Inside a bureaucratic jungle, Laura Trejo always finds room to roar.
When Trejo sat in the midst of a panel of experts during the recent launch of a new state senate committee on aging, she spoke plainly yet firmly. During her 10-minute lecture, simmering tension escalated into barely controlled fury.
“We have lots of reports, we know what needs to get done, we just need to implement something,” insisted Trejo, who heads the City of Los Angeles Department of Aging. “So that’s my recommendation: implement something.”
Trejo received a standing ovation from the crowd of 125 – most of them within aging services.
Indeed, Trejo has implemented a long list of programs targeting LA’s aging community that have received kudos for their prescience and innovation.
When two years ago the city slashed its adult education programs, teachers slipped from 300 to 70 and were placed under Trejo’s tutelage. Instead of lamenting the demise, Trejo used it as an opportunity to create more streamlined classes focusing on practical aging issues to promote exercise, disease prevention, and improving memory – the last via dementia expert Dr. Gary Small, director of UCLA’s Longevity Center.
“One of her greatest strengths is her creativity,” says Dr. Catherine Sarkisian, director of the Los Angeles Community Academic Partnership for Research in Aging (LACAPRA), which Trejo co-directs. “She is constantly thinking of new ways individuals and teams can work together to increase their impact.”
Always operating at a street level, Trejo pursued the alliance with Sarkisian and LACAPRA for a specific reason: “We were trying to create a relationship where academics would truly listen to us.”
Trejo also helped establish five mental health teams for older adult interventions that include a public health nurse, a social worker, and a physician with geriatric training to provide wraparound support.
She has also adopted the “Savvy Caregiver” program to educate overworked – and overwhelmed – family caregivers.
In fact, each of the city’s 16 Multipurpose Centers, or MPCs, knit together a wide array of senior services that include case management and healthy living classes: one-stop shopping for older adults.
Trejo also embraces new technologies in her outreach efforts.
The department first used TV for the older adult exercise program “On the Move,” developed by Harvard-trained geriatrician Dr. Scott Kaiser. The show is now available on YouTube.
Microsoft courted her for two years before she adopted their HealthVault technology, which tracks medical data to encourage healthier lifestyles. Allied with the Partners in Care Foundation and St. Barnabas Senior Services, Trejo folded the technology into the cutting-edge Exergamers Wellness Club – an XBox-based virtual exercise program to encourage seniors to move vigorously at the MPCs.
The club, which has been replicated citywide, netted Trejo and her community partners a 2012 Aging Innovations Award from the National Association of Area Agencies on Aging.
“Laura is a wonderful, open thinker who is very imaginative and very practical,” says June Simmons, who heads Partners in Care. “She imagines how things should be and she creatively pulls all kinds of people and fiscal resources together and transforms them into new shapes that have greater impact.”
While many government workers discuss policy victories, Trejo prefers stories of isolated individuals in peril.
She movingly recounts the tale of an elderly woman considered a mentally ill hoarder. In truth, she was one of the first female reporters for the Los Angeles Times who devoured books. When Adult Protective Services showed up with police, a cascading series of unfortunate events sent her to a psychiatric hospital for the weekend.
“We were the first team that walked into her life and tried to actually understand her,” says Trejo.
The woman eventually became the keynote speaker at a meeting of the county’s Department of Mental Health where she recounted her horror story. Afterwards, Trejo asked the attendees “Does anybody think she’s crazy?” No hands rose. “It’s official,” added Trejo. “Nobody thinks you’re crazy.”
In fact, Trejo says her department is structured precisely to help those older adults most acutely in need.
“There are seniors at home who have nothing, and that’s who we focus on,” she says. “We are always trying to figure out ‘What is the most dignified intervention?’”
While focused on the actual effects on real people, Trejo is also politically savvy. When the city sought to trim its adult day centers, she preempted the decision by helping the city “thoughtfully close” the centers first, replacing them with wellness centers run within the MPC’s health promotion programs.
“I tend to churn ideas in my head until I figure out where they belong,” she says.
At heart an optimist, Trejo sees plenty of challenges ahead for older adults, who are overwhelmingly represented in the greater Los Angeles area: one in four California seniors live in Los Angeles County.
“We’re being asked to plan for 40 plus years of a life span,” Trejo told the senate committee. “When we say ‘older adults’ we say ‘Anything over 60 – you go figure it out.’”
Trejo is particularly dismayed at the meek lobbying power of aging organizations, which often defer to children and the disabled during funding battles.
“I haven’t seen funding for aging programs as anyone’s priority,” she says.
Underpinning the problems of older adults is their most acute challenge.
“Economic security,” says Trejo. “That’s an incredible stressor for older people.”
Today, Trejo is heartened by the support she has received from L.A. officials, especially over the past two years. She cites the support of Mayor Eric Garcetti along with the director of the county’s Department of Public Health, Dr. Jonathan Fielding, who has consistently addressed the needs of older adults in public lectures.
And Trejo needs everyone on board for the coming “silver tsunami.”
“This is the first time in human history we’ve had this many old people,” says Trejo, who remains hopeful for the future.
“I get to work with the best of the human species. The people who have adapted and overcome.”