Culture of Health Elderly Population Draft Framework

Elderly Population Group Member List

Contact Name / Organization / Email
Erin Johnson / Steering Committee- Group Co-Chair /
Nancy Frietag / Steering Committee- Group Co-Chair /
Jenny Senti / Steering Committee /
Tara Brandner / Steering Committee Co-Lead /
Lois Ustanko / Steering Committee /
Tracee Capron / Steering Committee Member /
Jessica Reier / Steering Committee Member /
Josh Askvig / AARP /
Shelly Peterson / ND Long Term Care Association /
Heather Wendorf / VA Dementia Care Clinic /
Lynn Mcgarry / Grand Forks Senior Center /
Donald Jurovick / UND School of Medicine and Health Sciences /
Nancy Joyner / Nancy Joyner Consulting /
Mary Ann Devig / Calvary Lutheran Church /
Jane Strommen / North Dakota State University /
Tammy Theurer / ND Association for Home Care /
Nancy Nickolas-Maier / ND Aging and Disability LINK/ Adult Protective Services/Ombudsman Program /
Delores Rath / Co-Chair Governors Aging Committee /
Tracy Regimbal / Quality Health Associates of ND /
Judy Beck / Quality Health Associates of ND /
Celeste Carlson / VA Community Health Nursing Services /
Trisha Chadduck / VA Caregiver Support Program /
Kathy Bauer-Kottenbrock / VA Hospice/Palliative Care /
Kari Jensen / Altru Health System /
Michelle Meyer / Wowicala Community Health Training & Consulting /
Margret Brown, RN / Spirit Lake Nation Senior Service Program /
Heather Lawrence, Director / Spirit Lake Nation Senior Service Program /
Mary Anne Marsh / ND Center for Nursing Board /
Karen Semmens / University of North Dakota School of Nursing and Professional Disciplines /
Kris Hendrickx / University of North Dakota School of Nursing and Professional Disciplines /
Carey Haugen / University of North Dakota School of Nursing and Professional Disciplines /
Becky Pfau / Hospice of the Red River Valley /
Gail Grondahl / ND Center for Nursing Board /
Darleen Bartz / ND Department of Health / Darleen Bartz

Andrea Lang – LSS – Erin Johnson

Good Samaritan society? Nancy Freitag

Dept of health? Patricia to email director

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 1: Mindsets and Expectations: Awareness of how our individual health affects others- and how the health of our communities influences our own- is key to building a culture of Health. Do our policies reflect our communities needs and values? These measures reflect how we as individuals, families and communities, and as a nation- think about health and well-being.

Examples: Value on Health Interdependence, Value on well-being, public discussion on health promotion and well-being.

What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Aging Services Division / Foot care clinics and education, rapid inspection health assessment, nutrition education at meal sights and home delivery programs. / Senior Centers / Older Americans Act
Alz. Assn / Education and consultation, families, public/community / State-wide program / State funds
UND college of nursing / Virtual dementia tour – simulation
Center for Rural health
Sanford Health
CHI/St. A’s / Community HealthAssessments / Community (any town with a hospital = 36 critical access hospital) / ACA, federal and private
NDSU extension / Education – variety of topics on well being of older adults / counties / State and county
UND geriatrics / Needs on geriatric education / Grand Forks / No funding
Churches – GF / Memory cafes – support, speakers / Fargo (new to Fargo), Grand Forks

What are ND’s gaps (geographic and programmatic) for this driver?

  • Ageism
  • Denial of cognitive changes in late life
  • Interest in decreasing burden to adult children
  • Lack of understanding of geriatric expertise and its value
  • Lack of providers’ knowledge and skills in geriatric principles of care

#4 and #5: Federal funding through workforce program – improving geriatric education; family members through health professionals. Opportunities to redesign HCS to implement geriatric principles into primary care.

Ongoing efforts to provide interprofessional education in geriatrics through post-graduate training programs in family medicine, internal medicine, NP programs.

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 2: Sense of Community:Residents of socially connected communities are more likely to thrive. Research suggests that individuals who feel a sense of security, belonging, and trust in their environment have better health. People who don’t feel connected to the community are less inclined to engage in health-promoting behaviors or work together for positive change. These measures indicate to what extent people feel a part of their communities.

Examples: Sense of community, social support.

