Dr. Michelle Jo Park works with the Council on Aging – Southern California, where she serves as the program psychiatrist for its ReConnect Program. She shares how her practice has changed over the course of the pandemic, including the benefits and obstacles of an all-virtual practice. She also discusses the impact of the pandemic has had on our older adult population.
Kate Gosney:
Hello and welcome to Hope Happens Here. I'm Kate Gosney Hoffman and I'm so glad you're with us today. Today I have the pleasure of speaking with Dr. Michelle Park from the Council on Aging, Southern California. Today we're going to explore the impact of the pandemic on our elderly population and probably some other things.
Kate Gosney:
So, a little bit about Dr. Park. She's the program psychiatrist for the ReConnect Early Intervention Services for Older Adults Program of the Council on Aging, Southern California. She's a graduate of Stanford University and Loma Linda University School of Medicine. She completed her combined residency in family medicine and psychiatry at the University of California at Davis Medical Center. She's board certified in both family medicine and psychiatry. Her professional interests include integration of mental health into primary care and mental health in emerging adulthood and older adults. What an accomplished person you are, and I'm so glad that you're here with us today.
Dr. Michelle Park:
Thank you so much for having me, Kate. I'm so excited.
Kate Gosney:
Absolutely. How are you?
Dr. Michelle Park:
I am pandemic good.
Kate Gosney:
What is pandemic good? I like that, I'm going to use it.
Dr. Michelle Park:
It's something that I talk about a lot with my patients in my private practice in psychiatry. I feel as if we've all been adapting and changing as the pandemic has been changing and shifting, there are different phases of it. So, pandemic good for me means given the chronic stress that we're all living under that's still prevalent, and given how we've all adjusted, and I've adjusted, my family's adjusted to this new way of living. That being said, right now it's okay.
Kate Gosney:
So, in other words, you are, all things considered, doing pretty well.
Dr. Michelle Park:
Sure. I mean, I have been tremendously privileged. I cannot complain. So, yeah.
Kate Gosney:
Boy, I bet. I mean, I'm curious to know how this past year has affected your practice. I mean, I want to talk about the Council of Aging as well. There's a lot to talk about, but as a physician yourself, I mean, how has this affected your personal work?
Dr. Michelle Park:
Sure. So yeah, we'll come back to the work that I do for Council on Aging-
Kate Gosney:
Yeah, of course.
Dr. Michelle Park:
... and ReConnect. So, I'm their program psychiatrist, and that's a small part of the program and also small part of what I do. So, I also have a private practice in psychiatry and I just recently started working for The Mental Health Collective, which is an outpatient intensive outpatient program and residential program for folks with mental illness who need that level of care, and have done family medicine work for Kaiser as a per diem physician and done consulting. I've worked in a lot of different places over the time that I've been here since graduation and here in Orange County. But the shifts that I've made are pretty across both in terms of organizations, ReConnect, the Council on Aging, as well as other colleagues out there in the community will be pretty familiar. Everything switched to virtual.
Dr. Michelle Park:
I had been doing telepsychiatry before because I had experience in it and training in residency and I would do that every so often for folks. A large part of my private practice is college students, and so would always have video sessions for folks when they went back home for vacations or whatnot, or over summer break, winter break, things like this. So, it had been a small part of my practice, and just overnight pretty much with the lockdown switched to all virtual.
Dr. Michelle Park:
The same was true, and we'll talk about this, in terms of the older adult population. That transition has been much more rough for the Council on Aging because I used to see patients in my private practice. Our case managers would actually provide transportation. So they'd pick up the participants, bring them into the office, sit there with them if they wanted in the session, and it made for I think for a lot of these folks who maybe had not had an experience with psychiatry before and mental health, and have a lot of stigma in various different communities around seeking mental health.
Dr. Michelle Park:
I think it made for a lot warmer sort of introduction into getting a consultation, figuring out what they might want to do to improve their mental health, and of course that just disappeared. We just could not do that safely, right? And we still have not been able to figure out a way to do that safely, so everything switched to virtual visits, but the proportion of older adults who are able to manage a Zoom call or meeting on Google Meet. I think this is true probably across a bunch of organizations that are trying to provide services to older adults, that's been so challenging. Just the technology gap and that piece of whether you have a family member or a friend who can help you figure out how to get your phone set up to have a video call, or have a laptop setup to do that. I think at least in terms of the folks that I've seen it's been a very small proportion of folks.
Dr. Michelle Park:
So yeah, in terms of my greater practice I think because I said, it's interesting, I have this sort of bimodal distribution in terms of my patient population of sort of older adults that I see through Council on Aging as well as in my private practice, and then a lot of young adults. So, the young adults adapted very quickly.
Kate Gosney:
Sure.
Dr. Michelle Park:
It was like no issue, but I mean, it's been a noticeable generational gap, which has been difficult because to do as a clinician for myself, to feel as if I'm doing my best work, I'm really able to get a sense of what's going on with people, and especially for older adults where there may be more cognitive issues and things that are more apparent. Even like the physical exam, or being able to have someone on video to see are they trembling, are there any other symptoms that I might be looking out for, signs that I might be looking out for to suggest what might be going on with them. Diagnostically that's been very difficult to come by in terms of the older adult evaluations.
