Stories from the Field: Susan DeMarois

What inspired the California Department of Aging to promote Flipping the Script on Aging as a public health campaign? What observations, gaps, and/or opportunities influenced this direction?

We’ve come to recognize that ageism is a public health issue. When aging is framed as decline, vulnerability, and risk, people delay planning, waiting for a crisis, and important conversations about finances, health, and care don't happen early enough. So, one of our goals in the California Master Plan for Aging is to destigmatize aging and normalize planning across the lifespan. The Flipping the Script on Aging campaign is another tool to help reframe aging conversations by drawing attention to the strengths, contributions, and assets of adults as they get older. Ageism also creates a barrier to accessing supports, shaping the outdated idea that you’re either fine and independent or you’re frail and headed to a nursing home. It’s more of a continuum. Older adulthood is now four decades of life, from 60 to 100. We need to talk earlier about the services and supports that are available across the life course. Many Californians are not prepared for the realities of longer lives. Our thinking is that if we change how we communicate about aging, people will change how they plan for it. 

Please share an example of an innovative program or practice you are implementing, or plan to implement, that focuses on improving healthspan for older adults.

Improving healthspan is one of the five bold goals of our Master Plan for Aging. We call it Health Reimagined. The chronic disease model is all about disease management, but not life management. We want to broaden how people think about healthspan beyond clinical conditions, diagnostics, and treatment plans. Whether it's diabetes, Alzheimer's disease, or ALS (amyotrophic lateral sclerosis), how do we help people protect and promote their function and independence? Healthspan means mobility, nutrition, social engagement, and caregiver support. It means knowing how to plug into networks of care and find the services you need to live in your home and community. We hear it all the time: "I had no idea. If only I'd known." That's why communicating better about the continuum of home- and community-based services, and making sure people know how to access them, is central to our work. The Local Aging and Disability Action Planning Grant Program is a great example of healthspan initiatives coming to life at the local level, supporting communities in planning and creating their own aging and disability action plans. 

Is the California Department of Aging considering any of the strategies highlighted in the Milken Institute's report, Longevity Ready: A Systems Approach to Aging Well at Home?

We know that navigation is key to helping people find the networks, supports, and services they need. The current system creates too much of a runaround for people, and all the categorical funding and eligibility requirements make it even harder to find a way in. We need to break down these silos. It’s a huge lift, but it’s something we’ve spent a lot of time thinking about. Imagine if a physician could just hand out one phone number and say, "Start here." We are entering an era of 10 million older adults in California. We have to move from a kitchen-table network and workarounds and one-offs to navigation at scale. Most people don't even know what an Area Agency on Aging is—they could drive by one every day and not know it's there to support them. So, building awareness and education also needs to be part of our strategy. Looking ahead, AI is an opportunity to help with lighter-touch needs, freeing up humans for more complex case management. And the nimbleness and tech-enabled resources that the private sector can bring will be essential to getting there.

What advice would you give to colleagues in the public sector working to help their constituents become "longevity ready"? Where should they start?

The first step is to normalize the conversation. We have a campaign called Start the Conversation for exactly this reason. Embed planning into the natural touch points where people are already engaged and most receptive—benefits enrollment, health visits, retirement transitions. That's how you meet people where they are. Second, elevate the voices of the people you are trying to serve. So many well-intentioned programs miss the mark because the people they're designed for weren't brought in early, or assumptions were made about what they would want or need. The lived experience of older adults has to inform the process. And finally, make proactive planning the easy choice. Right now, the barrier to entry is still high. Community-based organizations and Area Agencies on Aging can change that by putting information and resources in front of people that are easy to understand and easy to act on, delivered through trusted community messengers and partners.