JUST WANT TO STAY IN THEIR HOME.

THEY DON'T WANT TO BE FORCED WHERE THEY RAISED THEIR FAMILY THEY HAVE THEIR MEMORIES THERE.

THEY WANT THEIR CHILDREN TO COME BACK AND VISIT THEM THERE.

>> THE SENIOR COMPANION PROGRAM LETS THE SENIORS WHO WANT TO STAY IN THEIR HOMES DO SO WITH A LITTLE HELP FROM THEIR FRIENDS.

THE SENIOR FRIENDS WHO VOLUNTEER HAVE TO BE 55 YEARS OLD AND GO THROUGH STATE AND FEDERAL BACKGROUND CHECKS.

BUT OTHERWISE, NO OTHER EXPERIENCE IS NECESSARY.

MOST OF THESE HELPERS ARE LOOKING FOR A FRIEND THEMSELVES.

>> LOOK HERE.

YOU LIKE WIND CHIMES?

>> YES, I LOVE THEM.

>> THE COMMUNITY ACTION SENIOR PROGRAM HAS BEEN AROUND IN CENTRAL KENTUCKY FOR MORE THAN 20 YEARS AND TODAY HAS 25 ACTIVE VOLUNTEERS ACROSS SIX COUNTIES.

IT IS NOT ENOUGH TO HELP EVERYONE, BUT EVERY LITTLE BIT HELPS EVERYONE.

>> LET'S FACE IT OUR OLDER GENERATION IS THE BABY-BOOMER GENERATION.

THERE IS A LARGE NUMBER OF THOSE SENIORS OUT THERE THAT ARE HITTING THIS AGE AND WE REALLY JUST DON'T HAVE THE CAPACITY TO TAKE ALL OF THOSE FOLKS IN.

SO ANY PEOPLE THAT WE CAN HELP TO STAY IN THEIR HOME, MAKES MORE ROOM FOR PEOPLE WHO DO NEED THAT 24-HOUR OUT OF HOME ASSISTED LIVING EXPERIENCE.

THAT NEED TO MOVE INTO THAT SITUATION.

AND SO IT BENEFITS EVERYBODY.

>> AND THAT INCLUDES THE SENIOR HELPERS, TOO, WHO MOST WILL TELL YOU IT HAS GIVEN THEM MORE THAN A NEW PURPOSE IT'S GIVEN THEM A FRIEND.

>> IT GETS PEOPLE OUT OF THE HOUSE.

AND IT GIVES THEM SOMEBODY TO TALK TO.

GIVES THEM SOMEBODY TO GRIPE TO.

>> WE DO A LOT OF THAT.

>> THIS IS NOT A JOB.

THIS IS SOMETHING YOU VOLUNTEER TO DO.

IT'S OUT OF YOUR HEART.

PEOPLE LOOK AROUND, YOU PROBABLY GOT A NEIGHBOR THAT DON'T GET OUT.

GO CHECK ON THEM ONCE IN A WHILE AND YOU FIND THAT IT MAKES YOU FEEL GOOD TO CHECK ON PEOPLE TO KNOW PEOPLE CAN IF THEY NEED HELP, JUST GET OUT AND DO IT.

JUST GET OUT AND DO IT.

GIVES YOURSELF A CHANCE TO DO GOOD FOR SOMEBODY AND IT'S ALWAYS COMES BACK GOOD FOR YOURSELF I'M TELLING YOU IT REALLY DOES.

>> THE WORKFORCE.

EMPLOYERS.

YOUR EMPLOYEES PROBLEMS CAN BECOME YOUR PROBLEMS AND IF YOUR EMPLOYEES HAVE RAISED THEIR KIDS NOW HAVING TO TAKE CARE OF THEIR PARENTS THAT IMPACTS THE WORKFORCE, TOO.

SO THERE'S JUST A LOT OF WAYS THIS PROGRAM BENEFITS THE COMMUNITY AND HELPINGS MAKE THE COMMUNITY STRONGER.

>> FOR KET, I'M KELSEY STARKS.

>> Renee: THE SENIOR COMPANION PROGRAM SERVES BRECKINRIDGE, GREYSON, HARDEN, MARION AND WASHINGTON AND THEY ARE ACCEPTING NEW VOLUNTEERS.

TO FIND OUT MORE YOU CAN CALL THE CENTRAL KENTUCKY COMMUNITY ACTION COUNCIL AT 270-692-2136 OR VISIT THEIR WEBSITE AT CKCAC.ORG.

WE'VE TALKED ABOUT THE NEED FOR MORE HOME HEALTH WORKERS AND VOLUNTEERS TO HELP KENTUCKY SENIORS LIVE THEIR BEST LIVES, UNFORTUNATELY THE SHORTAGE IN THE WORKFORCE ALSO INCLUDES DOCTORS AND NURSE PRACTITIONERS TRAINED TO TREAT ELDERLY PATIENT BUILDING.

THESE MEDICAL PROVIDERS ARE KNOWN A GERIATRICIANS.

THE NUMBER OF GERIATRICIANS PRACTICING IN KENTUCKY HAS INCREASED IN RECENT YEARS.

THE LATEST REPORT SHOWS 27.5 GERIATRICIANS PER 100,000 KENTUCKY SENIORS.

HOWEVER, THAT IS STILL BELOW THE NATIONAL AVERAGE OF 38 GERIATRICIANS PER 100,000 SENIORS.

OUR CHRISTIE DUTTON TALKS TO ONE OF KENTUCKY'S GERIATRICIANS TO FIND OUT WHY MORE MEDICAL STUDENTS DON'T PURSUE THE FIELD OF GERIATRICS AND WHAT IS BEING DONE TO INCREASE THE NUMBER OF GERIATRICIANS IN OUR STATE.

>> Dr. LAURA MORTON YOU ARE A PRACTICING GERIATRICIAN AND YOU SPECIALIZE IN GERIATRIC MEDICINE AND YOU TEACH OTHERS HOW TO TAKE CARE OF OLDER KENTUCKIANS AND OLDER ADULTS.

