Thriving on the Prairie

Jodi Bruns talks with Jane Strommen, NDSU Extension gerontology specialist, about Community of Care, a program to help older adults remain in their rural homes.

Show Notes

Resources:
Jane’s contact information, Jane.strommen@ndsu.edu 
More about the Community of Care model, https://communityofcarend.com/

Transcript:
Jodi Bruns: Welcome to Thriving on the Prairie. A podcast exploring issues concerning families and communities that inspire North Dakota movers, shakers and community difference makers to engage in lifelong learning. I'm Jodi Bruns, Leadership and Civic Engagement specialist, with NDSU Extension. I'm joined today with Jane Strommen, NDSU Extension gerontology specialist and I'm glad that Jane has decided to talk to me today about the Community of Care program. And what that's all about, how it is impacting communities across the state of North Dakota. So welcome, Jane, and thanks for joining me.

Jane Strommen: Thanks for having me, Jodi, looking forward to it.

Jodi: So I started working with.. with Jane and her team who works on community of care to facilitate some meetings, thinking about making this opportunity available to other communities. And so, I think it's important that we share exactly what is this program, Community of Care and what's happening with communities that are embracing this particular program.

Jane: Community of Care is a nonprofit organization that started in rural Cass County back in 2003. And it was really started by the Good Samaritan Society as a pilot project. At that time, the Good Samaritan Society was interested in how to help older adults and their family members that were living in the community because their core business was on skilled nursing facilities across the country. And so they wanted to do a pilot and they chose Arthur, kind of as the foundation area to do this project because that was where the company was founded. And so we had some seed money from the Good Samaritan Society and at that time also a grant from the Almstead Commission, to look at how do we start addressing the needs of older adults that live in a rural community. And so it really started as a pilot project and just engaging members and the community and talking about what's going on in rural Cass County. There's a lot of rural communities, small towns that comprise kind of the geographic area. And so, it began as a conversation, inviting people to be part of some meetings and tried to get representatives from all of the different geographic areas and communities, as well as making sure we had, you know, business and commerce, education, faith communities, healthcare, social services, government, whether it was the city or county. We had some legislators, and invited people together and when we learned about what was going on in our state. What were some of the challenges and then we started doing some discussion and needs assessment around what are the needs in this particular area, rural Cass County. And so that's that was kind of how it first started.

Jodi : So what were you hearing from people? I assume that there were older adults who were part of this planning process. And when they came to the meeting and said, “We think we want to be part of this in our community needs this” why... what.. what we're hearing at that time? 

Jane: Well, when we did a kind of a needs assessment. We went through a fairly structured process to to identify the needs and there were alot.  There were a lot of needs identified, but the ones that really rose to the top of the list was the need for a volunteer program that could do…. provide a lot of different services for older adults, but the biggest area was around transportation. Rural Cass County and you know,  had some, some services in the county you know a dentist, part time clinic, those types of things, but for a big portion of folks living here they needed to travel to the Fargo/Moorhead area for services. And so that became a kind of the top need, as as well. There was a need also for just information. How do people find out about services and, you know. Because it's not something that you just know or or often you... you're really not interested until maybe a crisis occurs and all of a sudden, where do I get this? And you know, you don't even know what questions to ask. So, they talked about, you know, let's let's develop some kind of a resource center where there are staff that can help people that would be local where people could go. So those are some of the first things that we started with, is developing a volunteer program and developing a resource center staffed by a social worker, a care coordinator that could help people with whatever it was that they needed help with. Not being constrained by any kind of government funding that says you can only serve people of this age or you can only do, you know, your program areas, only this kind of narrow window. We were, we had great flexibility and how we were able to serve people

Jodi: So I think it's interesting. I read a statistic this morning that said between 2010 and 2025 the number of adults ages 65 and older in North Dakota is expected to grow by 52%. In 1980, older adults were 12% of the population, by 2025 they're expected to be 18% of the state's population. So older adults continue to be an economic driver in our rural communities. And I think this program is one way to make sure that our older adults can remain as active citizens in our communities all over the state. 

Jane: Absolutely. You know, our older adults, you know, we have a higher percentage of older adults living in rural counties than we do our metro areas. And we know that older adults really contribute to to their community in in great ways. In addition to just the economy and financially, but they are also great volunteers. And I'll just give you an example, community of care has a volunteer program and the majority of their volunteers are older adults. They're retired and they're stepping up to fill a need in the community. And it's really a win-win situation. And, you know, they're a key element of success for Community of Care because they're supporting it in so many ways. And to be able to help our older adults feel like their community is a good place for them to retire and continue to live as they age is, I think, really important work.

