#17 Aging with Altitude: PEARLS of Colorado

Aging with Altitude

PEARLS is the Program Encouraging Active Rewarding Lives for Seniors and is run by Cynthia Margiotta. Cynthia has a Bachelors in Social Work and a solid history of supporting older adults in the Pikes Peak region. From her work teaching direct care staff best practices to her volunteering with the Alzheimer's Association and the Family Caregiver program with the Pikes Peak Area Agency on Aging, Cynthia has the best background to support older adults who are struggling with anxiety and mental health needs. The PEARLS program is a unique in-home 19 week program focusing on goal setting and much more. PEARLS of Colorado

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country. We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado. The Pikes Peak Area Agency on Aging is the producer. Learn more at Pikes Peak Area Agency on Aging.

Transcript:

You’re listening to studio 809. This is what community sounds like.

Melissa Marts:

Hi, welcome to all. This is the Pikes Peak Area Agency on Aging’s Aging with Altitude podcast hosted at studio 809 podcast. We provide answers, assistance, and advocacy for people over 60 and their caregivers. Thank you for joining us today. I am Melissa Marts, program administrator with the Pikes Peak Area Agency on Aging. Our topic today is about behavioral health, but let’s just call it kind of anxiety and frustrations that our older adults, some of our best friends, go through and are suffering with and some ideas about how to help them. And to talk about this today we have Cynthia Margiotta with us. Cynthia is typically our podcast host so you’ll recognize her voice from other podcasts, but today she is our special guest. Last year during COVID, Cynthia launched the PEARLS Program of Colorado, a unique behavioral health program here in El Paso County with goals to spread it around Colorado, but she started it here in our region. Cynthia is also a strong advocate for older adults, and she’s supported the aging community for years with her All About Dignity courses, her volunteering with the family caregiver support program at the Pikes Peak Area Agency on Aging, and many other programs. Then also today we have a special masters of ceremony, Ms. Jenny Nihill, who is a military fellow, and she is currently doing this with the Pikes Peak Area Agency on Aging, so thank you Jenny for joining us. Thank you for your over 20 years of military service and jumping in today as the emcee with Cynthia. I’m going to turn it over to Jenny.

Jenny Nihill:

Alright, thanks Melissa for the introduction. I’m happy to be here learning and working with Melissa and the Area Agency on Aging. Now I’d like to introduce Cynthia and learn more about the PEARLS Program of Colorado, so let’s get started. Can you tell us what is the PEARLS Program of Colorado and who is eligible to use the program?

Cynthia Margiotta:

PEARLS Program of Colorado, we just call it PEARLS for short, but PEARLS program of Colorado is a program that is specifically set up to help seniors in our community. We work with the folks 60 plus population. It is an evidence-based program that I took many classes for in order to hold that program here.

Melissa Marts:

Cynthia, what does PEARLS stand for?

Cynthia Margiotta:

PEARLS stands for Program Encouraging Active Rewarding Lives for Seniors.

Melissa Marts:

Thanks. It’s funny how we get so used to just saying PEARLS and then we forget to actually, to call out those really special words that PEARLS means.

Cynthia Margiotta:

Yeah, it’s a great one. I wish I had thought of it.

Jenny Nihill:

So before we came here today I did go looking on the website so I could learn a little bit more about the organization. It did mention that there were coaches. Can you tell us about the coaches, who they are, what kind of training they might have gone through?

Cynthia Margiotta:

I am the only coach in El Paso County, so I travel all over El Paso County from top to bottom, to left to right, but the training. Oh my. So the training I took for this particular program is out of Washington State University. About a year and a half ago now wasn’t it. Then there were some other programs that I also took on my own to make it even more valuable like actually what to do when a person has a seizure. There’s a difference if they have a seizure and they’re known seizure victims or unknown. Different classes like that through the past year and I am currently in a class where I am becoming a PEARLS master trainer.

Jenny Nihill:

That sounds good. Can you tell us what the stool concept of PEARLS is?

Cynthia Margiotta:

The stools concept. You’re very smart. Yes, the stools concept is a great part of the PEARLS program. The way we think of it is a three-legged stool and each leg holds up the person. So those three legs are one leg is the socially active. We encourage people to be socially active, whatever that means to them, and another one is to be physically active. Being physically active actually reduces depression and anxiety so that’s important as well, and then also to be like planning an activity of interest. And I don’t mean planning to go to Mexico in three years, but maybe going to have supper with a friend next week. So those three legs, and then it’s held up by the floor, and the floor is actually in our program, the psychologist and the nurse practitioner so they in a sense they supervise me and help me to understand the medications people are on and what might be a better approach with any particular person. There is really a team of us that do that.

Jenny Nihill:

Great. So when participants are enrolled in your program, can you tell me what they can expect to get out of the program?