WHY IS THAT SO IMPORTANT TO HAVE THAT TRAINING WITH OLDER ADULTS AS A DOCTOR?

>> BECAUSE OUR OLDER ADULT POPULATION AS YOU KNOW IS GROWING IN NUMBER.

AND THEY ARE COMPLICATED, THEY ARE EACH UNIQUE.

AND THAT ADDITIONAL TRAINING HELPS US REALLY TAILOR OUR CARE TO TAKE CARE OF THE WHOLE PERSON.

AS THE POPULATION AGES WE NEED MORE PEOPLE WHO ARE AWARE OF AND ABLE TO TAKE CARE OF THAT POPULATION.

>> AND THERE ARE THINGS THAT ARE DIFFERENT WITH OLDER ADULTS THAN YOUNGER ADULTS LIKE MEDICATIONS?

>> I THINK THE BIGGEST THINGS THOSE OF US GERIATRIC MINDED IS FIRST MEDICATIONS WE LOOK AT POLY PHARMACY ANYONE WHO TAKES MORE THAN FIVE OR MORE MEDICATIONS.

THAT IS THE VAST MAJORITY OF OUR OLDER ADULT POPULATION.

AND SOME OF OUR YOUNGER POPULATION ACTUALLY.

AND I THINK THE OTHER THING WE THINK ABOUT IS FUNCTIONAL STATUS.

SO HOW IS SOMEONE ABLE TO LIVE IN THEIR HOME?

WHAT SUPPORT SYSTEM DO THEY HAVE?

IF WE GIVE SOME MEDICAL TREATMENT IS THE PERSON ABLE TO ACTUALLY DO IT PHYSICALLY OR FINANCIALLY?

SO WE THINK ABOUT ALL THOSE THINGS EACH TIME WE MAKE A TREATMENT OR RECOMMENDATION FOR OUR PATIENTS.

>> SO IT IS A HOLISTIC APPROACH WITH THAT AND IN YOUR FIELD, IN GERIATRICS, THERE IS A LACK OF GERIATRICIANS A LACK OF PROVIDERS, DOCTORS, NURSES THAT ARE TRAINED IN THIS.

WHY IS THAT?

WHAT ARE THE BARRIERS?

>> SO FOR GERIATRIC MEDICINE THERE'S 7500 GERIATRICIANS THAT ARE BOARD CERTIFIED IN THE COUNTRY CURRENTLY.

ONLY 39 IN THE STATE OF KENTUCKY.

AND A LOT OF THE BARRIERS ARE RELATED TO FINANCES AS WE KNOW IN THE HEALTHCARE SYSTEM A LOT OF THAT IS DRIVEN BY PAYMENTS AND REIMBURSEMENTS AND MEDICARE HAS DECREASED AND CONTINUES TO DECREASE PAYMENTS TO PHYSICIANS WHICH IS A BARRIER TO GETTING YOUNG DOCTORS AND RECRUITING THEM INTO THE FIELD.

>> AND SO YOU KNOW, A LOWER PAYING PERHAPS PRACTICE, BUT THERE ARE REWARDS, RIGHT?

>> ABSOLUTELY.

AND I THINK THE OTHER BARRIER FOR PEOPLE GOING INTO THIS FIELD IS THAT THE PATIENTS ARE COMPLICATED.

THEY TAKE LONGER.

AND SO IT'S HARD TO SQUEEZE THEM INTO A TRADITIONAL PRACTICE WHERE YOU GET 15 TO 20 MINUTES PER PATIENT.

BUT THE REWARDS ARE IMMENSE.

I THINK ABSOLUTELY TAKING CARE OF THESE PEOPLE AND HELPING THEM AND REALLY CAN BE THE SMALLEST THINGS THAT MAKE A HUGE IMPACT ON PEOPLE'S LIVES.

AND WE CAN HELP OLDER ADULTS THRIVE AND FUNCTION INDEPENDENTLY AS LONG AS POSSIBLE.

>> TRAGER INSTITUTE HAS BEEN WORKING IN THE SPACE TO TRY TO GET MORE PROVIDERS TRAINED IN THIS WAY, RIGHT?

>> YES, ABSOLUTELY.

WE HAVE HAD THE GRANT A GERIATRIC WORKFORCE ENHANCEMENT PROGRAM AND THE GOAL OF THAT GRANT IS TO TRAIN OTHER PROVIDERS ABOUT HOW TO TAKE CARE OF OLDER ADULTS.

AND REALLY TRANSFORMING PRIMARY CARE PRACTICES SO THEY HAVE BETTER TOOLS AND THEY ARE BETTER PREPARED TO TAKE CARE OF THIS POPULATION.

WE TRAIN NURSE PRACTITIONERS, NURSING STUDENTS, SOCIAL WORK 0 STUDENTS IN ADDITION TO THE RESIDENTS AND MEDICAL STUDENTS THE DOCTORS IN TRAINING ABOUT HOW WE PROVIDE CARE FOR THE OLDER ADULTS.

>> WITH THAT LACK OF GERIATRICIANS WHAT ARE SOME THINGS YOU THINK MIGHT HELP GETTING THE NEEDED POSITIONS FILLED?

>> THE BEST THING IS INTRODUCE YOUNGER PEOPLE WHEN THEY ARE IN MEDICAL SCHOOL OR EARLIER ABOUT GERIATRICS AND INTRODUCE THEM TO WORKING WITH OLDER ADULTS SO THEY CAN SEE THE BENEFITS AND THE REWARDS THAT THEY CAN GET.

AND SEE HOW GREAT THE POPULATION IS TO TAKE CARE OF.

>> AND YOU WERE TO GIVE THAT ELEVATOR PITCH TO A NEW STUDENT, INTERESTED IN MEDICINE, WHAT WOULD YOU SAY?

>> I WOULD SAY THAT AS A GERIATRICIAN, EVERYDAY IS DIFFERENT.

AND IT IS THE BEST THING GERIATRICS IS A CALLING FOR ME.