Kate Gosney:
I can imagine. Yeah.
Dr. Michelle Park:
So yeah. Anyway, so that's a long [crosstalk 00:06:20] answer.
Kate Gosney:
You've had to adapt a lot. No, I mean, because I fully recognize that. Everybody's had to adapt, and as a physician that's a really good example of sort of the gaps that I didn't even think about, about you can't get a full picture of somebody virtually, especially when somebody isn't familiar with the technology, right? So, I mean, the navigating of those kinds of obstacles is something really real and I just ... I appreciate hearing that because I can see the amount of effort and adaptation that has had to go down for physicians and other clinicians that are really working to trying to continue to have the best service and do no harm, right? And make sure that you're offering, like you said, what you want, which I'm sure you are. But this has been tough.
Kate Gosney:
So, I appreciate all that you do, and I'm curious about the Council on Aging. Can you tell us what that is and what your role with the Council on Aging of Southern California is and what you do with them?
Dr. Michelle Park:
Sure, yeah.
Kate Gosney:
We'll go from there.
Dr. Michelle Park:
So, the Council on Aging is a nonprofit that has been here in Orange County for a very long time, I think it's over 40 years possibly.
Kate Gosney:
Yeah.
Dr. Michelle Park:
My involvement with them is much shorter. It's been over maybe the past five years or so, and I am part of their preventive mental health department and specifically their program called ReConnect. I offer basically, I'm county funded, and so I provide free psychiatric consultations. We offer free psychiatric consultations and evaluations for our participants. The program itself is up to 12 months of case management services in addition to ... And the whole purpose of it is for prevention. So, the mission of Council on Aging is to keep seniors healthy, protected and ... Oh gosh, I forget what the last one. I'll think of it again. I don't know. I'll come back to our catchphrase, this is important. I need to get this.
Dr. Michelle Park:
Anyway, so the Council on Aging's mission, as far as a preventive health department, is really that. So, to help prevent depression, to help prevent to the extent possible neurocognitive disorders. It's by tackling the risk factors that we know are really important in terms of prevention of mental health issues in older adults like loneliness and social isolation. So, the ReConnect program really helps to get people more involved in their communities, offers social groups, support groups, individual therapy, and a lot of case management help in terms of linkage. Help is needed for a lot of our participants in terms of housing, in terms of access to medical care, services, and it's open to all Orange County residents who are 60 and above.
Dr. Michelle Park:
So, I try to tell all my primary care colleagues, everyone that I talk to in psychiatry about it, because I just think it's such a fantastic resource-
Kate Gosney:
Yes.
Dr. Michelle Park:
... that not a lot of people know about for older adults, and the scope of what they've been able to do, particularly in this pandemic, has been just so impressive to me because I, again, I do my small part of seeing folks for evaluations, but they have done just amazing work with meeting seniors where they are, really transforming their program from in person, in home evaluations is what we used to do, and transportation services and whatnot, and having to just modify all of that to keep our staff safe, obviously our participants, our older adults safe, has been just incredibly impressive for me to see.
Dr. Michelle Park:
So, over the pandemic they have adapted to provide financial assistance in some cases because our older adults have really been struggling, perhaps a lot of them who were supported by family, but then family lost their jobs or were furloughed or whatnot.
Kate Gosney:
So tough.
Dr. Michelle Park:
Yeah. A lot of older adults who were already isolated, for example, in the beginning and had no access to try to find even toilette paper, soap, hygiene product, masks, if you're a homebound or really isolated for whatever reason. Don't have transportation, they had no access to that. So the program just shifted to create these personal protective packages that they were able to deliver to seniors and older adults.
Kate Gosney:
That's so wonderful.
Dr. Michelle Park:
Yeah, and food insecurity has been a huge issue obviously for our older adults. I mean, not just now during the pandemic, but making sure people-
Kate Gosney:
It was already there, and now it's-
Dr. Michelle Park:
It was already there, and worse.
Kate Gosney:
Right.
Dr. Michelle Park:
On top of that, the food banks here in Orange County, I can speak to Orange County, but I know that this was sort of all throughout, were stretched so thin because of our economic crisis. So families that didn't need to use those services did need to use those services, which means that the folks who were already using those services that there's just less to go around. So our ReConnect program and our preventive mental health department also shifted to create culturally appropriate food boxes because-
Kate Gosney:
They got that specific.
Dr. Michelle Park:
Yeah.
Kate Gosney:
Oh wow.
Dr. Michelle Park:
I think that this has been such a strength of the program and I'm so proud and honored to be a part of it, because there's really such a focus on providing culturally appropriate care. So, our services are provided in multiple languages, English, Spanish, Korean, Vietnamese and Chinese, to name a few.
Kate Gosney:
This is fantastic.
Dr. Michelle Park:
Yeah. For our older adults who are living in various, in older adult communities and don't have the English skills, it just offers such an opportunity for them to connect to other people and to connect to services. But to come back to the food, it goes back to I think the greater mission of sort of meeting our participants where they're at and really trying to provide that culturally appropriate competent care. So, food boxes that you get from say Second Harvest or other food banks and pantries may not contain the food that you're used to if you come from a different culture or you're used to cooking Korean food all the time. So, the program shifted to try to create appropriate food boxes for our participants.