Jodi: I read also today that some North Dakota older adults far exceed the national average in volunteering in communities. Statewide 41% of older adults volunteered in 2017 compared to the national average of 29 and a half percent. That, I mean, that's amazing that people continue to see value in helping neighbors and helping each other and just the value of prolonging people staying in their community and in how important that is. I think that's that really says a lot about the integrity of our communities and the people who live there.

Jane: I think it speaks to like who we are in North Dakota and beyond. Where we help each other. We... we want to help our neighbors, our friends. And older adults, just because they get to a certain age don't stop doing that, they're continuing to serve on the church on the school board and and volunteering for, you know, there are many times, keeping the community going because of their community service. So it's, it's, you know, they are a real asset in our state and we have a growing number. And in addition, you know it's it's really important as a person ages to to feel like they have a purpose. You know, everyone needs to have a reason to get up in the morning and to be able to have things that are you're passionate about that you can contribute to. I think it's just a win-win for, for everyone.

Jodi: So the expansion of this program I think is pretty important. So it's obviously been very successful in Cass County.

Jane: Yes.

Jodi: And and now there was some funding through the legislature to help try a pilot project in a couple of other communities. And those communities have been identified in Ransom County and Morton County. And so as we have been working to facilitate some meetings and find out some interest. Clearly these communities are very interested. And when we visited with them, some of the identified needs, I'll, I'll just read some of these, that.. that when we asked what's what's needed in those particular communities. You know, the number one issue remains, just as you said it was in Cass County, is transportation. And what I found interesting is, even if there is public transportation, many counties have provided like a county van or a bus for to take older adults to doctors appointments and so forth. The struggle is is if they have, let's say a cancer treatment, and they just aren't physically able to ride in a van or bus for for the extended period or wait for other patients. So, I mean, that was, that was pretty eye opening. I just hadn't, I think what you said earlier is pretty important, you just don't know the need until you're faced with it.

Jane:  You know, fortunate to have some transportation services, but what we hear so often from people and not, not just in rural Cass, but, you know, across the state and all rural areas, have issues with limited transportation options for them to access services. And I think when you have a fixed schedule or fixed route, it becomes really challenging for older adults who have very specific transportation needs to really get their, their needs met. And you provide it in a good example of, you know, somebody has a an 11 O'clock doctor's appointment, but they need to get on the van at seven, you know, to get to that appointment at eleven then they can't get back home until later in the afternoon because it's a fixed route. It gets to be a long day, especially if somebody isn't feeling well. And so there's so many situations where that maybe the public transportation options really just don't work. Somebody needs, you know, has dialysis or maybe they are getting chemo treatments and so it's maybe multiple times a week. And that person really wants to go in, have their appointment and come back home. So matching what's available with some volunteer transportation really helps fill a need or fill one of those gaps. And in our experience, experience at Community of Care is you know, those the volunteer drivers, you know, it's, it's a great way for some socialization to happen as well. When they're on the road and going to appointment and oftentimes we hear that, “Oh well, we went out for pie after the appointment” or, you know, just somebody else that's checking in with them seeing how they're doing. And so sometimes it serves more than just the transportation need, as well. 

Jodi: So that was identified as the number one issue in these meetings as I'm looking at this list and the second one, you led us into that pretty nicely, is friendly visits from people. Just phone calls, companionship, coffee visits,socialization, someone to check on me. You know, those are all the things that were listed as another need. I mean, we’re busy and we have places to go and things to do and for people whose lives have slowed down, we can't minimize the importance of some of that companionship and socialization.

Jane: Absolutely, and I think this last year has just really highlighted that with a pandemic and many older adults feeling more isolated from friends and family and getting out to, you know, different functions and just seeing people and being engaged with the community. And so it's something that we, you know, we live, I live in a small community and, you know, we we reach out to people, you know, we're friends with people, we’ll maybe see them at church or the grocery store or the cafe, those types of things. But it's something that can easily be enhanced in our rural communities by a program like Community of Care. It maybe just needs to have somebody coordinating some of these types of activities and making sure that we are reaching out to those people who really could benefit from that friendly visit, somebody just checking in on them. So it's maybe just need somebody coordinating that effort.