AND TAKING CARE OF THOSE PATIENTS IS SO REWARDING AND AT THE END OF THE DAY, I FEEL LIKE I'M ENJOYING MY JOB AND EVERYDAY THOUGH IT MAY BE CHALLENGING IS A PLEASURE.

>> Renee: CHALLENGING AND A PLEASURE.

AND A MEANINGFUL CONTRIBUTION TO IMPROVE THE HEALTH OF KENTUCKY'S OLDER POPULATION.

WHEN TALKING TO SENIORS AND CARE PROVIDERS ACROSS THE STATE MANY TOLD US THAT ONE OF THE BIGGEST OBSTACLES TO HEALTHCARE ACCESS IS LACK OF TRANSPORTATION.

MANY OLDER ADULTS DRIVE LESS OR STOP DRIVING ALTOGETHER IN THEIR GOLDEN YEARS.

THE LACK OF AVAILABLE AFFORDABLE AND CONVENIENT TRANSPORTATION OPTIONS PLACE AN ADDITIONAL HEALTHCARE BARRIER ON OLDER KENTUCKIANS, ESPECIALLY THOSE IN RURAL AREAS.

KET'S JUNE LEFFLER TAKES US TO CARTER COUNTY WHERE TRANSPORTATION CAN BE THE MOST DIFFICULT PART OF A DOCTOR'S VISIT.

>> MARVIN AND REGINA SHOCKEY LIVE ON THE FAMILY FARM IN RURAL CARTER COUNTY.

THIS IS MY HOME.

THIS IS WHERE MY FAMILY IS.

WHERE I RAISED MY DAUGHTER.

>> MARVIN DOESN'T DREAM OF LEAVING HIS NEIGHBORS OR HIS VIEW FOR THE CONVENIENCES OF A BIG CITY.

>> I SPENT A LOT OF MONTHS LOOKING OUT A HOSPITAL WINDOW AND.

>> YEARS AGO MARVIN DEVELOPED A SYNDROME THAT ATTACKED HIS NERVOUS SYSTEM.

>> IT'S VERY RARE.

HE WAS ON A VENTILATOR FOR 100 DAYS.

HE WAS IN A HOSPITAL FOR 10 MONTHS.

HE HAD TO REGENERATE ALL HIS NERVES AND START ALL OVER AGAIN LEARNING HOW TO SPEAK, EAT, FORT D. EVERYTHING.

>> I WAS IN THE HOSPITAL TO SEE SOME UP.

IT'S SAD.

BUT I COULDN'T.

I COULD NOT GIVE UP.

>> MARVIN IS IN A WHEELCHAIR.

REGINA TAKES CARE OF HIM FULL-TIME.

>> IT TAKES A LONGTIME TO GET READY TO LEAVE THE HOUSE.

I HELP HIM WITH ALL HIS DAILY ACTIVITIES OF LIVING.

HE TRANSFERS FROM HIS BED TO THE WHEELCHAIR.

AND THEN HE GOES TO THE CAR.

WE HAVE TO TRANSFER OUT OF THAT WHEELCHAIR INTO THE CAR.

AND THEN I PUT THE WHEELCHAIR IN THE CAR TO GO WITH US.

SO GOING TO THE DOCTOR'S OFFICE HE WOULD TRANSFER THREE TIMES AND THEN COMING HOME HE WOULD TRANSFER THREE TIMES.

SO BY THE TIME WE GET HOME HE IS REALLY TIRED AND IT'S JUST A LONG DAY.

BUT I DO IT GLADLY AND I'M GLAD THAT I CAN.

>> I LOVE YOU.

>> REGINA COULD USE A VEHICLE WITH A WHEELCHAIR LIFT BUT THEY ARE HARD TO COME BY.

>> AND THE NEW ONES ARE SO EXPENSIVE, THEY ARE PROBABLY $65 TO $100,000.

>> THE SHOCKIES ARE NOT ALWAYS ON THEIR OWN.

A NONPROFIT OFFERS RIDES SO PEOPLE WITH ALL ABILITIES CAN GET TO THE GROCERY STORE OR A MEDICAL APPOINTMENT FARTHER AWAY.

>> IT'S LIKE OUR OWN CHAUFFEUR.

I LOVE IT.

I GET TO RELAX WHEN THEY COME.

AND TAKE US TO LEXINGTON AND IT'S JUST MORE OF A CAREFREE TRIP.

>> THERE'S MORE TRANSPORTATION PROVIDERS ACROSS THE STATE.

BUT SOCIAL WORKERS SAY THE PATCHWORK OF SERVICES CAN BE HARD TO NAVIGATE FIVMENT YOU DO A QUICK GOOGLE SEARCH, THEY ARE HARD TO FIND.

>> THOSE SERVICES ARE SOMETIMES COSTLY DEPENDING ON INSURANCE AND REQUIRE ADVANCED NOTICE AND PAPERWORK.

>> MOST OF THE PEOPLE PEOPLE GIVE UP AT THAT POINT.

WHENEVER WE TALK TO THEM, AND THEY SAY YOU NEED A LETTER OF MEDICAL NECESSITY FROM THE DOCTOR'S OFFICE SAYING THAT WE CAN TAKE YOU FROM YOUR HOUSE TO LEXINGTON FOR THIS APPOINTMENT.

MOST OF THE TIME, THEY ARE LIKE NEVER MIND I WILL JUST PAY MY COUSIN TO DRIVE ME.

>> RELYING ON FAMILY AND NEIGHBOR SUPPORT IS TYPICAL.

BUT MARVIN DOESN'T ALWAYS WANT TO ASK FOR HELP.

>> I DON'T WANT TO HAVE TO ASK EVERYBODY TO HOLD THE DOOR FOR ME, PLEASE.

AND THEY ARE PERFECTLY WILLING THEY ARE GREAT PEOPLE OUT THERE.

BUT DIGNITY LACKS WHEN YOU ARE IN THIS POSITION.

>> SOCIAL WORKERS HOPE TO BETTER CONNECT CLIENTS TO THEIR TRANSPORTATION OPTIONS TO GIVE LOVED ONES A BREAK AND SUPPORT THOSE WHO MIGHT NOT HAVE ANYONE ELSE.