Kate Gosney:
I just love that so much because that is ... I mean, I'm almost ashamed to say that I wouldn't have thought about that. You think of a food bank as a food bank and you're delivering food, but you're right. The food is such an important part of a culture and we're already in kind of a state of trauma, or they're already in a state of trauma, and then to also not be able to have the food that they're used to. I mean, that goes a long way I can imagine, having that respected and honored in that way, having the food be part of the culture. I mean, I just think that that is such a thoughtful and respectful step in a wonderful direction. Maybe one of the good things that have come out of this hard time too.
Dr. Michelle Park:
Right, because it's not necessarily something that was a big part of the services that we provided, but I guess it goes down to Maslow's hierarchy of needs situation.
Kate Gosney:
Yeah.
Dr. Michelle Park:
Right? I mean, I think the pandemic made it such that yes, we are obviously still providing case management services, trying to do as much as we can in terms of socialization, helping with mental health needs, helping with prevention but also there was this huge gaping need for basic, your basic necessities.
Kate Gosney:
Basic necessities, right.
Dr. Michelle Park:
This is one organization that has shifted like so many I think in the community to try to meet the needs of the community in the best way possible. So yeah, it's been really impressive to see, and again, I feel really privileged to be a part of it.
Kate Gosney:
Absolutely, and I love learning about it because what an important role you are all playing in this because that is a population that's been affected greatly. I mean, how would you describe the difference between how the elderly population has experienced the pandemic versus the younger population? Why is it different for them?
Dr. Michelle Park:
Sure. So, I always hesitate to say because like with any other group in society or in a population, certainly it's not monolithic, right?
Kate Gosney:
Absolutely.
Dr. Michelle Park:
So older adults as a population, I think the data that's been coming out more recently that I've been able to present on has been really interesting in terms of in the beginning we were really worried about the mental health for our older adults particularly. Sure, worried about everyone's mental health because this is an unprecedented pandemic, but particularly because obviously as we know the pandemic has had the greatest toll on our older adults just in terms of mortality.
Dr. Michelle Park:
So, I think in Orange County it was maybe 15%, 12% of the total infections, 12% of the confirmed COVID cases were responsible for 76% of the folks who passed away from COVID were over 65. So, sort of a disproportionate risk, right? Of COVID, the disease itself meant that there was higher risk for our older adults of serious disease and death, and especially the adults or older adults who were in any sort of long-term care facilities and nursing home facilities. That is I think less than 1% of our population lives in long-term care and they represented up to I think in some cases I think it was up to like 30% or more of-
Kate Gosney:
Such a big number.
Dr. Michelle Park:
... total mortality in the US. So, I think older adults in the beginning, what we were really concerned about is okay, we're doing social distancing, there are stay at home orders, they're already at risk for isolation, this is going to be really bad for older adult mental health. I think what I've seen and what the program has seen, the ReConnect program has seen is definitely higher need. So, there was a tremendous increase. So I saw maybe 21 folks, did a quick chart review of my patients, before this just to get a sense of what was normal. So I'd see maybe 21 participants in a given year the last two years, and this past year I saw 41. So double the number of participants who were being evaluated and our case managers felt like oh, they could really use some psychiatric consultation to see what's going on and how we can best help them.
Dr. Michelle Park:
The same is true for I think the ReConnect program at large. They've seen their numbers increase by at least like 43, 53% in terms of the number of hours that are required and put in for case management services. So, the need has been a lot higher in terms of mental health and also basic needs, as we were just talking about, that seniors have had a lot of ... Have needed a lot of help, but it's obviously not monolithic because I kind of liken it to I've developed sort of this theory of the K-shaped recovery that people are talking about in terms of the economy. So, that everyone sort of took a hit with the financial crisis, but that there's been this K-shaped recovery in the sense that folks that are doing well or maybe corporations or whatnot that were doing well pre pandemic are sort of continuing to do well. So, they're recovering much faster, like a V shape recovery, as opposed to there are certain businesses, certain sectors of our economy that are just not recovering in the same rate, and I feel like that's similar for older adults as well in the sense that there are more studies coming out showing that older adults showed more resilience in terms of mental health actually, contrary to what we may have thought.
Kate Gosney:
Oh really. Yeah.
Dr. Michelle Park:
Yeah, so more resilience in the face of the pandemic over at least the first couple months of the pandemic. So data, so studies that have come out studying what was happening last summer basically. So, we're obviously having to sort that out and figuring out what are the factors that led to resiliency in certain older adults, and we do know that there are caveats. So, there are the older adults who were part of minority populations, underrepresented populations, older adults who are caregivers in particular, caregivers both of grandchildren or their spouses, or partners, or friends. They definitely struggled more, so there are certain ... And folks who were particularly financially stressed or struggling to take care of their basic needs.
Dr. Michelle Park:
So, obviously in those situations their mental health is going to take a greater hit, but it's interesting. So, when you compare sort of by population age ranges, older adults have seen less impact in terms of negative impact of the pandemic on mental health. Then the highest group, so sort of based on age, the 18 to 24 age range was the highest, where there was the greatest proportion of folks who were negatively impacted by the pandemic. So, it's an interesting thing. It's been sort of this mixed bag of how the older adult population has been dealing with the pandemic. Even in my experience, seeing participants of those folks that I saw, there's a good proportion of them, maybe about 40% or so that when we were talking about their concerns and the things that were sort of top of mind for them and the things that are really impacting their mental health, the pandemic doesn't count.