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Senior services / MOW (meals + informal welfare checks), social activities, nurse/foot care, bone builders / Various communities / MOW – Older Americans Act;
Federal, state, local mix. United Way, memorials/donations
Community rec center / Silver sneakers
VA? / Senior olympics
Faith organizations / Informal and formal (bone builders) / Various communities
Senior services / Stepping on; injury prevention (maintain in home and socialization, meals) / Spirit lake nation / Fed gov. grant; federal funds
Sanford / Home visit program by paramedic / Fargo ND
AARP and YMCA / Social and exercise, health-focused programs / Bismarck ND
AARP / Driving program / Is this being offered anywhere???
Online communities? Chat rooms
UND / Senior philosophy program – monthly gathering of seniors around philosophical issues / EGF library
Lutheran Social Services / Companion program and senior volunteering program
Parish/church / Companion program / Nativity, others?
VA / Respite volunteers and companion program – weekly basis / Grand Forks, Fargo VA CLC
Senior Corps / National – do we have a state chapter?
Faith org / Grassroots – volunteers go to nursing homes/hospitals/homes: communion distribution, outings which may include to church, etc / Grand Forks, Spirit Lake
PACE program / Jamestown, Minot, Bismarck area

What are ND’s gaps (geographic and programmatic) for this driver?

  • PACE – limited geographically? Special requirements
  • Rural and frontier conditions influence availability of services.
  • People don’t necessarily understand the importance of community for the elderly. Social isolation occurs as people lose the ability to drive.
  • ND folks do not necessarily like to participate in “programs” or ask others for ongoing help.
  • Cultural gap – how you approach tribal communities – unique needs
  • Transportation – difficult to participate in programs when can’t drive, resistance to using other types of transportation.
  • Portland, OR has free public transportation – how do they do this?
  • Don’t want to wait for public transportation
  • Confusion/worried about using transportation services
  • Senior rider in Grand Forks through area transit – reluctance to sign up (financial?)
  • Senior center offers half price tickets for eligibility criteria

HRSA grants, pop. 300-400, bone builders “we exercise and then we go have pie”

Various ages and functional abilities –do we have programs

Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?

Driver 3: Civic Engagement- Civic engagement creates healthier communities by developing the knowledge and skills to improve quality of life. Voting and volunteering are among the many measures of an engaged population. In both cases, people’s actions show they care about the outcomes of their community or their nation, and they want to cultivate positive change. These Measures reflect whether individuals feel motivated and able to participate and make a difference.

Examples: Volunteer engagement, voter participation,

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source

What are ND’s gaps (geographic and programmatic) for this driver?

  • Inability to drive prevents elderly from voting.
  • Lack of engagement may inhibit awareness.

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 1: Number and Quality of Partnerships: Research indicates that building relationships among partners is the most challenging aspect of creating change. Measures look at how organizations are working together to improve health and well-being.

Examples: Health department collaboration with community organizations, school districts, workplace health promotion

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Parish Nurses
Streets Alive Collaboration with NDSU Extension / Wellness/Fitness / Fargo/Grand Forks
YMCA programs / Wellness/Fitness
Senior Centers / Nutrition/Community Gardens

What are ND’s gaps (geographic and programmatic) for this driver?

  • Many of these are community based and not statewide. Websites have great info and links for elderly but there is no funding for marketing to advertise.
  • Many gaps are geographical – most resources concentrated in larger cities and eastern part of state.

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 2: Investment in Cross-sector Collaboration: In addition to measuring the quality and quantity of cross-sector collaborations, it is important to track investments that support these partnerships. Corporate and federal contributions have the power to influence our nation’s health, both directly and indirectly. Measures help identify whether there is adequate financial support to enable cross-sector partnerships.

Examples: US Corporate Giving, Federal allocations for Health Investments,

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Sanford / Looking at services available and those not available / Southern ND / Martha Cargill Grant
AARP funding for making communities livable
Greenway project
Governor’s Main Street initiative / Fitness/Walking / Blue Cross Grant
Great Plains / Deliver fresh produce / To smaller communities / USDA funding
Spirit Lake / Farmer’s Market for healthier foods, focus on nutrition, food distribution center / Tribal locations
Margaret Cargill organization/foundation / grants
Blue Cross Blue Shield / Fitness/wellness discounts
AARP / Make community more livable / grants
USDA / Business and industrial improvements

What are ND’s gaps (geographic and programmatic) for this driver?