FOR KET I'M JUNE LEFFLER.

>> Renee: WHEN ADULTS AGE 60 AND OLDER CAN NO LONGER DRIVE THEY MAKE 15% FEWER TRIPS TO THE DOCTOR.

59% FEWER TRIPS TO SHOP OR EAT OUT.

AND DRIVERS OF THE SAME AGE.

THIS IS WITH LOVED ONES TEND TO TAKE THE BIGGEST CUT WHEN SENIORS CAN NO LONGER DRIVE WHICH CAN LEAD TO SOCIAL ISOLATION AND LONELINESS.

ACCORDING TO THE NATIONAL INSTITUTE ON AGING, LONELINESS IN THE ELDERLY HAS BEEN CONNECTED TO AN INCREASED RISK OF DEMENTIA, FUNCTIONAL DECLINE AND EVEN DEATH.

KET'S Dr. WAYNE TUCKSON SPOKE WITH NEUROLOGIST GREG JICHA ABOUT THE IMPACT SOCIAL ISOLATION HAS ON THE AGING BRAIN.

>> THANK YOU FOR BEING WITH US AND TAKING TIME TO SIT DOWN AND HAVE A CHITCHAT.

WHEN WE'RE TALKING ABOUT SOCIAL ISOLATION, WHY ARE WE SEEM TO BE MORE LIKELY TO EXPERIENCE ISOLATION AS WE GET OLDER?

>> YOU KNOW I THINK THIS IS A GENERAL PHENOMENA BECAUSE OF THE CHANGE NOT JUST WITHIN OURSELVES BUT IN THE WORLD AROUND US AS WELL.

AND THE TWO IMPACT ONE ANOTHER.

FOR INSTANCE INSIDE OF EACH OF US WE MAY BEGIN TO DEVELOP OTHER CHRONIC DISEASES, FORMS OF EARLY MEMORY LOSS THAT MAKE US A LITTLE MORE RHETT SENT TO GET OUT THERE.

SIMULTANEOUSLY OUR FRIENDS MOVE TO BE CLOSER TO THEIR CHILDREN AND GRANDCHILDREN AND OUR SOCIAL CIRCLES BEGIN TO SHRINK.

AND SO THERE'S LESS OPPORTUNITY AND SO THE REALLY PRESENTS A SCENARIO WHERE WE HAVE TO WORK TO BOTH EXTERNALLY TO CREATE THE OPPORTUNITIES TO PREVENTS SOCIAL ISOLATION.

AND INTERNALLY TO PUSH OURSELVES A LITTLE BIT TO NOT BE KEPT IN THE HOME BECAUSE SOCIAL ISOLATION IS A KILLER.

>> IN WHAT WAY DO YOU FIND THE HEALTH IMPACTS OF SOCIAL ISOLATION?

>> WE RECENTLY LOOKED AT THIS IN THE COVID PANDEMIC.

AND THE SENIORS THAT WE CARE FOR.

BECAUSE WE WERE QUITE WORRIED ABOUT THE PANDEMIC LOCKDOWN AND THE SOCIAL ISOLATION.

AND WE SAW A DRAMATIC JUMP IN DEPRESSION BASED ON A VALIDATED DEPRESSION SCALE WITH AS MUCH AS 90% OF THE SENIOR POPULATION EXPERIENCING DEPRESSION AS A RESULT OF SOCIAL ISOLATION AT THAT TIME.

AND SO IT CAN BE VERY DYNAMIC AND JUST GETTING INTO A SITUATION WHERE SOCIAL ISOLATION IS A PART OF IT, CAN DRAMATICALLY TURN YOUR LIFE UPSIDE-DOWN OVER A SHORT FEW MONTHS.

>> DO YOU SEE ANATOMICAL CHANGES AS WELL AS CHEMICAL CHANGES AS A CONSEQUENCE OF ISOLATION?

OR MORE JUST A FUNCTIONAL THING?

>> WE CERTAINLY DO SEE CHANGES IN BRAIN, DYNAMIC BRAIN IMAGING.

BLOOD FLOW TO DIFFERENT REGIONS OF THE BRAIN.

BEING RESTRICTED IN FOLKS WHO ARE SOCIALLY ISOLATED.

THOSE AREAS OF THE BRAIN THAT WE TURN ON WHEN WE DO ENGAGE SOCIALLY, ESSENTIALLY SHUTTING DOWN.

>> ARE THERE CERTAIN COMMUNITIES OR EVEN REGIONS WHERE IT'S MORE LIKELY THAT THEY WILL EXPERIENCE ISOLATION?

AND DOES SOCIAL ISOLATION ALWAYS GO WITH GEOGRAPHIC ISOLATION?

>> I THINK THOSE ARE GREAT QUESTIONS.

AND THE TRUTH IS WE DON'T HAVE AN ABSOLUTE ANSWER FOR ANYONE INDIVIDUAL PERSON.

BUT ONE CERTAINLY CAN THINK ABOUT SOMEONE WHO LIVES IN A MORE RURAL AND REMOTE AREA BEING DEPENDENT ON DRIVING THEIR CAR FOR SOCIAL ENGAGEMENT AND AS WE AGE, SOME CATARACTS, MACULAR DEGENERATION NOT AS QUICK WITH OUR REFLECTS, SLOWING THAT ABILITY TO ACTUALLY GET OUT.

SO THERE IS GEOGRAPHIC ISOLATION THAT BECOMES MORE IMPACTFUL AS WE AGE.

>> TELL ME, ARE OUR INSTITUTIONS AS SENSITIVE TO THE NEEDS OR TO THIS PROBLEM OF SOCIAL ISOLATION IN OUR ELDERLY?

>> I THINK IT'S GETTING BETTER.

I THINK THIS IS SOMETHING THAT IS JUST REALLY COMING ON INTO VIEW FOR THE MAJORITY OF THE AGING POPULATION.