Kate Gosney:
What pandemic?
Dr. Michelle Park:
Not that they're not aware of it, obviously like I said, pandemic normal. So, everyone's sort of dealing with the stresses and figuring out how do I get my hand sanitizer. That being said, so for 40% of them the things that they are most concerned about are things that would be happening sort of regardless of the pandemic. So, they're caregivers and their partner is getting worse, or they are dealing with housing insecurity, or they're dealing with a family conflict. So, the flip side is that almost 60% of them the pandemic is causing a significant strain, is like a major factor in their mental health and how it's worsening, excuse me, for all the same reasons. So, for example, if you're a caregiver it's going to be difficult, you are dealing with caregiver burnout, especially if you're dealing with a partner or a family member with dementia or neurocognitive disorders.
Kate Gosney:
Right.
Dr. Michelle Park:
That would be happening one way or the other this year, the next year is a progressive disease. However, with the pandemic, it took away so many resources for our caregivers. So adult day cares shut down, senior centers shut down, gyms shut down, all these different places that used to provide socialization not just for the caregiver but also for their care recipient.
Kate Gosney:
Absolutely.
Dr. Michelle Park:
So, that's been huge. Respite care resources shutting down basically, other transportation, and so much uncertainty around how do I keep my care recipients safe. How do I make sure that I can keep my family safe during this time?
Kate Gosney:
And that's a lot of pressure for a caregiver.
Dr. Michelle Park:
Of course.
Kate Gosney:
Because all the sudden, I mean, they're already caring for them, but there was kind of a support team outlets, right? All the things that you just described and all the sudden it's just them-
Dr. Michelle Park:
It's them.
Kate Gosney:
... and the person they're taking care of.
Dr. Michelle Park:
Exactly.
Kate Gosney:
And that, I mean, that's very scary, I can imagine.
Dr. Michelle Park:
Right, yeah. I think that's been true across the board, not just for caregivers for older adults. I'm sure caregivers of all ages it's been really difficult to sort of rebuild and figure out what that is going to look like, what's the support system going to look like given that we're in this pandemic.
Kate Gosney:
Yeah, yeah.
Dr. Michelle Park:
Wanting to keep everyone safe and not having the training. I mean, that's a big part of it as well, right? That caregivers, family caregivers, unpaid caregivers, they haven't gone to school for this, they haven't figure out, they just have to learn on the fly.
Kate Gosney:
They've relied on the expertise of the support system that they've had put in place, and when that's taken away. Boy, that's a rabbit hole that's kind of ... Lots of things can happen from that. So I mean, the support that you guys are all providing for that is all the more important, just considering that. When people are kind of in this mutual state of trauma is not a recipe for great things. So, having that, you guys coming in, the Council on Aging coming in, the ReConnect program coming in and being able to provide support, even just linking to you to get an evaluation, to provide resources is ... I just, boy, just doesn't get more important than that.
Kate Gosney:
Kind of a question that popped up in my head when you were talking about the resiliency of this population and the what pandemic that you said, because they are more focused on their immediate needs, right? Which I can understand, but in thinking about most people who are in this population age wise, they've experienced a lot of life.
Dr. Michelle Park:
Exactly.
Kate Gosney:
And they have experienced a lot of things in society, traumas in society, wars, economic crashes, whatever, depending on where they ... Maybe they migrated here from somewhere ... I mean, who knows, but the history is rich and deep. So, I wonder if that plays into what do you think about kind of their perception about all of this, about why it may not have been ... Not saying it didn't affect them, but may not have been as emotionally traumatic as maybe one thought it would be.
Dr. Michelle Park:
Right, or at least that they had some resilience in the face of that [crosstalk 00:24:08].
Kate Gosney:
Yeah, that's another way to say that.
Dr. Michelle Park:
... mass trauma.
Kate Gosney:
Exactly.
Dr. Michelle Park:
Yeah, so fascinating. One of the review articles that I read recently that talked about sort of older adult mental health and this unexpected finding, on the one hand possibly expected because we know that there is a lot of research showing that there is this resilience in order adult mental health, that they're less likely actually to suffer from depression or anxiety than younger populations, even pre-pandemic. Just looking at how that trajectory would play out in the case of this sort of unprecedented universal stress of the pandemic. So, for the first time the entire population is faced with the same mass trauma, with the same stress, so like what happens.
Kate Gosney:
Collective, yeah.
Dr. Michelle Park:
Right. One of the articles talked about that there may be these, it hasn't been delineated yet, what makes this particular older adult or older adult population more resilient, but some of the theories include wisdom. So this concept of wisdom, given that they've had this experience, that they know kind of what's happened before, that they can put this experience in the context of other challenges and struggles that they've had before and then are able to have maybe possibly a better perspective on it. I think that that can certainly be the case.
Kate Gosney:
Yeah.
