Robin Clough
Director of Recreation & Volunteer Services, SCV Senior Center
Dr. Gene Dorio
Senior Advocate

Interview by Leon Worden
Signal Multimedia Editor

Sunday, April 9, 2006
(Television interview conducted April 4, 2006)

Dorio-Clough     "Newsmaker of the Week" is presented by the SCV Press Club and Comcast, and hosted by Signal Multimedia Editor Leon Worden. The program premieres every Wednesday at 9:30 p.m. on SCVTV Channel 20, repeating Sundays at 8:30 a.m.
    This week's newsmakers are Robin Clough, director of recreation and volunteer services for the Santa Clarita Valley Senior Center, and Dr. Gene Dorio, a local medical practitioner. Questions are paraphrased and some answers may be abbreviated for length.

Signal: Robin, how long have you been with the SCV Senior Center and what do you do there?

Clough: I have been in this position of director of recreation and volunteers since July. But I have been with the Senior Center for several years. I originally was a volunteer.

Signal: You're probably one of the youngest people on staff.

Clough: One of the youngest, but I am getting up there.

Signal: How many people work at the Senior Center?

Clough: We have about 30 or 40 on staff. They are all very dedicated and committed. Their hearts are in the right place, to be there.

Signal: You're the person who figures out all the fun stuff for the seniors to do.

Clough: Yes. It's a great job.

Signal: Dr. Dorio, you handle the other end of things. You see seniors when they aren't having fun.

Dorio: Absolutely. I try to help them out and get through life. I do housecalls. I've been doing it in this valley for almost 20 years. One of the things we try to do is see them, get them better and keep them in their homes so they can flourish and have good quality of life.

Signal: How many people in the SCV are doing housecalls today?

Dorio: Two. I have a brother who is also a physician. He does housecalls, as well. Sometimes we get paid not through any insurance plan and not monetarily, but we get eggs and we get fruits and vegetables and quite a few other things as (doctors) had gotten in the past.

Signal: In this day and age, why would a doctor want to make housecalls?

Dorio: Our seniors need them. ... I think it's a part of life. It's a part of a feeling for our seniors that it will help them out and make them feel better, and we have a impact on them.

Signal: How many seniors are there in the SCV?

Clough: Approximately 36,000. It's growing rapidly. The Senior Center itself serves 8,000 of them, so were serving about one in every five senior households.

Signal: What age do you mean when you say "seniors"?

Clough: Fifty-five plus. It seems younger and younger.

Signal: (To Dorio) Are you a senior yet?

Dorio: I am very close. I have a few months to go. I did get my AARP card when I was 50. I will be eligible for living in senior housing in a few months, and in about 10 years I will be on Medicare.

Signal: Your brother will be able to visit you.

Dorio: That's right.

Signal: You're interested in keeping seniors in their homes. Tell us about that.

Dorio: There are many aspects to keeping seniors in their homes. There are physical aspects, there are emotional aspects, and the community here has to start to work together to make sure that we maintain that. With the seniors here in this community (numbering) about 36,000, in less than 10 years it will be over 50,000, and by the time 2030 comes, it could be 100,000. As this population grows, we are going to need to have the facilities and be able to maintain our seniors the best we can.

Signal: When you talk about staying in their homes, you mean instead of living in a nursing home?

Dorio: Absolutely.

Signal: What kind facilities do we have in our valley?

Dorio: We don't really quite have a — we have a nursing home, but I don't feel that it is adequate, and it certainly doesn't have enough beds for our seniors. We have to maintain the seniors' quality of life so they maintain their mobility and they're not institutionalized.
    We have a growing community, so we have started to expand the hospital. (CEO) Roger Seaver at Henry Mayo Newhall Memorial Hospital has done a great job in starting to develop the acute care plan and emergency plan that will help our senior community. We have a transitional care unit, which acts as a stepping stone for seniors when they are ill, but they are discharged, but they yet can't go home. They get to go to this transitional care unit where they have time to get supportive care, yet also recuperate, and then eventually shoehorn their way back into their home life.

Signal: You see patients at Henry Mayo, do you also see patients at hospitals in the San Fernando Valley?

Dorio: I used to, and with having to get on the freeways, I have tried to avoid that. I stayed up here almost exclusively, just because the population is greater and I'm busier up here.

Signal: If seniors stay in their homes and something bad happens, aren't they worse off than they'd be in a nursing home, where they'd conceivably be supervised around the clock and assisted?

Dorio: Our hope is that by helping our seniors out, they will be attentive for themselves. And if not, the support systems that we have in this valley will allow that awareness, should they be having trouble, that we will know right away.
    For instance, at the Senior Center, right away in the mornings there are seniors who call seniors to make sure they are up and around. Neighbors and caregivers also watch our seniors, and they have been very good at making signals, opening the drapes, closing the drapes and keeping an eye on our seniors.