AND FOR THE MAJORITY OF ADMINISTRATORS, POLITICAL FORCES, BUSINESS ENTERPRISES THAT ARE POISED TO ACTUALLY CHANGE THIS.

AND I DON'T KNOW WHETHER OR NOT IT'S THE EXTENSION OF THE LIFESPAN THAT THE PERCENTAGE OF OUR POPULATION THAT IS AGING IS INCREASING.

THERE ARE DEMANDS BEING PLACED ON SOCIETY OF, YEAH, WE MAYBE OLDER BUT WE STILL WANT A GOOD LIFE.

WE STILL WANT QUALITY OF LIFE.

AND WE DESERVE IT.

>> Renee: GETTING AFFORDABLE, QUALITY AND CONVENIENT HEALTHCARE CAN BECOME A COMPLEX TASK FOR OLDER KENTUCKIANS.

MANY HAVE TO NAVIGATE THROUGH THE WEB OF RESOURCES AND PATCHWORK OF SERVICES TO ACCESS NEEDED MEDICAL CARE.

LUCKILY, A NEW PROGRAM CALLED PACE AIMS TO BE AN ALL INCLUSIVE OPTION FOR SENIORS IN KENTUCKY.

KET'S LAURA ROGERS TAKES US TO BLUEGRASS CARE NAVIGATORS THE PACE CENTER IN LEXINGTON.

>> WHEN EASTERN KENTUCKY NATIVES CECIL HAMM AND JUDITH HAMM MOVED TO LEXINGTON TO BE CLOSER TO THEIR DAUGHTERS.

>> NOT GETTING ANY YOUNGER.

>> THERE WAS AN ADDED BENEFIT.

THEY NOW LIVE MILES AWAY FROM A PACE PROVIDER.

>> WE LOVE TO DO THE FIRST DAY.

>> IT'S PROGRAMS OF ALL INCLUSIVE CARE FOR THE ELDERLY.

>> WE HAVE PHYSICAL THERAPY WHICH IS GOOD.

YOU KNOW YOU DON'T HAVE TO GO ANYWHERE TO GET IT IT'S HERE.

>> THE COUPLE TAKES FREE TRANSPORTATION TO THE CENTER THREE DAYS A WEEK.

>> IT GIVES A DIFFERENT PERSPECTIVE ON LIFE.

WE ARE NOT JUST IN THE APARTMENT ME AND HIM.

THERE'S OTHER PEOPLE TO SOCIALIZE WITH.

>> THE SOCIAL ASPECT OF PACE IS ONE OF OUR BEST MEDICINES.

CHAD HELTON IS EXECUTIVE DIRECTOR.

BLUEGRASS CARE NAVIGATORS WAS THE FIRST PACE PROVIDER IN KENTUCKY.

COMING TO THE STATE TWO YEARS AGO.

>> WHEN YOU DESCRIBE IT TO SOMEONE THAT HASN'T HEARD IT BEFORE IT'S ALMOST TOO GOOD TO BE TRUE.

YOU DO THIS AND YOU HAVE TRANSPORTATION AND THE PACE CENTER.

>> PACE IS A MEDICARE AND MEDICAID PROGRAM FOR THOSE 55 AND OLDER.

>> 067.

>> WHO NEED NURSING FACILITY LEVEL OF CARE BUT PREFER TO KEEP LIVING AT HOME.

>> WITH PACE WE KNOW THEY ARE DOING IT SAFELY AND GETTING HEALTHCARE AND PEOPLE ARE LOOKING AFTER THEM.

>> PACE OFFERS EVERYTHING FROM PRIMARY CARE AND SOCIAL SERVICES TO THERAPIES AND NUTRITIONAL COUNSELINGISM THE THERAPIES HELP THE ATTENTION FROM THE MEDICAL STAFF HELPS.

>> IF WE CAN GET ANYTHING ALL WE GOT TO DO IS TELL OUR PACE WORKER AND SHE WILL PASS IT ON TO THE MEDICAL TEAM.

>> IT'S OFTEN THE COMMUNITY THEY ARE BUILDING OF FRIENDSHIP AND SUPPORT THAT IS THE MOST IMPACTFUL.

>> I DON'T FEEL AS ISOLATED, I GUESS.

>> IT'S REALLY ESPECIALLY JOYABLE HERE.

>> THERE'S ASSESSMENTS WE DO WITH OUR STAFF TO MAKE SURE OUR PARTICIPANTS WOULD MEET THAT THRESHOLD.

>> HE NOTICED BIG TRANSFORMATIONS.

>> O75.

>> YOU CAN WATCH A PERSON TRANSITION FROM WHO WE MEET AND THEN A MONTH, TWO MONTHS, SIX MONTHS DOWN THE ROAD IT IS A BRAND NEW PERSON.

THEY ARE ACTIVE, THEY ARE MOVING AROUND MAKING FRIENDS AND SMILING OUT OF THAT ISOLATION.

>> GREAT RECREATION DIRECTOR AND HE IS NAMED DUSTIN.

HE HAS SOMETHING PLANNED IN THE MORNING AFTER BREAKFAST.

>> SCHEDULED ACTIVITIES INCLUDE GAMES LIKE BINGO.

>> THE STAFF ARE REAL CAPABLE THEY WORK VERY HARD TO SEE WE'RE ALL COMFORTABLE AND HAPPY AND WE'RE ALL SMILES AND WE ENJOY THE PLACE REAL GOOD.

>> ALL SMILES AND ALL HEALTHY THANKS TO A TEAM OF PROVIDERS DEDICATED TO THEIR WELL-BEING.

>> THERE'S GREAT CARE PROVIDED IN THE NURSING HOMES ARE NECESSARY BUT WHAT IF WE COULD STAY AT HOME WITH THE PEOPLE WE KNOW AND LOVE WITH OUR STUFF.

THAT IS IMPORTANT.

IF WE CAN DO THAT WITH ALL OF OUR RESOURCES AND TEAM, IT'S WORTH IT.

>> PACE CURRENTLY SERVES MORE THAN 50 COUNTIES AND PLANS TO EXPAND THROUGHOUT THE ENTIRE STATE.