  • Availability of food sources to rural and elderly
  • Geographic limitations; access to services

Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?

Driver 3: Policies that Support Collaboration: Policies play a key role in encouraging and maintaining collaboration across sectors, as well as creating incentives for different sectors to contribute what they can to the cause of improving our nation’s health. Measures highlight some of the policies that have the potential to catalyze widespread improvement in health and overall well-being.

Examples: community relations and policing, youth exposure to TV ads, climate adaption and mitigation, support for working families

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
QSP programs/ Caregiver support policies / Care in Home / Statewide / State and Federal Funding. This is something well-funded in ND
TBI intiative, brain health
Elder abuse initiative / Policy/advocates / Fargo / Federal funding
Spirit Lake
Parish Nurses / Both go into homes to educate families and elders to keep them in their homes.
FMLA / leave for people to care for families
Rape & abuse center / Includes elder abuse advocates / Fargo / Federal???

What are ND’s gaps (geographic and programmatic) for this driver?

  • Not everyone has the Family Medical Leave Act as a benefit. Need shelters for older abuse victims.
  • Family caregivers-do we have healthy families? They are relied on for caregiving.
  • Elderly who live alone have no one to help them. Some don’t want help in the home because they don’t want anyone to see how they live and/or force them out of the home.
  • Poverty: some families rely on 1 social security check for the entire family
  • Increase awareness that family members could be paid to caregiving services
  • Should we include law enforcement. They are very important in the rural communities. Law enforcement often knows intimate details of people and/or their families that health care workers could benefit from knowing in order to help in careplanning.
  • Spirit Lake spoke about having conversations with patients and county services in order to keep people in their homes. Noted there is a lack of resources/staff to go to communities to have the conversations regarding providing resources to keep people in their homes safely.

Creating Heathier, More Equitable Communities: The places where we live, learn, work and play contribute to our ability to become and stay healthy.

Driver 1: Built Environment: Health-promoting environments are safe, affordable and provide access to exercise and nutritious food. Feeling safe in our neighborhoods will also allow us to take full advantage of the space around us. Measures gauge whether our physical environments support well-being.

Examples: housing affordability, access to healthy foods, youth safety

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Silver Sneakers / Exercise/walking / Not sure all locations. Fargo. Grand Forks, etc. / YMCA, insurance offers discounted memberships
Community fitness centers
Ashley, ND has exercise program in Senior Center / Safe indoor spaces / Various, Turtle Mountain / Blue Cross and Bremer
UND piloting a personal trainer program in collaboration with Sanford. / Grand Forks
National Meals on Wheels / Mail meals to rural communities, including UPS home delivery
Local frozen meals – not sure which community or organization / home delivery
Independent living communities for 50+ / Open
Sanford / Personal training / Grand forks?
Property tax relief for people with disability / Available statewide?
Spirit Lake food distribution center / Food distribution with transportation and nutrition educator on site.

What are ND’s gaps (geographic and programmatic) for this driver?

  • Assisted living facilities are costly so not available to lower income people and not all smaller communities have them.
  • Many transportation issues. All programs depend on transportation.
  • Healthy food is more expensive, need to shift that so it is more available.
  • We learned that there is Property tax relief for homes with someone with disabilities but many don’t know that.
  • Difficult for elders to use the above services in the winter.
  • Ability or knowledge in how to cook, meal planning, or how to grocery shop
  • With loss of one spouse, decrease in Social Security payments
  • Someone mentioned (maybe with quality improvement?), there are diabetes self-management education classes that collaborate with other organizations for healthy food options.

Creating Heathier, More Equitable Communities: The places where we live, learn, work and play contribute to our ability to become and stay healthy.

Driver 2: Social and Economic Environment: Our social environment influences a community’s sense of trust and cohesion. Factors like enduring racial and socioeconomic segregation have an impact on community health. Research points to strong connections between our environment, economic prosperity and health. Measures identify social and communal factors that influence wellness.

Examples: residential segregation, early childhood education, public libraries

What is happening in North Dakota for this driver? Is there work being done in this area now?Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.

Entity/Organization / Brief description of Action / Location / Funding Source
Lutheran Social Services / Creating safe housing for seniors / Small communities
UND School of Medicine / Home visits for senior new Americans / Grand Forks
Cultural Senior Centers / Provide ethnic meals and English classes / Fargo

What are ND’s gaps (geographic and programmatic) for this driver?