Signal: Where does the Senior Center enters into this, in terms of watching over seniors?

Clough: It's very comprehensive. Actually if they are just coming home from the transitional care unit, we send out a case manager to assess their situation, see what they may be needing, and then we try to find the resources they might need.
    For example, they may be needing a home-delivered meal, so we arrange for them to get onto that (program) immediately so they will be assured at least one hot meal a day. We have all kinds of support groups for them. We have caregivers who go out to make sure that they are doing all right.

Dorio: And there are social workers who go out, as well, to visit and assess and make sure they are doing OK. There are nurses who go out, and they report back to the physicians as well as to the Senior Center. There are a lot of people now who are involved in home care for our seniors, allowing our seniors to stay in their home.

Signal: If only one in five seniors uses the Senior Center, where does everybody else go for help?

Clough: I am positive that everyone will, at some point, access one of our activities or services. Many of them come to our Senior Center for grief counseling (because) they lost a spouse; when you reach the age of a senior, its inevitable that you're suffering through some kind of loss or going through some type of trauma, either with yourself or from the loss of loved ones.
    We offer mainly socialization, all kinds of opportunities for people to make new friendships and share with others the grief or the loss that they are going through. They are all in it together, and they all urge each other on.

Dorio: And the Senior Center is a full-service senior center. It does many things for the seniors. (People tend to) see seniors as using walkers or wheelchairs, and certainly at the Senior Center you might see that, but the most popular thing that we see at this Senior Center are the trips and tours. Our seniors are going to Las Vegas or to Laughlin to spend their money and gamble.

Signal: If there are 36,000 seniors today and 50,000 tomorrow, and more seniors are living at home, will the Senior Center be able to keep up with the growing demands? Will there be enough places for seniors to go and interact with others?

Clough: That's a major issue. Already our funding has been cut. We're really struggling, so we will need as much community support and charitable giving as possible, in order to assure that we can continue these services.
    Baby boomers are going to be turning into seniors soon, and we want to make sure everything is in place for them and continue with what we're doing. But we have to have some type of community involvement in funding.

Signal: In partnership with builders, the SCV Committee on Aging has developed senior housing complexes around town; are there plans for a second Senior Center?

Clough: We'd like to keep everything central. We think we have a better hold on everything that way. But we do have offshoots at these affordable housing senior living complexes. We do have people out there and actives out there, health and wellness lectures, but mainly we want to keep everything central.

Signal: (To Dorio) How many housecalls do you make in a week?

Dorio: Probably around 40 to 50 per week.

Signal: What are the biggest aliments you see?

Dorio: Probably the biggest one is lack of mobility. Some are bedridden, some are in wheelchairs, and for them to get in a car or onto a bus and get to their physicians, it's almost impossible.
    Certainly if they were in a skilled nursing facility like a nursing home, yes, they will have 24-hour supervision. But when you go to any of the skilled nursing facilities, it's depressing. And they would rather not be in that environment.
    (At home) they have their own television, they have their pets, their cats, their dogs; they have their own pillow to sleep on. They'd rather be in a situation where they can flourish. By doing a housecall, it allows them to do these other things. I can assess their health, I can assess their mobility and some of their chronic conditions, make sure they're OK.
    The best part about what we have in the valley is, we have nursing. We have X-ray. We can do lab work, and people will come out and do the lab work for us. Even somebody will do an EKG and some of the special testing. We can do all of that in a home environment now, and assess the patient and essentially keep them from utilizing the hospital-type of facilities and getting sicker.
    Also, sometimes they are getting worse, and sometimes we have to bring in hospice care, and there are agencies out there now that we have come in, and they help give support for those who are suffering.

Signal: We've got a new cardiac catheterization lab coming to Henry Mayo; are there other things we need that we don't yet have here?

Dorio: The cath lab is very important. We now send our patients down to the San Fernando Valley to get their catheterizations. That's going to be a huge asset.
    This hospital has changed tremendously since I have been here, for the positive. We have pretty much the same things now — except for the catheterization lab — that we have at any facility in Southern California and even the United States. It is state-of-the-art. And the physicians are state-of-the-art physicians and doing, I think, a very, very good job. The administration at the hospital is looking ahead and planning ahead for this community to make sure the needs of this community are met.

Signal: What are some of the trouble signs for people to look for in their senior parents?