Jodi: And finally, something else that I heard that I I learned was such an important part of this program too, is the connection of resources. Again, if you're put in a situation where you have, let's say you have an older adult as a parent who is in need of some services, where do you go for that information? I mean, all of a sudden I mean there's no rule book, all of a sudden you're you're in that situation where you're in a place of need, what do you do? And I see that as a number one factor in Community of Care is to have a point person that can be reached when someone needs a resource. 

Jane: Absolutely. I think Community of Care has been around long enough now that they’re a known resource in the community. And if somebody has a question, so maybe there's a new need and a family somebody needing some in home health or some kind of service, they know that they can call Community of Care, they can set up an appointment. They can go in and meet with staff. And they can sit down with them or talk to them and tell them about these are the types of resources that are available to help your loved one or help you if it's for the person themselves. And so it's such a need because people don't seek out the services until there's a real need. They don't try to learn about these services in advance because it's just it's, number one, older people really don't like to think about themselves as aging or being in a state where they're less than fully independent and so it's

Jodi: Right.

Jane: So maybe just a natural tendency for us not to kind of learn too much about that or have to think about that but, you know it does happen, and we need to have that information. And being able to have somebody who's knowledgeable, staff that's knowledgeable and they’re local and they know what's available and they can can help you, I think means a lot. I've had an opportunity to do some statewide studies for different topics, one was around family caregiving, a number of years ago, and I heard over and over and over again from family members, “I wish I knew where to go. I wish there were some place that I could go to that I could just get a simple list”. Instead of maybe going and trying to search your website and you know just really not understanding. There was a simple way that they could understand what's available. “I live in Hettinger, what's available here?” You know, I, it doesn't do me any good to have research and find something that's only available in Grand Forks, so it has been a real stressful time for family members when they're needing to find services or some type of help. In more an emergency situation too and they don't really, they don't know where to turn. And sometimes they don't know what questions to ask. And so just having a local resource available has been just a great asset.

Jodi: So, just so people are clear. Again, we're visiting today and I'm joined with Jane Strommen the NDSU Extension gerontology specialist and we're talking about the Community of Care program. And just so people are clear about what exactly this is, so I it as I understand it's a program where a volunteer coordinator is hired and I see that as a point person in the community, to assist people with their with finding the necessary services for particular need. With the end goal of allowing older adults to remain in their home as long as they feel safe and independent. and so Community of care, this volunteer coordinator might assist someone that needs transportation to a doctor appointment or maybe they need some errands run, or groceries picked up, or prescriptions, or maybe they just need a phone call.

Jane: You're talking about the Ransom county and the Morton county sites right now.

Jodi: Right. Yes.

Jane: We, NDSU Extension had received a grant from the North Dakota Department of Human Services last February, and it was around enhancing home and community-based services in North Dakota for older adults. And we had applied for a grant to look at how could we replicate something like Community of Care in ...in a couple other rural communities. There had been a lot of interest over the years from different community leaders and legislators, like “how do we get this in our community.” And so we applied for this this grant when it became available to start working on this; our goal in Ransom County and Morton County is to to work with the local, local community members and identifying the needs, which we know we mentioned volunteer transportation was listed and we are in the process of hiring a volunteer coordinator for both communities that would be a part-time position to start with. And that really need is really to develop a volunteer program. We’re wanting to understand, you know, how easy is it to establish this type of program, it doesn't mean, it's not going to be exactly like Community of Care. It will be unique to what the needs are and how those community members envision this this kind of program in their own community. And we're calling it kind of Aging in Community, and identifying unique names for each of these programs. But we start with part time staff that really can start working on these top needs that have been identified. And what we're hoping to do is use the resources that we have within the staff of Community of Care now in rural Cass, and in in Ransom County there's another program called the heart program that provides similar type of services and we're really looking to them to help these, like in Ransom county, to help develop a volunteer program. And figure out how to, to have a quality program, you know, having the policies and procedures and the training and everything done well, there's a little bit of work involved to do that. We have some of the expertise and a team of people that are going to be helping these two communities, develop these services. You know, in Ransom County, it was kind of the volunteer coordinator. In Morton County, they they talked about the volunteer coordinator, but also somebody that would.. could really be maybe help develop a resource center. You know, where like at Community of Care, people can call there, they can walk in, they can learn about services, and so that's one of the things that we're looking at in Morton County, as well. But the goal is to. how do we replicate these Community of Care model in these two communities, but making it their own. It will look unique to those communities and it's really, the beauty of the program is that it needs to be owned by the community. And that's how Community of Care started and that's why it's been successful is that community ownership. Community members need to decide what do they want. How did they want it to look….what services should be offered those types of things.

