Frances Stout
Bringing
Our Elders Home
Before
2003,Tohono O’odham elders, like the elders located on
many other reservations, had to leave their Nation and
go into the city if they needed skilled nursing care.
This was painful for them because they missed their
home and family; the food was unfamiliar; the
caregivers didn’t speak to them in their Native
language; and they couldn’t take part in traditional
ceremonies. Family and community members also found it
difficult and painful to be separated from their
elders.
Tohono O’odham elders wanted to come home. Their families
wanted to bring them home. Thanks to a determined group of
O’odham people, including Frances Stout, Tohono O’odham,
RN, elders can now stay in their home community for nursing
care, and even hospice care, if needed.
Building the Facility and Program
In the 1990s,
when family members complained about sending their elders
to nursing homes and other facilities off the reservation,
a task force was established to look into this issue.
Stout, who was then a nursing administrator at the Indian
Health Service (IHS) hospital on the reservation, was asked
to be a liaison between the IHS and the Nation. Stout and
the advisory group, which succeeded the task force, pursued
their dream for many years, exploring potential building
sites, hiring an architect, working with an advisor who
helped with the business plan and much more.
After Stout retired from the IHS, the advisory group was
still hard at work, so Stout continued her advocacy for the
project. She was amazed that the group remained so
determined to create a skilled nursing facility. After
serving more than 30 years as a nurse on three reservations
with the IHS, she knew that funding and staffing the
project would be an enormous challenge.
Later, speaking about the advisory group, Stout said, “They
were determined to have their own place with their own
people. Some of that passion rubbed off on me, We really
worked at it. We got the funding. Now the dream is a
reality.”
TONCA
board of directors. Back row L to R: Lee Olitzky,
Administrator, Malinda Folsom, board member, Frances
Stout, Chairperson, Janice Felix, Secy/Treasurer,
Richard Ramirez, Vice Chairman. Front row, L to R:
Judith Dworkin, Corporate Counsel, Priscilla Domingo
and Madeline Saklestew, board members.
In 2002, after almost 10 years of hard work, the
Archie Hendricks Sr. Skilled Nursing
Facility and the
Tohono O’odham Hospice indeed became a reality. In place
of the advisory group, there is now the TONCA Board of
Directors (also known as the Tohono O’odham Nursing Care
Authority) on which Stout serves as chairperson.
Elders
enjoy a variety of activities
Located
in the same building, the nursing facility and hospice have
60 beds and a staff of 130 people. Residents of the nursing
care facility include people who are staying for a short
time as well as people who will live at the facility
long-term. Residents are helped to feel valued, respected
and at home in the nursing care facility. “We have cultural
food,” says Stout. “We celebrate the traditional holidays.
We are open to families all the time. Families bring
potluck meals and celebrate birthdays. When there are
events on the Nation, we make sure that residents, who are
able, can attend these events, if they want. Residents take
part in the Nation’s well-known annual rodeo. They
participate in the parade and have won some awards.”
Children
entertain the elders
Hospice care is provided in elders’ homes in the community.
If their home is the nursing home, they can receive care
there. Occasionally people who receive hospice care in
their homes in the community need to come into the nursing
home for a short period of time, for example, to relieve
pain symptoms.
In addition to western nursing and hospice care, residents
can ask for traditional healers at any time.
Employees are Well Treated
The nursing
care facility requires employees with a variety of skills
and knowledge. Lee Olitzky serves as the administrator.
There is a medical director who is supported by adult nurse
practitioners, registered nurses, licensed practical
nurses, and certified nursing assistants. Several of the
nursing staff members have additional certifications in
such areas as wound care and intravenous medication
administration. In addition, the facility has a physical
therapist and an occupational therapist. Restorative care
aides work under the supervision of these therapists and
the nursing supervisor. In addition, a pharmacist and a
podiatrist serve as consultants to the nursing facility.
Each department is supervised by a trained manager and, in
most cases, an assistant manager. These departments
include, human resources, business office, social services,
therapeutic recreation, environmental services, plant
operations, and dietary services. Dietary employs a
part-time dietician.
Stout and her Board try to attract as many tribal members
as possible, even members who have left the reservation.