MAKING SURE SENIORS HAVE ACCESS TO THE HEALTHCARE THEY NEED IMPACTS ALL OF US.

I HAD THE OPPORTUNITY TO SPEAK TO A PANEL OF EXPERTS DEDICATED TO IMPROVING HEALTH OUTCOMES FOR KENTUCKY'S OLDER POPULATION.

WE'RE JOINED NOW BY BARBARA GORDON DIRECTOR OF COMMUNITY ENGAGEMENT AT THE UNIVERSITY OF LOUISVILLE TRAGER INSTITUTE.

Dr. RICHARD KING, NEUROLOGIST SPECIALIZING IN MEMORY AND AGING AT THE KENTUCKY NEUROSCIENCE INSTITUTE AT U.K. HEALTHCARE.

GARY ADKINS, VOLUNTEER STATE PRESIDENT FOR AARP KENTUCKY.

AND VICTORIA ELRIDGE, COMMISSIONER OF THE DEPARTMENT FOR AGING AND INDEPENDENT LIVING IN THE KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES.

THANK YOU ALL FOR BEING HERE.

IT IS AN IMPORTANT DISCUSSION AND WE KNOW YOU WILL ADD TO IT GREATLY.

WE KNOW AND HAVE BEEN DISCUSSING HOW KENTUCKY CONSISTENTLY RANKS AT THE BOTTOM OF HEALTHCARE OR ACCESS IN ALL KINDS OF ISSUES WHEN IT COMES TO SENIORS AND THEY HAVE POOR HEALTH RANKINGS.

KENTUCKY HAS MEDICAID AND MEDICARE WHICH WE THINK SHOULD THAT NOT COVER IT ALL.

WHAT IS MISSING AND WHY DOES THAT NOT COVER IT ALL AND GIVE THE SENIORS ACCESS TO THE HEALTHCARE THEY NEED?

>> MEDICARE AND MEDICAID IS VERY, VERY COMPLICATED.

MEDICARE PROBABLY MORE SO.

OFFENSE RECENTLY EXPERIENCED I TURNED 65 EARLIER THIS YEAR AND HAVE WORKED IN THE FIELD FOR MORE THAN FOUR DECADES.

AND WAS SURPRISED AT HAVING KNOWN WHAT MEDICARE DOES HAVING HELPED OTHER PEOPLE, ACCESS MEDICARE, I WAS VERY SURPRISED AT HOW COMPLICATED IT REALLY IS BECAUSE I WAS GOING THROUGH IT MYSELF.

SO THAT'S FIRST AND FOREMOST TO UNDERSTAND HOW COMPLICATED THESE SYSTEMS ARE IN PROFESSIONAL LIKE I AM WHO WORKED IN AGING FOR YEARS, IF I'M HAVING SOME CONCERNS ISSUES, QUESTIONS, ABOUT WHAT I SHOULD OR SHOULD NOT DO WITH MEDICARE, CAN YOU IMAGINE HOW COMPLICATED IT IS TO THE LAY PERSON WHO IS GOING THROUGH IT FOR THE FIRST TIME EVER.

>> MANY PEOPLE THINK MEDICARE IS AFTER I TURN 65 I WILL HAVE MEDICARE AND THERE SHOULDN'T BE PREMIUMS AND COSTS ET CETERA.

NOT EVERYBODY UNDERSTANDS THAT OR HOW MUCH IT WILL BE HOW IT WILL IMPACT THEIR INCOME.

SO THAT'S VERY CHALLENGING.

MANY INDIVIDUALS ALSO DON'T UNDERSTAND THE DIFFERENCES BETWEEN WHAT WE CALL STRAIGHT MEDICARE, MEDICARE ADVANTAGE AS WELL AS OTHER DIFFERENT TYPES OF PLANS THAT MAYBE AVAILABLE FOR MEDICARE.

AND WHAT THEY DO OR DO NOT COVER.

>> Renee: GREAT POINTS.

I WANT TO GO TO YOU Dr. KING MANY SENIORS AVOID CARE AS WE HEARD IN THE EXAMPLE THAT MS. GORDON SHARED BECAUSE OF THE COST.

AS WE LOOK AT SOME OF THE CHALLENGES PERHAPS THAT YOU ENCOUNTER WHEN YOU ARE TREATING AN OLDER POPULATION CAN YOU SPEAK TO YOUR EXPERIENCE IN THIS ARENA?

>> ABSOLUTELY.

SO AS A PROVIDER WHO COVERS MAJORITY ELDER INDIVIDUALS, IT'S INTERESTING THAT OF ALL THE THINGS WE'VE LEARNED IN MEDICAL SCHOOL HOW TO FINANCE HOW TO PAY THE PROCESS OF REIMBURSEMENT WASN'T ONE OF THEM.

WE ALL LEARNED THIS ON THE FLY.

WE ARE SO FOCUSED WHAT IMAGING DO WE NEED AND WHAT LAB TESTS ARE APPROPRIATE DOESN'T OCCUR TO ME AS TO HOW MUCH THAT TEST COSTS.

HOW MUCH GETTING ALL OF THESE TESTS MIGHT COST TO GET MY DIAGNOSIS.

I'M MUCH MORE FOCUSED ON THE DIAGNOSIS.

IT IS A PROCESS OF LEARNING THAT PART OF TREATING MY PATIENT PART OF LOOKING AT SIDE EFFECTS ISN'T JUST THE MEDICATION SIDE EFFECT BUT THE FINANCIAL SIDE EFFECT OF THESE PIECES.

>> Renee: COMMISSIONER LET ME ASK YOU WHEN YOU HEAR THE STORIES AND WHAT YOU DO IN YOUR DEPARTMENT AS HELP SENIORS NAVIGATE THE COMPLEX ISSUES, MANY OF THESE PROGRAMS ARE UNDERUTILIZED THAT PERHAPS THE DEPARTMENT RUNS AND OFFERS.

WHY IS THAT?