Jodi: That is what I've admired most, as I have learned about this program, is no one ever went to these communities and said this is how you have to do this. This is how it should look. There's no cookie cutter approach. It is you identify the need, and let's do our best to meet those needs for community members. 

Jane: Absolutely. You know, when Community of Care started, rural Cass County, it was really kind of like a blank piece of paper and we brought people together and we talked about, yes, there are many needs. These are the ones that we want to start with. And we started. We just started offering those services and within two or three years, the steering committee members were saying, this, our funding, our grant funding was going to be coming to an end. And they said, “We need to figure out how this continues, because we don't want this program to end.” And that is when Community of Care started the process of incorporating and getting this articles of incorporation in place, its initial board of directors and getting its 501 c3 status and figuring out how, how can we sustain this financially and otherwise. It would not have happened had it not been for the engagement and the passion of the local community members.

Jodi: So who are some of the organizations that that you have partnered with to make this such a successful program? Because you know, obviously, you're the point person at NDSU Extension, but rarely do we ever do any of these programs alone. It's always about a partnership. So who are some of the partners in this that makes it so successful?

Jane: Absolutely. You know, we're working with the Community of Care staff, you know, obviously, and Myrna Hanson is their executive director and she is just as passionate, I know their board of directors, they feel passionate about helping other communities, as well to figure out how they can have a program like this, bringing more resources for older adults and so she's been a key partner. We've also been working with Quality Health Associates, Jamie Steig is our local person who has really been instrumental and interested in figuring out how how their organization can be helpful, as well. And locally, we depend on our local Extension family and community wellness agents and so our agent in Ransom County, Deb Lee, and our agent in Morton county, Vanessa Hoines have been that local liaison, the local point person. They know the communities. They’re well respected, they know which community members to to engage in these conversations as we begin the work in both, both of those counties. And so those are some of the partners that we, and of course other resources that you know like yourself, Jodi, Jodi helping with meetings and facilitating some different planning processes have all been really critical for the project to be successful.

Jodi: Interesting. There's such a diverse group of people on with each community, you know, maybe it's clergy in one, a clergy member and just volunteers from the senior center, who help with meals. And maybe it's county health and other volunteers who have joined our calls, who just deeply care about what's happening in their community, as well. They're really concerned about the safety of older adults in their community and wanting them to to stay in their home as long as they feel safe to do so.

Jane: We don't just look to those individuals or professionals who are are working in the kind of that aging network world, we're looking beyond that. Who represents the community? and do they have a concern or a vested interest in keeping their older adults in their community and safe and healthy? And so we do have different different community members that are are coming to our meetings and wanting to be part of this work, and I've been just really pleased with both communities. That you know, people are good. They love their community and they want to help. And even in the midst of a pandemic, people are willing to give up their time and and come to meetings and this is this is good, this is good. This would be good for our community, let's figure out how we can do it.

Jodi: Alright Jane. So if, if people listening to this want this particular program in their community or need more information should they reach out to you?

Jane: Yes, absolutely, I'd be glad to talk about what we're doing with this aging and community project and to give an update and share what I know and what's going on. And so I'd be happy to talk with anyone who wants more information.

Jodi: Great, great. So people can contact your local Extension agent for more information and connect you with Jane or you can go ahead and reach Jane via email and Jane, do you want to share your email address?

Jane: Yes, it's jane.strommen@ndsu.edu

Jodi: Alright. Thanks Jane. 

Jane: Absolutely.

Jodi: And we appreciate everyone joining us today. Thanks for listening to Thriving on the Prairie. To subscribe to the podcast and access a full transcript and resource links from this episode visit ag.ndsu.edu/thrivingontheprairie. You can find more resources for families and communities at ndsu.edu/extension. This has been a production of NDSU Extension. Extending knowledge, changing lives. Thanks for joining us today.

What is Thriving on the Prairie?

A podcast that inspires North Dakota movers, shakers and community difference-makers to engage in lifelong learning, featuring conversations with NDSU Extension professionals and guests exploring issues concerning families and communities.