(upbeat music) Entrepreneurship, small business creation, home ownership and collaboration have always been the backbone of our local economies. With all of that under threat and communities fighting against further division, conversation mill turns on the mic for everyday difference makers in our local communities. Whether they be farmers, mayors, builders, creators or doers. Every week, join me, Rebecca Dale here in conversation. (upbeat music) Last year, I had the opportunity to sit in conversation with the Executive Director of Mountain Care, Elizabeth Williams. She was such a joy to talk to and the topic of caring for aging adults can be difficult, but it's an important and necessary conversation. I wanted to replay this episode to continue to bring attention to the caregivers out there caring for aging adults and specifically caregivers out there caring for aging adults with cognitive decline. Whether it's family members or organizations like Mountain Care, we are all aging. We will all experience providing care or needing care. So how can we offer support now or how can we set up support systems for our loved ones or for our future selves? That may come in the form of supporting organizations like Mountain Care and others locally where we live. Please join Elizabeth and I in this replayed conversation from this time last year. And as always, thank you for listening to Conversation Mill. (upbeat music) Executive Director of Mountain Care, Elizabeth Williams sat down with me in the conversation that follows surprised me in the best way. Elizabeth has a thoughtfulness when it comes to the beauty of the declining period of our lives. And it makes her the perfect fit for her role. This conversation woke me up too and I believe will wake you up to the need to fund adult care facilities and those that work in them providing a break for family caregivers. I will let the conversation speak for itself, but before we jump in, let me share the mission of Mountain Care to give you an understanding of who they are. Mountain Care provides supportive and enriching adult day services enabling older adults to age in place. They aspire to be an unwavering partner for adults and those who care for them. Together, they encourage independence, provide meaningful connections and build community. Now please join me in conversation with Executive Director of Mountain Care, Elizabeth Williams. (upbeat music) Let's begin with share a little bit about who you are and what your background is and how you came to this career. - Yeah, so a pretty untraditional path, I think. I didn't enjoy aspects of school, but I went to college as it was kind of expected and then I was in business and I dropped out on my third year and it was up north and just like, I'm not doing this anymore. This doesn't make sense. I'm done with society. Like, this is just, you know, mobility is young, et cetera. So really was looking for a different way of life and a different way of being in the world than it felt was available to me through education. So I ran away to the West Coast with the idea of starting like a pretty grandiose, like commune new world order kind of thing. - Sure, okay. - Not where you thought this was going, right? And I did it with a friend. We were both like, you know, brainstorming this and we decided that I needed carpentry skills to achieve this grandiose dream of, you know, people are gonna need to live in this new world we're creating, right? - Yeah. - So I became a carpenter, a local 547 in San Diego, a union carpenter, and I thought, you know, skinny little girl, I don't come from folks who build things that are not mechanically inclined and necessary, I didn't, I never picked up tools really before I did that for school. So I was like, yeah, I'll get fired quick, right? I'll learn some stuff and that would be, you know, great. But I didn't get fired and I kept on getting different careers and getting pushed up to the top and it was very stressful and it was a lot of responsibility. It was large construction projects that I was running, multiple construction tasks in a hospital environment and I knew everything about seismic codes and fire codes and hospital and it was just like, I'm like, what am I doing? What happened? Like, you know, 15 years go by and I'm like, this is not the commune, that was annoying. Like, what happened? Life just, woo, just, yeah. Brought me somewhere that I did not intend to go and so I took some time off, I took a few years off and kind of exploring what I wanted to do. I went and lived in a commune and I went and visited a bunch. I traveled around the world and in that time, I also spent time with my mother who was taking care of my grandmother who had cognitive issues and so my mother was working full time and my grandmother had come to live with her and I also spent time the last six months or so of my spouse's mother who was dying from cancer and so I spent six months with her in hospice and those two experiences being someone through the death process and really being able to be there with her through that and then also seeing what it was like to be a caregiver and the cognitive issues and I was like, yeah, I think there's something in here that I want to do and in my other career, I volunteered a lot, I worked a lot and I volunteered a lot and so I really wanted to do something more of service and bring that together and so I started exploring that and I thought maybe I'd be an OT or PT or something in the healthcare kind of field and so I became an employee at care partners and then I came into adult day and when I came into adult day, which is a program for folks primarily that have cognitive issues, but also folks that are just having issues with aging, that's primarily what we do and we have about 50 to 70 people here a day that are aging with cognitive issues and I walked in and I was like, oh, this is where I want to be, this is what I want to be doing and I just love, there's so much about this that I love, it's real, it's authentic, it's supporting people where they are, it's honoring, I feel so much in our society, we're so unbalanced, we honor growth, we rejoice over growth and growing and expanding and doing and being more and we don't, that's only half of it, right? We all live and grow and become and then we also all work towards dying and diminishing and leaving and I really liked being part of that other process but there's just as much love and wonder and mystery and curiosity in this other side and yes, there's a lot of sadness and hardness and difficulty with it, but there's also just some really amazing experiences in this too and