Dr. Michelle Park:
Another factor that was mentioned was having, that kind of stems from wisdom, but sort of understanding that the quality of social connections is more important maybe than the quantity, and by that time, by the time that you've reached a certain age that you have figured out okay, these are the folks that I want to stay in touch with, these are the folks that are important to me, and have sort of created those connections, created that community for yourself. Obviously that's not true for all older adults because social isolation is a big thing. Also, as we get older we lose friends, we lose family, we lose those connections along the way for various different reasons. So, certainly not a universal thing, but yeah. So, those are some theories.
Dr. Michelle Park:
Another theory that ... This is just the gestalt, I'll say, but also something that I talked about with our director in terms of the preventive mental health department. We've noticed that our participants, and folks, and patients who for example have a history of trauma in their past, or are dealing with PTSD, or trauma stress related disorders, or folks who had preexisting anxiety, particularly anxiety disorders. I think there is this phenomena where in a crisis or in a given trauma that folks who already had their anxiety levels high, folks who are already used to kind of dealing with the fallout from a trauma, then can feel there's a sense of normalization in a way because everyone then starts to feel kind of similar, and they get feedback from other people, like oh I'm feeling anxious too, or oh my gosh, I'm dealing with this. So, there's a sense of there's less maybe stigmatization and also less of a sense of isolation because they're not the only ones feeling this way.
Kate Gosney:
Maybe some validation about what they're-
Dr. Michelle Park:
And validation, right.
Kate Gosney:
Yeah, their validation about kind of how this has felt for them, and then all the sudden other people are feeling that way.
Dr. Michelle Park:
Right.
Kate Gosney:
So they don't feel like such a black sheep maybe.
Dr. Michelle Park:
Right, right. So, I think that there's an element of that possibly-
Kate Gosney:
Interesting.
Dr. Michelle Park:
... that's been happening during the crisis. Now, this is not to say at all that it's like a protective factor.
Kate Gosney:
No.
Dr. Michelle Park:
Obviously it is the opposite for folks who have been dealing with chronic mental illness, have been dealt with obviously it has exacerbated for a lot of people their preexisting conditions, and anxieties, and depression and whatnot. But there is I think something to be said in the sort of near term, while we're still kind of in it, that there's been greater awareness made of mental health issues and hopefully less stigma around seeking help. So, we're hopeful for that.
Kate Gosney:
I love that, less stigma for seeking health. This might be a push in that direction. Out of the crisis kind of comes some of those lessons learned, so maybe I should ask for help more often because I can see how this has benefited me, and hopefully continue to do so when things ease up a bit. I have a grandmother who is 94, and she lives alone, and she is a kick in the pants, has more energy than I do, right? I mean, she does pilates three times a week. I mean, she's amazing, but this pandemic hit her really, really hard because she is such a social butterfly. I feel like my grandfather, he passed away 30 years ago, so her social life has been her lifeblood, right? Because she's not even around, she's across the country from her family. So, I was so worried about her, just so worried about her. At one point the power went off during all those crazy storms of the East Coast.
Dr. Michelle Park:
Oh my goodness.
Kate Gosney:
So this 90 something year old woman was sitting alone in the dark for days and days, but that woman, the resiliency is insane. I mean, stronger than I think I would ever be. It blew me away, and I've heard so many stories about that within family members.
Kate Gosney:
Again, there is a spectrum. Everybody's situation is different, and there have been people who have not been so fortunate to be that resilient and I understand that and honor that totally, but it has been kind of it's been a beautiful lesson in sort of her strength and trusting her resiliency, and actually her life experience is serving her well and having a different perspective on all of it. She's not walking around doom and gloom about all of it at all. So, it's just been an interesting thing to observe.
Dr. Michelle Park:
Right. I mean, it speaks to I think maybe this embedded sort of assumed agism in a way.
Kate Gosney:
Right. Yeah. [crosstalk 00:30:17].
Dr. Michelle Park:
One of the authors in one of the studies that I read was talking about how everyone was so worried because the risk of COVID and the risk of death from COVID, that is objective, that is just fact.
Kate Gosney:
Well, 100%, yeah.
Dr. Michelle Park:
But at the same time it led to all this worry around okay, then that means that it's going to translate into worse mental health outcomes, and it's like well maybe not so much. There is a lot to be learned in terms of how we can sort of pull those lessons of resiliency and how older adults have been able to adapt in some ways much better than our younger folks to-
Kate Gosney:
That's so interesting.
Dr. Michelle Park:
... the conditions of the pandemic and also that ... and maybe it's a lesson about just in the developmental life course having these crises or traumas happen at different points in one's life, maybe that is more impactful, right? So, if you're ... We still don't know what the fallout is going to be in terms of children's mental health. I know you've had prior guests speak to how it's been across the board.
Kate Gosney:
Pretty daunting.
Dr. Michelle Park:
That and daunting.
Kate Gosney:
Yeah.
Dr. Michelle Park:
And we don't actually know what the fallout is going to be for older adults either, any segment of the population because it's sort of a rolling trauma, ongoing thing that we're dealing with. So, we don't know, but that I think is a great direction, just a great illustration of within families to see and to pull those lessons from the wisdom.
Kate Gosney:
Totally.
Dr. Michelle Park:
And the adaptability and flexibility that older adults have, that maybe there's sort of a societal assumption that they won't have, but I think that's definitely been true of a lot of participants. If they created that social network beforehand, that they are going to bounce right back and it's already created.