>> SO ONE THING THAT I WILL SAY THAT I AM SO GRATEFUL FOR IS GOVERNOR BESHEAR'S LEADERSHIP AND REALIZING AND RECOGNIZING THE NEED FOR HEALTHCARE ACROSS THE LIFESPAN.

AT THE DEPARTMENT OF AGING AND INDEPENDENT LIVING WE HAVE A PHENOMENAL RESOURCE CALLED AGING AND DISABILITY RESOURCE CENTERS WHERE OLDER ADULTS CAN CALL THIS NUMBER AND THEY CAN SHARE WITH THE AGING RESOURCE IN OUR COUNSELOR WHAT THEIR CURRENT NEED IS.

AND THAT COUNSELOR THEN EXPLORES ALL OF THE OPTIONS AVAILABLE TO THAT INDIVIDUAL WITHIN THE AGING DISABILITY RESOURCE CENTER THEY LOOK AT WHETHER OR NOT THEY ARE ELIGIBLE FOR MEDICAID.

IF THEY ARE CURRENTLY ENROLLED IN MEDICARE, WE HAVE STATE HEALTH INSURANCE ASSISTANCE PROGRAM COUNSELORS THAT CAN HELP THAT INDIVIDUAL NAVIGATE WHAT THE CURRENT BENEFITS ARE TO THAT OUR SHIP, STATE HEALTH INSURANCE ASSISTANCE SAVED KENTUCKIANS 3.5 MILLION ALONE IN PRESCRIPTION SAVINGS TO THAT.

>> Renee: AARP AND WE'VE BEEN A PART OF THIS PROGRAM AND THESE DISCUSSIONS FOR A BIT WE THANK YOU FOR YOUR PARTICIPATION.

HOW DOES AARP HELP SENIORS HELP THEIR HEALTHCARE DOLLARS GO FURTHER?

>> WELL, AARP HAS BEEN ADVOCATING FOR LOTS OF THINGS IT'S GOING TO HELP PEOPLE.

ONE OF THE THINGS IS THE LOWER PRESCRIPTION DRUG COSTS.

AND THE 2022 DRUG PRESCRIPTION DRUG LAW THAT WAS PASSED AS PART OF THE INFLATION REDUCTION ACT ALLOWS FOR NEGOTIATIONS FOR PRESCRIPTION DRUGS.

AND NEXT YEAR IN 2025 THERE'S GOING TO BE A CAP OF $2,000 FOR PRESCRIPTION DRUGS.

SO ANYBODY THAT IS ON ONE OF THE MEDICARE PRESCRIPTION DRUG PLANS THEY ARE NOT GOING TO PAY MORE THAN THAT.

IT'S GOING TO HELP FOLKS THAT.

>> Renee: A YEAR.

THAT IS A YEAR PER YEAR.

>> YES.

AND IT'S GOING TO INCREASE AS WE GO OUT TO 2029.

IT'S GOING TO AFFECT, I THINK THE ESTIMATE RIGHT NOW FOR KENTUCKIANS IS ABOUT 76,000 PEOPLE ARE GOING TO BE ABLE TO BE POSITIVELY AFFECTED WITH THIS THAT IS GOING TO HAPPEN NEXT YEAR.

>> Renee: LET'S TALK ABOUT ANOTHER CHALLENGE AND THAT IS ACCESS TO TRANSPORTATION.

ONCE SENIOR DOSE STOP DRIVING SOMETIMES THAT IS REQUIRED.

LACK OF TRANSPORTATION CAN BE A BARRIER TO GETTING TO YOUR APPOINTMENTS, PREVENTATIVE CARE AND OTHER SERVICES.

COMMISSIONER, THERE ARE VARIOUS PROGRAMS AT THE STATE HELPS PROVIDE TRANSPORTATION.

ARE THOSE BEING UTILIZED?

AND ARE THOSE SUFFICIENT AND WHAT WOULD BE LACKING?

>> THERE ARE AN ARRAY OF PROGRAMS.

ONE THINGS I HAVE THE HONOR OF OVERSEEING IS KENTUCKY'S 200 SENIOR CENTERS ACROSS THE STATE.

THERE'S ONE SENIOR CENTER IN OUR 120 COUNTIES AND SOME OF THE METROPOLITAN AREAS THERE'S MORE THAN ONE.

WITHIN THAT EACH SENIOR CENTER DETERMINES TRANSPORTATION.

TRANSPORTATION COSTS.

AND THEY ARE ABLE TO ADJUST THOSE BASED ON RIDERSHIP AND RIDER NEEDS.

WHAT WE SEE IS OUR BUSES ARE FULL.

THEY ARE ACTIVE.

THEY ARE ENGAGED IN COMMUNITIES.

I GET EXCITED WHEN I SEE THE BUSES OUT AND ABOUT IN THE REGION.

WE ALSO HAVE A GREAT PARTNERSHIP WITH COMMUNITY ACTION OF KENTUCKY AND THEY ARE DOING PHENOMENAL THINGS.

I KNOW IN THE BLUEGRASS REGION, THEY DO NOT LET COUNTY WINES LIMIT WHERE THEY CAN TRANSPORT INDIVIDUALS YOU ARE TAKING INDIVIDUALS FROM COUNTY TO COUNTY FOR MEDICAL OR SOCIAL REASONS OR EMPLOYMENT.

I WOULD BE REMISS IF I DID NOT MENTION HAVING ACCESS TO TRANSPORTATION HELPS TO SUPPORT OLDER ADULTS MENTAL HEALTH.

ENSURING THEY ARE ENGAGED IN THE COMMUNITY.

THE U.S.

SURGEON GENERAL IDENTIFIED THAT LONELINESS IS ONE OF OUR GREATEST HEALTHCARE CRISES AND WE HAVE TO HAVE TRANSPORTATION TO ENSURE AND ENGAGE IN A STRONG KENTUCKY.

>> Renee: HOW DOES TRANSPORTATION AFFECT PATIENT CARE?

>> SO CERTAINLY LOCAL TRANSPORTATION IS A BIG ISSUE AND I'M GLAD THAT THAT IS INCREASINGLY AVAILABLE.

