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Vision for Yurok Long Term Elder Care

Vision for Yurok Long Term Elder Care. Indian Health Services Planning & Assessment Grant. Grant intended to determine the needs of Yurok elders and a plan to address those needs.

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Vision for Yurok Long Term Elder Care

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  1. Vision for Yurok Long Term Elder Care

  2. Indian Health Services Planning & Assessment Grant • Grant intended to determine the needs of Yurok elders and a plan to address those needs. • Intended to identify Elder’s needs in the Tribal Service Area (Humboldt & Del Norte Co) and for the Tribe as a whole. • Awarded September 2006 • Delay in activity the first year of grant due to staff vacancies

  3. Grant Goals • Design a survey instrument which will fill identified data gaps, assess cultural, religious and other values/preferences • Gather Current Information from Yurok Elders on their priorities and needs • Develop a Tribal Plan to address feasible priorities • Community Meetings to share results and plan • Tribe puts plan in action

  4. Native Elder Issues • Growing elder population with Boom generation • Lower life expectancy • Higher chronic disease rates • Higher health risk factors • Lack of screening • Lack of long-term care services in Indian Country • Changing family structure (NRCNAA 2008)

  5. Regional Variances • One size does not fit all • Variation in regard to life expectancy and chronic disease • Once you seen one tribe you’ve only seen one tribe (NRCNAA 2008)

  6. Our Approach to Gathering information and Developing a plan • Guided by Planning Committee. • Feedback about survey sought from Cultural Resources Committee (Elders). • In person contact with Elders at local gatherings. • Identified local persons to assist with presentations and contact of elders. • Gifts in exchange for elders’ time • Informing Tribal community throughout process (through community meetings & Tribal newsletter) • Original Plan included TANF participants interviewing elders.

  7. Yurok Elder Care Planning Committee • Representatives from agencies and programs serving Yurok elders: Yurok Tribal Council Yurok Social Services Advisory Committee United Indian Health Services, Senior Nutrition Bear River Band Yurok Indian Housing Authority Area 1 on Aging.

  8. Yurok Elder Care Planning Committee • Guided the entire the process of assessment and planning. • Selected, reviewed and modified the survey/supplemental survey. • Participated in preparing mail outs. • Researched resources • Offered valuable information and guidance to the team.

  9. The Survey, “Identifying our Needs: A Survey of Elders III” • National Resource Center on Native American Aging Needs Assessment • Health Status • Activities of Daily Living • Health Screening • Social Support/Housing • Social Functioning Supplemental Survey developed by Yurok Elder Care Planning Committee

  10. Survey Instrument The NRCNAA model uses: • Academically accepted design and methodology • Random sampling ensures fair subject selection • The results are independent from political influence • Informed consent, tribal approval, and tribal ownership • ensure tribal sovereignty is protected • The model developed with input from Native elders and • Native elder providers ensures respect for Native elders. • Ability to compare data to aggregate tribal data and national data. Useful for future grant writing and planning.

  11. Surveying Ideas • Face-to-face visits are highly recommended: • During a transport • At a meal-on-wheels visit • Have other young/able-bodied native elders make the visit • High School or college students can be asked to volunteer • Combine with a home health visit • Tribal employees taking a day to conduct interviews in the community Source: NRCNAA Website

  12. Efforts to Make In Person Contact with EldersGatherings/Focus Groups • Health Fairs • Yurok Spring Flings • Senior Meal Centers • Diabetes Support Groups • Yurok Cultural Resource Committee • Tribal Meetings • Tribal District Meetings • Phone calls to offer in person meeting for all elders 65 and older in Humboldt & Del Norte Counties

  13. Gifts/Incentives • Offered entry in a raffle for Pendleton blanket • Gift of a mug with Yurok basket design etched • Mailed out surveys all included bookmarks we had printed that had Yurok design and message in Yurok and English • Veggie bucks for produce from UIHS Potawot Community Garden • Meal/refreshments provided at focus groups

  14. Ideas for what you can give the elders to thank them for taking the time: • Traditional food or gifts • Casino/other coupons • A chance to bring other helpful items (one tribe connected their visits with safety visits to fix/install smoke alarms) • A meal • Your time and conversation • Other health promotion/prevention incentives, like pedometers, can openers for those with arthritis, etc. • Source: NRCNAA website

  15. Survey Response Rate • 1, 088 Survey were sent to Yurok Elders 50 and older • 268 responded • 170 of responses were from Humboldt and Del Norte Counties • The age group with the highest response rate was 60-69.

  16. Informing the community of Results/Plan • Elders and other Tribal members were informed of survey results and proposed plan to address needs. • At District/Community meetings and gatherings • Salmon Festival • Yurok Newsletter

  17. Survey and Focus Group responses are Consistent • Improved Coordination of Elders’ Services Improve access and availability of information • Support for Activities of Daily Living • Resources needed for Aging in Place • Transportation • Housing Repairs and Upkeep • Nutrition Concerns • Health Care Concerns & Prevention Activities

  18. The Proposed Plan • Three Phases Phase I • Develop a Team Approach • Elder Coordinator Position • Elder’s Council Phase II Increase current services, Increase # of gatherings Phase III Services increased further Site dedicated to Elder’s services

  19. Successes Some immediate needs were addressed: • High School students in Klamath volunteered to help elders with yard care/ household needs • Veggie vouchers for Community garden were given to elders • Good response rate to survey • Tribal Council approval of position to focus on Coordination of Elder’s needs

  20. Challenges • Buy in of Community--Tribal communities have participated in many, many surveys often without seeing benefits. • Changes in staffing led to staff unaware of original plan.

  21. Lessons Learned Be Flexible Changes to staff led to adjustments and delay to plan. Reciprocity is important Honor and value the time that Elders contribute by spending time with elders and/or small gift.

  22. Next Steps…. • Priorities • Coordination of Services • Regular check in with elders living alone • Help with ADLs • Coordinate Home modifications, particularly check on those with falls • Nutritional Health Potential Grants: Indian Health Services Elder Care Implementation Grant ROSS Grant

  23. Update August 2010, the Yurok Tribe was awarded the Indian Health Services Implementation Grant!! This is the second phase that will focus on developing the plan identified in the Assessment and Planning Grant.

  24. Questions/Comments What approaches have you seen work well?

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