Cynthia Margiotta:

A great deal of joy. That is what I hear from people. Yesterday I took on a new client who was suffering with pretty high depression. She’s just getting through the denial stage that people have of her husband’s dementia where, I don’t know. I don’t understand fully why, but it’s very common for people to say “oh mom you’re going crazy, dad’s fine,” “Why is she crazy and he’s not having problems?” It’s very common and so when I went to visit with her, I spent about an hour explaining a little bit about his disease, his kind of dementia to him. I’m also a longtime volunteer with the Alzheimer’s Association so having that knowledge has helped being able to explain that particular dementia. Helping her understand the difference between what she felt. She believes that she’s guilty for his dementia and explaining the difference between guilt and regret. I think when we were done a few hours later she was so much happier. She’s OK, that’s not her fault. That she’s not going crazy. And I liked seeing that in people. I like helping people. This is what really enthralled me about the program. Moving people toward more joy. Just because you’re over 60 doesn’t mean you have to sit on the couch all day.

Melissa Marts:

And Cynthia, as you bring up that story and talk about that personal experience that you had with this woman. I think we haven’t talked about it yet, where does PEARLS happen? When you are meeting with these folks, where are you actually meeting with them?

Jenny Nihill:

Yeah, especially during COVID now because we are still doing a lot of social distancing, with the elderly being a vulnerable population.

Cynthia Margiotta:

They are. Oh yes. I do offer to meet with them over the phone if they would prefer. My preference is to go to their home and be there for them. I see and experience things that you wouldn’t if you meet in the office. I love to always talk about experiences without names. There is one client I have worked with where she was going blind and deaf at the same time, and her husband. Let me explain how it is. She would sit in the chair and had one chair facing her to talk to her. Her husband would sit in a couch behind her. And I would not have known that if I had not gone to that home. What I suggested to her husband is, go to one of the ARC Thrift Shops and buy a chair so that you have a chair where you can sit where she can hear you when you’re talking to her. That’s important in a relationship, but if they had met me in an office, I would have never known that.

Jenny Nihill:

Right, so when you go meet them, how long are you there for? And how long does this program last? Is it a few sessions, is it just continuous as needed?

Cynthia Margiotta:

Actually, the visits are rather long because I try to talk to them about what’s on their mind, what are their needs. It’s not where I set up a goal for them. They tell me what they need help with. Those depend on you know, a little goal of like figuring out how to I don’t know, toast. Using the toaster is easy you know. Where figuring out the difference between depression and anxiety’s a little bit more time consuming. And so they tend to vary in time and length per session, usually somewhere around an hour and a half, and then the period in months we started out with this weekly. Then we go every other week or so. Then about once a month, and then about a phone call every now and again kind of thing. And so slowly over a period of many, many, many months we see them and talk to them less frequently.

Melissa Marts:

And can I jump in again?

Cynthia Margiotta:

Yeah. Oh please.

Melissa Marts:

I’m just kind of curious how you see PEARLS being different than kind of a psychotherapy appointment and how, how is this a different approach for older adults? And along with that maybe answering the question of how it’s paid for too?

Cynthia Margiotta:

People here don’t know, but my husband is a psychologist and so I, and I had nothing wrong with psychology. What I see is a psychologist is there to hear and listen and reflect back. My job is to discuss with them, and to find what it is that they want to work on and help them, so we start from today. What’s going on today. And how can we change those problems into goals and meet those goals? Our funding comes through the Old Age Act, which is part of the Area Agency on Aging, and so we do have a grant through them and we are so appreciative because I love being able to go to people’s homes and say I’m not gonna charge you for these services. So I can see people who have like no money, or have nothing to spend. And yes, we do take donations don’t get me wrong, but you know. It’s nice to be able to see somebody who says “I, I don’t have money to pay you.” It means a lot to me.

Melissa Marts:

I know, and I’m glad that we have that opportunity to do that because oftentimes with counseling people have to somehow come up with money to pay for a counselor, and this is a resource that people can access for free. But again, Cynthia’s point about taking donations, you know the funds are limited. It’s not an unlimited budget, and so for people who can pay it forward when they have appointments with Cynthia and be able to you know, make a donation so that the program can go a little bit further maybe for the next person and other folks down the line is, is really appreciated of course.

Cynthia Margiotta:

Absolutely. I so appreciate that and send thank you notes to folks in hopes that they will keep us in mind in their future.

Melissa Marts:

Great.

Jenny Nihill:

You mentioned earlier that PEARLS here in Colorado Springs is under a larger program of PEARLS. What level is that at, and then where did you see the need arise in El Paso County to start the PEARLS program here?

Cynthia Margiotta:

Where did I see the need? You got three days to talk? No, there are so many folks that believe that once you’re about 60 or so, you should be happy with what I call “glued to the couch.” Where there’s no life. There’s no interests. That you look out the window and wish, and you can’t do things. I’ll use myself as an example. I do suffer with depression. And there are times, my friends all know that I’m a “plantaholic,” if you’ve ever heard of one of those. I am a plantaholic. I love plants. I’ve got more than a hundred at home, in the house. Some are taller than I am. That’s crazy, but I bring that up because there are days I know I need to water my plants. I have a few that say, “water me now or I’m going to die tomorrow.”

Jenny Nihill:

Those are the ones at my house.