Today about 80 of the 130 nursing home and hospice care
employees belong to the Tohono O’odham Nation. Eight
employees are from other American Indian tribes; one is
Alaskan Native. All of the managers are Native people. In
the future, Stout and her colleagues would like to see even
more Native people working in the higher-level
administrative and health care professional positions.
Stout said, “We desperately need for our own Native people
to move into careers in which they care for elders.”
The nursing home and hospice invests in its employees.
Caroldene Garcia, Tohono O'odham, Director of Human
Resources for the Nation, said, "Our philosophy in part is
that if we expect the staff to provide a caring and
supportive environment for our elders, we need to ensure
that the employees feel that the nursing home is equally
concerned about each of them."
All of the managers have had special training, which
includes working with outside consultants. For all
employees there is regular in-service education, with
presentations and on-line computers courses. “Monthly, the
cultural director brings in people to speak about our
culture,” says Stout. “This is especially helpful for young
people and non-Natives.”
If employees want to pursue degrees in nursing, nutrition,
and other professions needed for the facility’s programs,
the Board considers paying their tuition. The desert Nation
is in a remote area of Arizona, so employees have access to
apartments on the campus and low-cost meals from the
nursing facility’s dining room.
Elder
Care Consortium
Stout and her
colleagues have not been content to sit back and enjoy the
fruits of their hard work. They realize that in order to
provide the highest possible quality care to elders, they
need to address the issues that have an impact on the
health of elders, for example, transportation, housing and
safety. Stout says, “We realized that there were many
issues that we couldn’t address on our own, so we
established the Elder Care Consortium. It consists of the
Tribal Department of Health and Human Services, the Indian
Health Service, the Tohono O’odham Community College, and
us. “We meet monthly and talk about the issues of aging,
says Stout. “We’re passionate about our mission.”
The Consortium wants to create a continuum of care for
their aging population. One idea that is already underway
is building an assisted living facility that will be close
to the existing facility. The Consortium is also hoping
that the college will be able to set up training program
for needed employees, such as nursing assistants.
Many Awards
For her
leadership role, in 2009, Stout was given the
prestigious Robert Wood Johnson Foundation Community
Health Leaders award. The
Foundation also recognized Stout for establishing the
Elder Care Consortium.
The Robert Wood Johnson Foundation award honors exceptional
men and women from all over the country who overcome
significant obstacles to tackle some of the most
challenging health and health care problems facing their
communities and the nation. The Foundation noted, “Mrs.
Stout takes the idea of ‘creating opportunities for growth,
leadership and power’ one steps further; she just doesn’t
facilitate the opportunities, she literally reaches out her
hand to others to assist them up that proverbial ladder.
She merits further recognition as she does not accept the
status quo health care for Native Americans; never has and
never will.”
The Archie Hendricks Senior Skilled Nursing Facility and
the Hospice Center (AHSSNF) itself was the recipient of
numerous awards, including a 2008 award from the
Harvard Project on American Indian Economic
Development, a 2008
local impact award from the National Indian Health
Board, a 2009 award from the Indian Health Service, and
a 5 star rating from the Centers for Medicare and
Medicaid Services.
The AHSSNF was also cited by the Wall Street
Journal as one of the
“Top Small Workplaces for 2009”. AHSSNF’s investment in its
employees was an important factor in its receiving this
award.
Stout says that the Honoring Nations award from Harvard
provided an opportunity to share their story. “When we
share our story about success, we always mention passion.
We feel if someone doesn’t champion an idea, it probably
won’t go. In our case there was a group of ladies who kept
approaching the Nation asking if we had money now for
starting the program.
“You also need a Government that listens to the people and
honors the elders. A lot of times when we say, ‘We honor
our elders,’ but there is no action taken to care for them.
In our case, we had executives who followed through with
the money. This made it possible to move forward with the
building and our programs.”
Other Rewards
Stout says,
“When I walk into our facility and see care taking place, I
know the caregivers are feeling good by the looks on their
faces – their gentle smiles. I think they get feelings of
satisfaction of giving back, maybe not to their parents but
to someone’s parents.” Stout also feels good about the
wonderful care the elders are receiving.
Stout herself is in her 70s. She drives two and a half
hours each way to the frequent board meetings at the
skilled nursing facility. “Fortunately,” she says, “the
scenery is beautiful and calming. I was raised with the
idea that as long as you are physically and mentally able,
you serve.”