Kate Gosney:
It's amazing.
Dr. Michelle Park:
Their friends all get vaccinated, they get vaccinated, and then they get to sort of resume more of their normal life.
Kate Gosney:
Yeah, and I think it does speak to what you're saying of the wisdom. It does speak to, I don't want to make an overreaching statement because I know this is not true across the board, especially culturally, but I do believe that in a lot of ways, at least in our society, and this is just my opinion, there has been a fall away from the respecting the wisdom of our elders. This really does kind of circle back to that in a way, just we can learn a lot from them about resiliency and strength, and just pause and reflect on that wisdom, and respect that because they do have a lot that we can learn from.
Dr. Michelle Park:
Right.
Kate Gosney:
It just makes me pause and acknowledge that.
Dr. Michelle Park:
Right.
Kate Gosney:
The importance of it.
Dr. Michelle Park:
I mean, right, there's not ... I hesitate to try to make silver linings of the pandemic, but just in terms of I think highlighting the fault lines in our society, highlighting the fault lines in terms of our medical care system, our mental health system. These are really important lessons for us to learn, and it doesn't all have to be necessarily the actual faults. So, the actual deficits that have become that much more apparent, for example older adults in nursing homes. John Oliver did a segment on nursing homes recently in his show Last Week Tonight, and he said something like the way that we treat older adults in nursing homes really reflects how we value older adults. The lack of support, lack of resources, lack of regulation in many cases, which led to unfortunately during this pandemic just a horrific highlight of how understaffed and how difficult it is to keep our older adults who are in nursing homes or longterm care facilities safe. It's been really difficult.
Dr. Michelle Park:
So, there's that piece of it, where the pandemic has highlighted okay, these are areas that we really need to pay attention to and fix moving forward, but also like you said, on the areas where as older adults have been able to adapt, maybe we need to shift our focus a little bit, and not be so concerned about in certain cases. Obviously we want to have access to their healthcare and mental healthcare for those who need it, but shifting our attention to say hey, our older adults have been, this is not a blanket rule, but have been more resilient. Let's look at our other parts of the population that have not been so resilient and see what we can do to shore that up.
Kate Gosney:
Yeah. It's a both and situation, right?
Dr. Michelle Park:
Right.
Kate Gosney:
It's not oh, they are more resilient than we thought. Well, forget them, we're going to go over here.
Dr. Michelle Park:
Right.
Kate Gosney:
Do everything in our power because we realize how important it is to take care of them, and they are, like you said, concrete fact, more at risk. So, let's make sure we pay attention to that, and learn from them as we do it.
Dr. Michelle Park:
Right.
Kate Gosney:
Which I think is a beautiful combination of things. I hear that from you, I hear that that's what's been happening, and it's really neat to hear. Oh my gosh, my brain. I just had a question and it is gone.
Dr. Michelle Park:
I just remembered the slogan.
Kate Gosney:
Ooh, what's the slogan? Perfect timing, way to save me.
Dr. Michelle Park:
The mission of Council on Aging is to keep seniors healthy, connected, and protected.
Kate Gosney:
Ah.
Dr. Michelle Park:
Yeah.
Kate Gosney:
Healthy, connected and protected.
Dr. Michelle Park:
Right.
Kate Gosney:
Perfect. I love that. I was remembering, this isn't my question, but I was remembering when I was, oh, I don't know, maybe 14 or something, and I volunteered in a nursing home. Actually, I did that multiple times throughout my life, but I was part of an ... Why can't I say that word?
Dr. Michelle Park:
Ombudsman.
Kate Gosney:
I can't even say it. Say it for me.
Dr. Michelle Park:
Ombudsman.
Kate Gosney:
Ombudsman.
Dr. Michelle Park:
Council on Aging has that program too.
Kate Gosney:
Yes, and it's what made me think of it. It changed my life, just holding this woman named Alice's hand. I could cry actually thinking about it right now. I mean, it was in Monterey and she was an immigrant from Japan, and just the history that she shared with me during probably one of the most traumatic times for the Asian American population, that she came over and it was ... I mean, just changed my life. Just complete respect and love for the elderly population, and just I'll never forget her hand, just that frail, sweet hand, and just how much wisdom was in that hand. It was beautiful. So, this is a population that we need to honor and take care of, absolutely, and I'm so grateful for the work that you do. And I'm getting teary not because I'm super pregnant but because it has actually-
Dr. Michelle Park:
It could be an and.
Kate Gosney:
It's both.
Dr. Michelle Park:
Both and.
Kate Gosney:
Right, absolutely. It's just such an important thing. You mentioned earlier the protective factors of the elderly population, and I think that's an important thing to talk about briefly, about what are the protective factors when we're looking about kind of what does keep them safer, what keeps them physically and mental health wise in a safer position. What are things that friends and family can look out for in terms of protective factors?
Dr. Michelle Park:
Sure.
Kate Gosney:
Does that make sense, that question?
Dr. Michelle Park:
Yeah, sure. Yeah. I think that in the same way that you talked about your 94 year old grandmother, that your family is looking out for her, kind of making sure obviously basic needs, right?
Kate Gosney:
Yeah.