Dorio: I think an important one and an easy one is their mental status. When they see that there are some changes in memory, (that) they forget certain things; plus, when you go into the household, you will see that sometimes the household has changed: It's not as clean, it's a little bit more disrupted. Also, changes in mobility. Once you start seeing that, that becomes a problem, as well. There are clear-cut signs that one will see.
    We're alerted all the time from not only family members, but friends, neighbors, and also when the seniors are going to the Senior Center, the Senior Center alerts us that certain people are having problems. If we nip it in the bud and go in right away to evaluate those patients who might start to have trouble, we usually, in most cases, can turn them around and make them better and make them function better in their community and in their homes.

Signal: If the Senior Center recognizes a problem with someone's physical or mental state, what do you do?

Clough: We usually get a call from someone, and when they do go out to evaluate them, they determine whether or not there is a problem and then they contact the right sources.

Signal: Who's "they"?

Clough: The supportive services team. We have two RN's on our team, and psychology staff; a very good, impressive staff we have there.

Dorio: The best part is, they will go out and they will assess the individual. They will send a team to the home. They will call them up and talk to the caregiver of the family member and go out and assess them. Yes, sometimes it requires a extra call to a nurse or even a physician to make sure that their medical health is OK.

Clough: And this is ongoing. We constantly check on them. We call them every day with telephone reassurance. Our home-delivered meal drivers, when they deliver a meal, they do a little detective work and see, are they functioning all right? Are they OK? There have been many instances where they haven't been (OK), and our home-delivered meal drivers have actually saved them.

Signal: Do you ever run into a situation where a senior doesn't believe anything is wrong and doesn't want help?

Dorio: Absolutely, all the time. We hear that. We cannot force ourselves into the door, we can't get staff out there. That tends to be a problem. Typically, though, we have family members; we find out who the families are, a son, daughter, whoever it might be, and have them go in.
    Now, sometimes we will have some who don't want to be seen, and they're not seen. On occasion, sheriffs have to come out and go in to evaluate and make sure that they are OK. ... Our job is to assure that they're doing all right. Even though they want to be left alone, that is OK with us. That is not a problem. But when we think they are in dire straits, we will be there to help them.

Signal: Of these 36,000 people over age 55 in our valley, how many have limited incomes?

Dorio: Well, probably a lot. I see a lot, and some are actually below the level of poverty. But we do have the affordable housing, we have Title 8, we have people who maybe can't afford it and maybe are just doing it on their own through Social Security, through MediCal and through their Medicare and are making it. There are others who live above that. A lot of times they are supplemented by their children or their own previous income, and they are able to live a little bit different life and better life. But for the most part, I'd say we sit in the average zone of individuals, some lower and some higher.
    The best part is, I think, no matter where you are in this whole gambit, even the people (of limited means) still can receive really good care and attention for any of the problems they might have.

Signal: What kind of affordable mental health services are available?

Dorio: In our society, there really isn't a whole lot. I think mental health problems are ignored. In our seniors, though, they are going to suffer from depression if they lose a spouse or lose a friend; that's just the nature of it. In terms of the Senior Center, we have counseling, there are support groups, psychotherapists, people they can talk to; socialization, as well, that might help bring them out of their depression.

Signal: So when you encounter seniors with mental health problems, a lot of them can be handled through the Senior Center?

Dorio: We have to evaluate them and make sure that they're medically OK, that there aren't electrolyte problems, anemias, diabetic problems, things like that.

Clough: And once they are assessed and it's found that it is nothing chemical or medical, the Senior Center has a lot of activities, a lot of grief support groups, counseling, socialization. Even lunch time is an event where people are allowed to socialize. There is a live band. There are all kinds of opportunities for people to interact with their peers, and many of our volunteers are actually seniors.
    So I think it's a great help to them, to help overcome depression by just interacting with others. We do all we can to bring people over to the Senior Center. We have buses available to bring them out of their homes so they're not isolated.

Signal: You mentioned mobility. Do you have sports activities at the Senior Center?

Clough: Yes, we do, for all levels. We even have chair exercises for people who are in wheelchairs or just do not want to do the more strenuous aerobics. We have tai ch'i classes, we have yoga — which is not what you would think of as yoga with standing on your head, or whatever; it's a very gentle yoga that brings body awareness. We have all levels. We even have water aerobics. Something for any interest.

Signal: How important is physical activity in a senior's life?

Dorio: Very important. It makes a total change in one's life when they are exercising. Some complaints of not being able to sleep, and mobility — it improves everything. There are different ways of doing it. We think of running as a exercise, and that's fine, but we also have water exercises, which a lot of our patients are turning to now — at the YMCA; we have physical therapies that have pools; we have College of the Canyons, which has a pool; there's deep-water running now, (where) you put vests on and you're floating but you're running, and it really takes a lot out of you.
    I see seniors being active, I see them exercising, I see them running marathons. I try to participate with them and stay up with them. They are out there. They are doing so much by staying active and doing these exercises. It makes a huge difference in their life.