Cynthia Margiotta:

Yes, bring them over. I’ll babysit. But in any case, there are times when I can look right at that plant and I can’t get off the couch. I cannot get off the couch to go water them and that’s depression. And that’s a lot of the folks we work with that can’t get off the couch. I see my job as, what gives me more joy than anything is when I see them get up off that couch, when want to go do things. When they talk to me and they say I wanna go to the senior center. I want to go volunteer at Area Agency. I want to do things. That gives me a lot of joy.

Melissa Marts:

And I’ll add a little bit to how the need kind of came to be in our region around behavioral health. You know we, a couple of years ago realized that there were lots of conversations happening at the governmental level around behavioral health and suicide, but no one was talking about it from an older adult perspective. Even our county health plan didn’t have a chapter to address older adults and behavioral health. It was really focused completely on people who were under the age of 60, and of course especially adolescents, which we know there was a significant need in that area, but yet we also discovered there is a significant need for older adults, and that the suicide rate for older adults is considerably high. It might not be a blatant overdose or a blatant suicide, but what it is it’s an accidental overdose of medications that people, as Cynthia refers to sitting on the couch and depressed, and they decide to take their own life with the medications that they have. The reality was we have many folks in our area that are alone, isolated, sad, depressed, anxious. We have two programs in our area that were able to provide behavioral health at the time when Cynthia started PEARLS, and they had waitlists. And so people couldn’t even get help if they wanted it. And many folks were not comfortable calling Aspen Point at the time. Now it’s called Diversus, but Aspen Pointe is kind of the emergency call for behavioral health relief and people didn’t want to call that. Especially older adults who are just sitting on the couch and feel like “well my life is over anyway and why should I call and ask for help.” At the Area Agency on Aging, we really wanted to see an additional resource around behavioral health and in the two years that we’ve been working on this we have seen exponential growth in funding, resources, support, conversations around the needs of older adults who would like to get extra support to feel better about their lives. PEARLS is a nice addition to a more clinical model approach. This is a home-based, much more personal and as Cynthia says, just really getting down and talking about goals. What do you want to do and how can we get there? It’s a great addition to our community.

Cynthia Margiotta:

Pre covid statistically the population of folks over 60 who were depressed, it was somewhere around 20%. And that’s people who acknowledged it. Most folks we find who are depressed say this is just the way it has to be so they don’t acknowledge it. We find a lot of them instead of saying they’re depressed they say, “we’re anxious.” The medication that people take for depression is the same medication they take for anxiety. So even then sometimes doctors don’t even mention to them “well I think you’re depressed. Here’s something for your anxiety.” And again, grin and bear it. It’s that population, grin and bear it.

Jenny Nihill:

PEARLS sounds like a great program with lots of benefits for our senior population. How can they reach out to you to participate in this program?

Cynthia Margiotta:

They can reach out to me, or the family can reach out to me by calling very easily. They can call my phone number. My phone number is 719-459-2017. They can look on the internet. Our website is PEARLSprogram.net. And they can call Area Agency on Aging, talk to people there and say, “hey I need to get a hold of the people at PEARLS.” Family, they can tell family and have family call me. I do prefer to call them because folks who are depressed tend to not get off the couch.

Melissa Marts:

So, Cynthia, again, thanks for sharing about how people can get in touch with the PEARLS program. That’s good information to know. Is there anything that we didn’t ask you? Maybe another story you want to share or something else that we forgot to ask.

Cynthia Margiotta:

Well, thank you for asking. I want to thank you Melissa. You’re the one who introduced me to PEARLS. When you first told me about it, it was like love at first sight. I’d been doing something very similar to this for many, many years where going to people’s homes and visiting with them and trying to encourage them. And to have a formal program that really helps me to do what I see as a better job has been wonderful and I hope that we can spread the PEARLS program throughout Colorado and get more of the Area Agencies on Aging to be involved with PEARLS. And I’ll do everything I can to help them do that.

Melissa Marts:

Well, I know you will and I appreciate you saying thanks to me. You know the funny story is is that when I was looking for more behavioral health resources in the community and I heard about PEARLS and I knew that Cynthia had a bachelor’s in social work and I knew the work that you had been doing, and in my mind, I was kind of hoping that maybe she would be interested. When we did talk about it, I was just kind of throwing it out there, hoping. So yes, you did jump in with both feet and I’m glad that you did. So thank you for that because it is a needed resource when people, again, I can’t emphasize enough how unique the model is to be kind of more on a personal level even during COVID right now. That can be a challenge, but that more personal touch where you do go into people’s homes and you can kind of see what’s going on and be in the real space with them is a good addition to the resources that are here already, and one that we really needed. So any other pieces before we turn this back over to Jenny and alright?

Cynthia Margiotta:

I’ll probably think of something tomorrow morning at 2 a.m.

Melissa Marts:

That’s right.

Jenny Nihill:

Well, I’d like to thank you for joining us today on Aging With Altitude, a Studio 809 podcast. Aging With Altitude is hosted by the Pikes Peak Area Agency on Aging. For more information on all things aging, we can be found online at www.ppacg.org or by phone at 719-471-2096.