Dr. Michelle Park:
Like she needs electricity, [crosstalk 00:38:08].
Kate Gosney:
She does need electricity.
Dr. Michelle Park:
Food, let's figure out how to get grandma all the things that she needs. Then I think it is like with everyone else, figuring out who your older adult, who your loved one is, and figuring out what they need in terms of their support, and that is really just there are some things that are universal, like getting them access to care. So, we were talking about the technology gap, making sure that they have figured out what their primary care doctor is doing now in terms of visits, figuring out how they're going to get their medication and make sure that to maintain their health in the best way possible. Figuring out if they do have mental health needs, who we're going to get them the care that they need while keeping them as safe as possible. But yeah, I mean, I think what's interesting and somewhat frustrating about what I've read thus far about the research of resiliency, it's not necessarily something that we can kind of impart as family members. It's sort of like these are maybe intrinsic factors to our loved ones and how they cope and deal with this stress and stressors in the future, it's something that we can sort of add to, and help, and sort of intervene when things aren't necessarily going well, but it's not necessarily something that we know yet that we can sort of foster.
Kate Gosney:
Right.
Dr. Michelle Park:
That being said, connectedness. So, we were talking about the quality of social connectedness, and I think that's been something that everyone probably has experience with over this past year, in figuring out for yourself, for your family, for the members of your family that may be more vulnerable, older adults more prone to social isolation, figuring out how you're going to connect with them in creative ways. I think that's been something that I appreciate has come out of the pandemic in the sense that families have been more intentional about what that means, how to do that, and having it in more maybe like really thinking about what's the best way that I can feel connected to other people and my family, and making sure that they feel my love. That they can feel loved and protected from my side in a way that maybe wasn't so intentional or conscious before something like this, with the pandemic.
Kate Gosney:
Love that. I love that because this is an assumption just based on my own connections I have in my life and what I've seen in my own clients' population in the past and everything, but the older populations seem to be less likely to ask for help. There is a little bit more of a, I don't know, resistance to that, maybe stubbornness, who knows what it is, generationally. But the word intentional I think is really important coming from the family members, that I'm not going to sit around and wait for them to ask, I think I just need to intentionally insert myself and show my love, even if it's just popping in or giving a call, whatever it is. Just yeah, to have that intentional and not be passive about it and not wait for them to make the first move maybe.
Dr. Michelle Park:
Right, right. I mean, I think it's so interesting what we've learned about social connectedness because of the pandemic. That it does matter having these close, intimate relationships, and the strength of social connectedness is really important, but also that even casual social connections make a difference in terms of quality of life.
Kate Gosney:
Yeah.
Dr. Michelle Park:
And how eliminating even those casual connections has had a significant impact on people's mental health as well, but yeah, I think that is something that's universal, not just ... I mean, I can speak for myself as well for my friends, figuring out an intentional kind of thoughtful way to maintain connectedness in a way that we really didn't do pre-pandemic.
Kate Gosney:
Right.
Dr. Michelle Park:
Because everyone's sort of living their life and figuring out how to get things done and maybe having social ... Like making plans with people for months in advance and then figuring things out, but not necessarily maintaining that emotional sort of intimate connectedness in the same way.
Kate Gosney:
Yeah, exactly.
Dr. Michelle Park:
So yeah, I think that that's something that's really important, one of the most important things I think for your listeners to keep in mind in terms of their older adult loved ones, is maintaining that sense of intentional connectedness moving forward.
Kate Gosney:
Beautiful, yeah.
Dr. Michelle Park:
And that it is such an important protective factor having that sense of community and that sense of connectedness, and family and love is priceless, truly.
Kate Gosney:
Absolutely. Connection is everything, and I say that all the time on this podcast. That it's in our blood, it's in our lifeline. We need it for survival. So, that's one thing about humans, we're really resilient and we find a way. So even when we've been kind of sheltering in place and disconnected on some level, I think that the magic of the human spirit comes through and we find a way. I hear that from what you're talking about here too, is that this is, like you said, not to make it all silver linings, but there are silver linings that come out of traumatic things and lessons learned, and kind of resets that happen for what we need to change and shift, and that's one of them, is I just love that intentional connectedness. I think it's a wonderful lesson, and we all need it.
Dr. Michelle Park:
Yeah. I'm just reflecting on the story that you just shared about holding the hand of this nursing home resident and how you felt like it was transformative, and I feel like that's such a great illustration of what's been lost in many ways because that human touch literally has been lost, and our ability as a program, me as a clinician, being able to have that touch is lost. We don't know exactly when we're going to be able to feel comfortable with that again in the future, and it just reminds me of there is this tension, right? Of as you say of holding on to and grieving, and being righteously angry about the ways in which we've seen that there are these fault lines that have developed and how we really need to improve access to care and equity in our communities while also holding on to the things that we can learn, and the beauty, and the meaning that we've had to make over this past year living through this sort of crisis.
Kate Gosney:
That is just so beautifully said, I couldn't agree more. Absolutely. We're all going through some kind of cocooning at this moment I think collectively. We will come out, and the people that are, I mean, like yourself and everybody that's rallying and doing what we can to make a difference with the tools we have at this moment, it's all needed and necessary, and the compassion that you're talking about, and just having a heart and not giving up and continuing to just pursue that human connection in whatever way possible will serve us well.
