The Best of…New Strategies Needed to Reach Minority Seniors

Published April 16, 2001, Pawtucket Times

As expected, the U.S. Census Bureau’s 2000 census data reveals that the United States of America has truly become a “tossed salad” of races and ethnic groups.Rhode Island’s growing minority population reflects this national trend.  Minority groups represent about 25 percent of the state’s total population.  In Providence, minority groups are now in the majority.

The Hispanic population in Rhode Island, now representing 8.7 percent of the state’s total population, has doubled in the past ten years, climbing from 45,752 in the 1990 census to 90,820 in the latest census figures.  Eighty percent of this increase has occurred in Providence, Pawtucket and Central Falls.

Aging service providers will need to adopt new strategies and ways to enhance access to programs and services to a growing Hispanic senior population.

Census data does not always give us an accurate demographic snap shot of the nation’s population, warned Edgar E. Rivas, Vice President for Policy at the National Hispanic Council on Aging.  “We really don’t know how many Latino elders are out there because of the potential undercount of immigrant Latino elders,” he stated.

Oftentimes, Hispanic families are not accurately reflected in census data because of their own distrust of the U.S. Census Bureau, Rivas told The Times.  . “Even those aging service providers who have a knowledge base of serving this population will have a very hard time if the undercounted seniors come out of the wood work,” he said.

“Aging service providers will have to relearn how to conduct culturally appropriate outreach and to provide services in ways that are comfortable to their Hispanic clients,” Rivas added.  To often Latino elders may be eligible for services but because of the way the services are delivered, they don’t feel welcome to the services, he noted, ultimately the choose to rely on informal caregivers or just go without services.

According to Rivas, informational materials about programs and services will have to be rewritten to reflect the specific needs of older Hispanics.  For instance, the Health Care Finance Administration offers bilingual materials to explain federal programs, like Medicare and Medicaid.  Even with this material written in Spanish, many aging Hispanic elders are intimidated by the way the information is presented.  This problem can easily be corrected if Hispanic aging advocates develop more user-friendly materials (e.g., using Spanish language videos, peer educators or literature using pictures to illustrate issues).

Ann Hill, former director of the Providence-based Saint Martin de Porres Senior Center and well-known aging advocate, states that with a more ethnically diverse population, nonprofit agencies must hire personnel that can reach out, understand and meet the needs of various ethnic groups.  She calls for more public dollars to be provided to the agencies to help them accomplish this goal.

,Joan Crawley, Senior Center Director at the Leon Mathieu Senior Center, agrees.   With interpreters who speak Spanish and Cape Verdian Creole at Pawtucket’s senior center, non-English speaking CapeVerdian and Hispanic seniors can now come in to see a primary care physician, with a social worker on hand to interpret their medical complaints and to explain treatment plans.  The social work is also available to case manage any of the other social service needs that the Hispanic or CapeVerdian client may have.

“We’re always trying to increase the trust level between our staff and the ethnic seniors who come to our senior center,”Crawley added, noting that she wants them to feel comfortable bringing their problems to her staff.

Susan Sweet, Chairperson of the Rhode Island Elder Minority Task Force and a consultant for minority and nonprofit agencies, commented that she applauds “the efforts of agencies serving elders to diversity their staff and services to serve all the elders in their communities.  However, it is extremely important to acknowledge, support, and strengthen those agencies that have been and continue to be the basic resource for minority elders, such as Progreso Latino, Cape Verdian Community Development Association (CACD), and Projecto Esperanza, to name a few in the Pawtucket/Central Falls area.”

“No longer can we do business as in the past.  We must update our strategies of delivering programs and service to meet the new century of diversity,” Sweet said.

New AARP Director Working for New Office

Published in Pawtucket times on April 9, 2001

It was a rigorous and long process for those seeking the position of AARP RI State Director, stated Kathleen S. Connell.

One evening two-months after submitting her application, Kathleen reminded her husband to write out a check for $10 to renew their AARP membership.

At that moment the phone rang and the caller stated he was from AARP. Kathleen chuckles now thinking that for  a split second she thought the phone call was to remind her to renew her AARP membership.  The call was to schedule her interview for the job.

“It’s been intense learning curve in the last four months,” admits Connell, who came to the job with a variety of professional experiences, nurse and health educator, state senator, and Secretary of State for Rhode Island.  She has been very busy learning about the national and state organization, meeting local membership and planning to opening of AARP’s headquarters in Providence.

“We have surveyed the market and reviewed submitted requests for proposals and visited properties with AARP staff from Washington, DC, Connell told The Times.

She expects a site in Providence to be selected within the upcoming weeks because AARP’s National headquarters want state offices to be located at the state capitols.

Rhode Island’s AARP office, staffed by the Rhode Island State Director, Associate Director for Communication, Associate Director for Advocacy and an Office Manager, should be up and running and fulling staffed by September 2001.