BUT THE PROBLEM OF GETTING TO THE PROVIDER IS ONE THERE AREN'T THAT MANY PROVIDERS WHO CAN PROVIDE SPECIALTY CARE ESPECIALLY FOR WHAT I DO.

I SEE OLDER FOLKS WITH MEMORY PROBLEMS AND MANY HAVE ALZHEIMER'S AND MOST ARE NOT DRIVING.

BUT THERE ARE ONLY TWO OR THREE PLACES THAT CAN DO THE WORK TO MAKE THAT DIAGNOSIS.

EVERYONE IN THE STATE THEN WHO WANTS THIS CARE HAS TO TRAVEL HUNDREDS OF MILES SOMETIMES TO.

I SEE PEOPLE FROM ALL OVER FROM ALL THE WAY FAR WESTERN PART IN THE DIFFERENT TIME ZONE TO APPALACHIA MANY PATIENTS ARE TRAVELING THREE, FOUR HOURS TO GET TO ME.

AND SO TRANSPORTATION OFTEN KEPTS FROM FAMILY AND SO THEY HAVE TO FIND SOMEBODY TO TRANSPORT THEM AND BACK.

AND THERE ARE TIMES PEOPLE WANT TO GET AN IMAGING STUDY IF I DON'T HAVE THE IMAGING STUDY I CANNOT COMPLETE THE DIAGNOSIS BUT CAN'T DO IT ON THE SAME DAY THEY ARE THERE BECAUSE IT REQUIRES A PRIOR AUTHORIZATION.

SO FOLKS HAVE TO COME BACK CAN I GET THE STUDY DONE AT HOME?

IF THEY DO HALF THE TIME, I DON'T GET TO SEE THE IMAGES BECAUSE IT DOESN'T GET SENT TO ME.

I GET THE REPORT BUT NOT THE IMAGES.

I ASK THEM TO COME SEE ME IN KENTUCKY TO GET THE IMAGES DONE AND THAT MEANS AN EXTRA TRIP.

>> Renee: A SECOND TRIP, YES.

>> WE MUST DO THINGS DIFFERENTLY TO MAKE SURE THAT ALL CITIZENS AND PARTICULARLY OUR MOST VULNERABLE HAVE ACCESS TO TRANSPORTATION.

ESPECIALLY TO GET TO AND FROM THEIR MEDICAL APPOINTMENTS AND ALSO FOR THOSE SOCIAL NEEDS AS COMMISSIONER ELRIDGE WAS DISCUSSING.

I WORK IN LOUISVILLE.

YOU WOULD THINK THAT LOUISVILLE WOULD HAVE A REALLY ROBUST PUBLIC TRANSPORTATION SYSTEM OR A SYSTEM THAT COULD SERVE OLDER ADULTS.

IT DOES NOT.

IT IS VERY, VERY LACKING.

I WORK AT THE UNIVERSITY OF LOUISVILLE TRAGER INSTITUTE OPTIMAL CLINIC WE HAVE A GERIATRIC CLINIC WHERE I WORK AND I CAN TELL YOU STORY AFTER STORY OF PATIENTS WHO DEPEND ON PUBLIC TRANSPORTATION.

WHO EITHER DON'T GET IT BECAUSE THE BUS DIDN'T SHOW UP OR BECAUSE THERE WAS A WAITING LIST FOR THE TRANSPORTATION SERVICE.

AS WELL AS THOSE WHO DEPEND ON THE PARATRANSIT WHO COME TO OUR CLINIC FOR THEIR APPOINTMENT AND SOMETIMES HAVE TO WAIT HOURS ONE SITUATION THE PERSON WAITED FIVE HOURS FOR THAT TRANSPORTATION TO RETURN TO PICK THEM UP TO TAKE THEM HOME.

SO THERE ARE SO MANY DIFFERENT ISSUES AND CHALLENGES TOO MANY THAT WE CAN COVER TODAY.

I JUST WANTED TO SHARE THE URGENCY FOR US DOING THINGS DIFFERENTLY WITH TRANSPORTATION.

I KNOW THERE ARE CREATIVE THINGS THAT ARE HAPPENING AT MANY OF THE AREA AGENCIES ON AGING AT THE DEPARTMENT LEVEL, TRYING TO THINK OF OTHER WAYS TO MAKE TRANSPORTATION AVAILABLE LIKE THROUGH USING UBER.

>> RIDESHARE.

>> RIDESHARE ET CETERA.

VOLUNTEER TYPE PROGRAMS ET CETERA.

BUT WE REALLY DO NEED TO DO MORE.

IT IS A NECESSARY SERVICE.

AND IT'S VERY LACKING.

>> Renee: WITH AGING POPULATION IT'S GOING TO BE A DEMAND NOT JUST A NEED BUT IT WILL BE A HALF TO HAVE.

WE DID COVER A LOT OF GROUND AND I CERTAINLY THANK YOU ALL FOR YOUR TIME AND EXPERTISE.

>> THANK YOU.

>> THANK YOU.

>> Renee: WE THANK YOU SO MUCH FOR JOINING US TONIGHT AND WE HOPE YOU NOW HAVE A BETTER UNDERSTANDING OF THE IMPORTANCE OF AFFORDABLE, ACCESSIBLE AND QUALITY HEALTHCARE FOR ALL OF KENTUCKY'S OLDER ADULTS.

BARRIERS LIKE THE HIGH COST OF MEDICAL CARE, LIMITED ACCESS TO SENIOR CARE PROVIDERS AND LACK OF TRANSPORTATION CAN HAVE PROFOUND IMPACTS ON SENIOR HEALTH.

WORKING TOWARDS SOLUTIONS FOR BETTER ACCESS TO CARE FOR KENTUCKY SENIORS CAN FOSTER A HEALTHIER MORE SECURE FUTURE FOR ALL OF US.

THANK YOU SO MUCH FOR WATCHING.

I'M RENEE SHAW.

TAKE REALLY GOOD CARE.

[♪♪]