Kate Gosney:
So, I want to thank you so much for being here, and ask you if there's anything else that you would like to share with our listeners in terms of resources for maybe themselves or for their loved ones through the Council of Aging or anything else that you think might be relevant?
Dr. Michelle Park:
Yeah. I mean, I think one of the things that I thought about, I know you mentioned how to promote that resiliency, what we can do on a personal level for our older adults, and like I said, I think that that comes down to figuring out how to meet your older adult loved one wherever they are with their needs and access. The Council on Aging has a great website with a myriad of different programs that I haven't even been able to get into that help to provide services as needed and also linkage to other places in our community that have those services. So, that information I would highly recommend for all your listeners to take a look at.
Kate Gosney:
Their website is really easy to navigate too.
Dr. Michelle Park:
Right.
Kate Gosney:
All of the services are listed very-
Dr. Michelle Park:
Not that our older adults are necessarily accessing it, but you as a family member or a friend of others.
Kate Gosney:
Just saying.
Dr. Michelle Park:
Just is the irony, right? It's like yeah, we have these resources, and Zoom classes, and Facebook Lives, and a YouTube channel, and all these things, whatever we can do, right?
Kate Gosney:
Yeah.
Dr. Michelle Park:
To sort of increase our reach so that ultimately our population gets it. But yeah, I mean, I also wanted to mention I think that advocacy on the part of older adults is going to be something really important.
Kate Gosney:
Yes.
Dr. Michelle Park:
And something that I don't want to get lost in the greater advocacy that needs to happen and is going to happen because of this ongoing sort of mental health crisis that's come on as a result of the pandemic and as a result of the economic crisis. So, for our older adults I think it became really clear that it's all connected. So, not only is it the stress of the pandemic but the economic stressors, and therefore then the cuts to services at the local level were really devastating. So, things like the adult day services that I mentioned, senior centers and whatnot, and that's something that I became way more aware of.
Dr. Michelle Park:
I'm sort of ashamed to say, I probably should've known this beforehand, but to know not just on a clinical level these are things that are super important that we should have in our community, but it doesn't just show up. That it does require advocacy to make sure that our state and local officials, that our federal government, that these funding sources know how important these services are and are so crucial for maintaining the wellbeing and health of our older adults. So I just wanted to I guess share that that is a really important piece that I wasn't as aware of sort of pre-pandemic, but is I think a really ripe area for advocacy, is to say I keep coming back to caregivers, which is a whole nother topic in and of itself.
Kate Gosney:
We can have a whole nother show on that.
Dr. Michelle Park:
Right, but particularly I think because I was hit with the evaluations that I did and consultations that I did with our participants who were caregivers, where it just seemed as if the bottom has fallen out, particularly in those cases where it's like they are socially isolated and whatever respite services that they had are gone too.
Kate Gosney:
Yes, yeah.
Dr. Michelle Park:
Really highlighted the need for advocacy for services, and these are unpaid caregivers that I was speaking to, they're family caregivers. So, I found it really I guess inspiring and sort of I was feeling more optimistic about the prospect of how we as a nation even politically talk about older adult care and caregiving because in, for example, the American Jobs Plan that the administration has put out, they talk specifically about how to address this gap in unpaid caregiving, that unpaid caregiving is such an important part of our society, and not just society but also economy.
Kate Gosney:
Right, absolutely.
Dr. Michelle Park:
And that it helps to keep everyone going because it's an important piece that if it falls through, if the person who is providing care, if your cousin, or your sister, or brother who was providing care then no longer can provide care, then maybe you have to quit your job or cut back because you need to care for your family member.
Kate Gosney:
There's a ripple effect.
Dr. Michelle Park:
Exactly. There are so many ripple effects of this. So I would say what I've seen in terms of what folks are hoping for and advocating for, and moving towards in terms of addressing the caregiver gap of looking at caregiver wellbeing and mental health, and ultimately improving older adult care, both medical care as well as nursing home care, and providing more resources for that. I feel like that is a step in the right direction and something that we can all keep in mind, that it is ... There are many different priorities and so many different ways in which we as a society can help and help to take care of our older adults, but it's something to be mindful of. It's something that I've learned that I need to be mindful of. Basically having accountability for our state and local officials to say hey, this is important. If you say that it's a priority, we need to figure out how to make this happen because they are in many cases our most vulnerable populations.
Kate Gosney:
And we need to take care of them, so advocacy is really important.
Dr. Michelle Park:
Right.
Kate Gosney:
Like you said, things don't just show up out of nowhere.
Dr. Michelle Park:
Right.
Kate Gosney:
We need to help be part of that creation. So, a really good reminder. I appreciate hearing that as well. It's a good reminder for me. Yeah, is there anything else? Any other resources or anything, I didn't want to cut you off, but for our listeners at all before we wrap things up?
Dr. Michelle Park:
No.
Kate Gosney:
Okay. Well, listen, you've been on the front lines and continue to be on the front lines, and I want to thank you for all that you do across the board, thank the Council of Aging and the ReConnect program. It sounds like such an amazing resource, and that's all on the website there. Dr. Michelle Park, thank you so much for being here.
Dr. Michelle Park:
Thank you.