“It was a bold step for AARP’s volunteer board of directors under the leadership of Horae Deets to decentralize f rom a regional level and to bring their offices to the state level to better serve its membership,” Connell said, noting that this effort involved a huge commitment of resources and time to establish 32 state offices throughout the nation this year.

It’s obvious, “having a presence in Rhode Island will be a factor in increasing AARP’s visibility at the statehouse, added Connell. Having a state office in Rhode Island will also be a catalyst in helping the group recruit more older Rhode Islanders to participate in the nonprofit group’s committee and activities, she said.

By having an office in Rhode Island, “We want to continue to raise the awareness in AARP membership about what the membership driven organization is doing within the state and at the federal level.

According to Connell, a new volunteer structure will be designed to bring more diversity and flexibility into the volunteer experience.

“One of the concepts that we will be exploring is the use of episodic volunteers, people who do a specific project, disengage and come back to work again on a future project.”

As the AARP begins to reach out to the aging baby boom generation (those born from 1945 to 1954), research tells the nonprofit that this demographic group because there is more leisure time available to them.

Connell states that the AARP will begin to actively recruit aging baby boomers to join AARP.

While you got to protect the current generation you must begin to watch out for those that follow,” she says.

Finally, Connell wants all to know that the AARP is a tremendous resource for members and nonmembers alike. She stated that on a number of issues that affect people age 50 and over, the group’s research is widely recognized for excellence and objectivity, adding that the data findings can be used by almost any group with confidence.

Medical Staff Shortage Hits Nursing Homes

Published in the Pawtucket Times on April 2, 2001

In 2001, a crisis is looming in how we care for the frail elderly in nursing homes throughout the state.

Both nursing home providers and long-term care advocates are working together to publicize this tragic crisis, a shortage and turnover of certified nursing assistants in the state.

High job turnover rate of certified nursing assistants is drastically impacting the quality of care provided in both nursing homes and home health agencies.

And this direct care staffing shortage is also financially hurting facilities, too, reducing their financial stability.

According to Hugh Hall, nursing home administrator and Chairman of the Nursing Home direct Care Staffing Task Force, testifying at the hearing at the General Assembly, vacancy rates for certified nursing assistants, in nursing facilities has reached 21 percent with turnover skyrocketing to over 82 percent.

With these startling statistics, this staffing problem must be on the radar screen of Governor Almond’s policy staff, state legislators and state officials. If not, we’re edging closer to a quality care disaster in nursing homes.

Nursing home administrators live with a staffing shortage every day, most are forced to temporarily hire certified nursing assistants from nursing pools at the rate of $ 23.50 an hour.

Quick fixes, like relying on nursing pools, are quickly chipping away at the facility’s financial stability. And the state’s Medicaid program drastically under reimburses for these staffing costs.

Every day, it takes compassion, ongoing training and continuing education, physical and emotional endurance and perhaps a sense of humor for certified nursing assistants to care for frail elderly nursing home residents.

But, like in many professions, money talks.  With an average starting wage of $ 7.69, large numbers are now beginning to walk away from the long-term care field. Yes, its obviously easier and less stressful to work at a fast-food restaurant. One has employment options especially when the local newspapers are filled with help wanted ads. This is reflected by the testimony of a concerned Hugh Hall who recently stated at the members budget hearing of the Department of Human Services that only half of the 26,000 licensed certified nursing assistants in Rhode Island are currently working in the long-term care field.

Like other states, the percentage of Rhode Islanders who are over 65, age 75, and even age 85, who require increased skilled nursing and medical are rapidly growing.

The number of Rhode Island centenarians, now numbering over 200 is expected to dramatically increase too. Moreover, the growth of the over 85 population, who will require more services and supports from certified nursing assistants, will drastically strain the existing long-term care delivery system.

The certified nursing aide crisis impacts on family members too, states Roberta Hawkins, Rhode Island’s Ombudsman and Executive Director of the Alliance for Better Nursing Home Care.

Hawkins says, “Children, grandchildren, and aging spouses, are all worn out from making daily “feeding visits” to help short-staffed facilities ensure that loved ones receive (and eat) hot meals.” The informal helping hand is now an unpaid, but very necessary part of the facilities daily care team, she says.

With the demographic time bomb ready to explode, its time to get serious to fix this problem. Governor Almond’s proposed FY 2002 budget which allocates $ 10 million dollars across the health care continuum to address this critical shortage is an inadequate response.

Both nursing home providers and the Alliance for Better Long-Term Care, the state’s Ombudsman for the frail elderly, call for an infusion of $ 14.1 million of state funds to leverage $16 million in federal dollars to pay a living wage for direct care workers.

Increased funding is only the first step to fix this problem. Both consumer advocates and nursing home providers also see a need for a career ladder for certified nursing assistants, and increased funding for training sites for individuals to become certified nursing assistants. Some have said that a society is judged by how well it takes care of its elderly. If so, let’s  hold up states to that high standard, too. The Rhode Island General Assembly must make a commitment today’s commitment to today’s home residents for their families, and to the growing number of baby boomers who might require nursing home care in the upcoming years.