Signal: Do you encounter seniors who just don't know how to get their foot in the door in terms of taking advantage of the programs at the Senior Center? How do you handle people who don't feel anyone there to support them, don't have confidence in their ability to drive, don't like big crowds, that sort of thing?

Clough: Last week (Dorio) referred a senior to me; he called me and said, "I am sending somebody over who is a little bit depressed and feeling isolated and lonely." So I was notified that she was coming over. I took her under my wing and showed her around, introduced her to people, told her what we had available, and got her into our supportive services program for counseling.
    We try to show them everything that's available and make them feel comfortable. And it is such a comfortable feeling when you get there, it's such a family feeling, and I think once people enter those doors, they see it's not the preconception they had about a Senior Center.

Signal: What if people just can't stay at home? Do you ever make that determination?

Dorio: All the time. And it's very difficult. We try to make it, also, where the patients themselves are making the decision, and most of the time they are able to, mentally. But sometimes they are not able to. Family is always involved.
    What is out there (for them)? There's not a whole lot. When you think of a nursing home, seniors cringe at that. They don't want to be there. Even if it's the best nursing home, it's the thought and the fear that this is their last stop. And what we try to do is, and the though process is, keep them in their home. Do the best that you can for them there and now.
    There are so many ways of doing that, that we are able to do it. With this community growing the way it is, with Santa Clarita's senior population also growing with it, we are going to have to accommodate those seniors. If we were 25 years before and accommodating those seniors, it would probably be fairly difficult with the number that weren't as active. Now we have active seniors. Now they are having quality of life. And now we're able to take care of them better and they're not using the facilities as much. It's costing this society less.

Signal: People in nursing homes have organized activities and opportunities to socialize with others and someone to watch over them, day and night. Why is staying at home so much better?

Dorio: The problem is, they don't do those things. The attitude right now is, they're there, and it's their last stop. And that's the ongoing attitude.
    Realize that most of the SNF's — skilled nursing facilities, nursing homes — are supported by government, and government has decided that they are not going to fund them. Because of that, the funding is much less, and they cut back the services, as well.
    So, yes. We go there, we see some activity, but most of the time, it's: Get them into a wheelchair, put them outside, let them get some sun, bring them back in, feed them, put them back to bed.

Clough: Depression rates are very high. It's important to keep them in their home if at all possible. (At) the Senior Center, our goal is to enhance their quality of life, and part of that is keeping them at home and independent for as long as possible.

Dorio: Seniors are the makers of our past and the basis of our future. They are the most important element of our society. The difficult part of that is that the baby boomers are going to be there, too. And for us baby boomers, we have to make sure that our seniors are taken care of now, so that when we're there, we'll be taken care of, also.
    A little selfish, but we need to look at those aspects right now: How we can help them take care of themselves. Because in the long run, it takes care of us, too.

Signal: As a doctor, what is your view of the new Medicare prescription drug benefit program?

Dorio: It has been very difficult for our seniors. It's a pile of paper and confusing laws. I am not sure whether it will work, but it's been put out there.
    At this point, I am not advising our seniors to sign up. There is a penalty; the penalty time deadline has been extended, but I think we see the fiasco that has taken place. Will the government come in and be able to straighten it out? I am really not so sure. There is thought that it will have to be scrapped. I think it's worthy to give it a try, (but) I still feel the Internet, Canada (and) other places are better sources and cheaper sources for medications that are good medications.

Signal: You're telling people not to sign up.

Dorio: Correct.

Signal: How did you develop an interest in helping seniors?

Clough: They are great. ... Like everything, you just stumble upon it. It's just like stumbling upon a gold mine. You just get so much from them. They're just so uplifting. We can learn so much from them. It's a joy for me every day to go to work and be with the seniors.

Dorio: My father was an older gentleman. He was 49 years old when he had me. But yet, at the age of 65, he led the whole family into the Grand Canyon and back up, and led us up and down. He was in great shape all his life, physically and mentally, and I did not see him as a senior, although he was. In my teenage years he was already a senior, but not acting like one.
    So I knew that seniors act as anyone else can act, and I know that because my father was my prime example, I knew that that's my place in life: to help our seniors out and make sure they have good quality of life like my father had.

Clough: Seniorhood is a state of mind. Don't have any preconceptions about seniors, because they are a vital force in our community, and we need to really do everything we can to support them. Because someday we will be there.

Dorio: Funding is so important for our Senior Center and the community, for our seniors. I want to make sure our baby-boom population understands that they need to be aware that whatever funding is now, it will help in the future for their own funding.

    See this interview in its entirety today at 8:30 a.m., and watch for another "Newsmaker of the Week" on Wednesday at 9:30 p.m. on SCVTV Channel 20, available to Comcast and Time Warner Cable subscribers throughout the Santa Clarita Valley.

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