Session 18-A, Nov. 1, 2015
By Elise Renner
The education programming at LeadingAge conferences is innovative, up-to-date and valuable for those working in the aging-services field. This year, we chose to highlight a representative sample of continuing education sessions from the 2015 LeadingAge Annual Meeting and Expo in Boston, MA, Nov. 1-4. This session summary presents the major points from session 18-A, Delivery Services in Rural Communities.
Speakers:
- Katie Lundmark, vice president of long term care, Perham Living, Perham, MN
- Jeanette Denson, director, Custer Care, Inc., Broken Bow, NE
- John Grace, Grace Team, Topeka, KS
- Julie Kaminski, Executive Director, LeadingAge Nebraska
Presenters spoke on behalf of their respective rural, aging communities, and discussed the issues they currently face, the concerns they have moving forward, and possible solutions. Each focused on their personal philosophies of aging, which resonated with many audience members, and made for a highly interactive, relevant presentation and question session to follow.
Background: The growth of an aging, rural population in the Midwest
Julie Kaminski presented some data:
Counties with the highest percentage aged 85-plus:
- Hooker, NE (8.3%)
- McIntosh, ND (7.5%)
- Divide, ND (6.5%)
- Traverse, MN (6.2%)
- Jerauld, SD (6.1%)
She cited 2 of the biggest issues in dealing with these high percentages: chronic conditions within the aging population, and a severely emaciated labor pool. She says a majority of elders:
- Lack access to providers
- Are underinsured
- Are more likely to have arthritis, asthma, heart disease, diabetes, hypertension and mental disorders
- Receive comparable or less care than urban residents for these conditions
… and that the communities they reside in:
- Face shortages in physicians, dentists, nurses and home care workers
- Receive lower Medicare/Medicaid reimbursement rates for providers
- Provide less access to health care networks, hospitals and clinics
She suggests that to solve these issues we must “find a way to bring home based services to rural community.” Some ways to do this would be:
- Adding more home care, “meals-on-wheels,” adult daycare, etc.
- Ask legislature for help in work force
- Increase listener flexibility
- Extend one practitioner license into more
Helping The Aging Population in Nebraska
Jeanette Denson’s philosophy of aging is to “fill the needs of the community,” and she takes two crucial steps to do so. First she identifies the problem, and asks herself, “what does the community need?” To address this, she looks at the continuum and progression of care for the aging population. She learned that her community was:
- Missing a place of daytime elder care
- Missing a place for Alzheimer’s patients
- Missing homecare services
Next, she looked for a solution, and asked herself, “how can we fill these needs?” Through community resources such as:
- Partnership with Home Health and assistant living services
- Local fundraisers
- Investors
- Volunteer groups
She was able to gather the “eyes and ears” of the community—doctors, famers, lawyers and bankers to create a working board of directors and a committed team, to form Nebraska Adult Day Care Association – Custer care, Inc., which provides:
- Adult day services
- Homes for Alzheimer’s patients
- Flexible, 24-hour home care
- Transportation services
She urges everyone to look toward the future and ask themselves: “what do you want to have when you retire?” “How do you want to live?” “Can your plan be improved?”
Rural Workforce in Perham, Minnesota
Katie Lundmark started by giving background information on Perham, MN, where Perham Living is located. She informed us that it will be experiencing a large increase in its 85-plus population in the next 30 years, affectionately named the “silver tsunami.”
Her organization provides primary and additional care, home health care, assisted living, independent living and adult day services for this population, all spread out on a “senior campus” in Perham. Unfortunately, as its clientele increases, Perham faces many problems due to a decrease in workforce. Employee retention among RNs, LPNs and NARs is declining. This problem is widespread across the Midwest, and has caused over 1,500 admissions into the care center to be denied in 2014, 12% of nursing communities to shut down admissions in 2015, and a 37-day median period that admissions were shut off.
Lundmark proposed solutions to this problem, and provided details on how Perham Living is trying to help. To increase the workforce, she focused on recruitment and retention. For current employees, she set clear expectations, asked for commitment, generated ideas through interaction, and kept an open mind. She also put out a call to the community, inviting all to work.
Katie mainly stressed the importance of implementing both long and short term solutions. Short term solutions focus on “now and 90 days from now.” Her solutions were to:
- Bring together a team of dedicated employees
- Immediately begin additional advertising
- Reconsider applications from previous years
- Organize a nursing assistant class
- Create an immediate rewards program
- Fill the GAP program: a 90-day program with weekly drawings for prizes worth $50 in value
- Provide staff with relief
Her long term solutions focus on the future. Her solutions were to:
- Send out a 4-question survey to all employees
- Why are people leaving? What do you want? What would make you stay? Anything else?
- Focus on orientation (most turnover occurs in first 6-months of working)
- Cater to Millennials who do not want health care or long hours
- Cater to baby boomers who want set hours and health care
- Look at compensation: are employee’s pay scale needs truly being met?
- Compare salaries between state, region and within company
- Provide scholarships for employees seeking higher education
Lundmark reported success in the implementation of these solutions, and urged everyone to find what works for their communities.
- Elise Renner is a student at Boston University.