this decreasing this and so we get to do that here. We, another piece of it is we get to see how people love those that they're caring for, like the life of a caregiver for someone who has cognitive issues, it's intense, it's really, really hard, unimaginable task that is put on millions of people aging for some, caring for someone who's aging. The way that, so the way that we, I mean, so, yeah, so caregiving, just really intense, I say all the time, I can barely take care of myself at 50, I mean, it's a full-time job. Making sure I'm resting or exercising or eating or hydrating, keeping the house clean, keeping myself clean, like it takes so much to do that. Nevertheless, working or taking care of someone else and in the, in part of, I think what's difficult about this is that there's not the hope and the joy of when you're taking some care of a child who's growing, there's this loss and there's this diminishing. And then there is also, they are coming from being a full adult and doing all of this themselves. And now you're having to navigate that if it's your mother or your father or your spouse. None of it's easy, aunt and uncle, it's all challenging. What you're experiencing of it and then they're experiencing of it. But what we get to see is the love of people doing it day after day after day. We have people who've been coming for years and years and years. Even when they come just a few years or a year, it's still, there's just so much love in it. That one story around that is we, there's this husband and wife, the wife had cognitive issues. She was a stunning woman. You could tell just from her clothes that who she was in the world and how she looked was something that was very important to her. And now it was her husband that was picking out her clothes. She had cognitive issues. It was her husband that was picking out her clothes, getting her dressed, just doing her hair. And he would do like an awful, awful job of her hair. Like he would curl it with the curling iron that he didn't know like to brush it out or something. So it'd always like stay in these tight curls. But I never said anything to him 'cause I just loved seeing that he was the one that was like taking that time, like every single morning to bring her 'cause he knew that that was like important to her. So like come and it was just, it's just so, it's these little love in these little ways. And so we see that and get that a lot. Who are the primary patients or I shouldn't say patients, but individuals that you have here on a daily basis, is it when you say cognitive, I guess, can you inform our listeners a little bit more what you mean by that? - Yeah, so typically people say dementia and I don't like that word. I don't like the connotation of demented. And it's the word that we're really using to refer to our elders. Like there's cognitive things, there's things that are happening in their brain and those things can be vascular dementia. It can be Alzheimer's, it could be Parkinson's. So it's the brain that's aging in a way that's causing cognitive issues. And so I just usually do it in a broad way of just cognitive issues. And dementia, it has a really negative connotation to it. I think already, particularly when you break it down to demented, I don't think, not that any of us want cognitive issues, but I don't think any of us want to grow up and be demented like this. - Right, right. - And then I think that the the censure for me was, when I was like, yeah, I'm not gonna use that anymore. I'm not saying that anymore. Was when that awful shooting in Las Vegas, so it was the shooting that horrific where the gentleman killed so many people at that concert. And the president had a statement that was like done a lot of headlines and it was like that gentleman was demented. And I thought that that was an accurate way to be describing him. Obviously he had mental health issues and such, but like, I'm like, yeah, so we're using the same word to describe my grandmother, our grandparents, our husbands and wives, whatever, that we're using to describe this mass shooter in Las Vegas and decided to make that change. So that's who we serve. Primarily it's folks that are having cognitive issues. Due to aging. It could be physical issues due to aging. So cognitively, they're doing fine, but maybe they're just not able to get around on their own. Maybe they need special diets. We have a nurse that's here for most of the day. So there's skilled support here. We serve meals. We help people go to the restroom if they need it. We serve special diets if they need it. And it could just be folks also come for socialization. So part of what the challenge around adult day is that this is a place that you have to come. So we have to create a place that people want to be. And so what it means is really like you're in your 70s or your 80s or your 60s and you're having to get up. Like you're retired now, but not, you have to get up. You have to get dressed. You have to get out of bed and you have to come to this place. And so we do that. We may get a place that people want to come to for both the people that are spending the day here with us and for the caregiver because it goes back to that caregiver. It's hard enough taking care of yourself. Nevertheless, someone else, you need that respite. You need a little bit of break. You need to be able to go to the grocery store without having someone there that needs your full on support or attention instead of buying the groceries. And so we want to make that easier for the caregiver. And then we also, if the participant, the person that's coming and spending the day here is enjoying themselves, that's better for the staff, that's better for them. It's just, it's win, win, win all the way around. - The caregivers that bring individuals here for day services. So I'll just use myself as an example. If I had to bring my mother or father here, under what circumstance am I maybe choosing you versus in-home care? Is it, I can't take on the financial burden of affording someone to come in or the individual that needs care doesn't have the insurance to cover it or the money in the bank to cover it. And so they're coming here or, I guess, what's the situations that? - Yeah, good question. So there's lots of different reasons why people would choose adult day versus in-home care. Some of it is financial. So some of it is, is there is funding sources that pay for adult day. There are limited financial resources that pay for in-home, but there's not as many. In-home is much more expensive. So we have a one to six ratio, so we need one staff person for every six folks that come in minimum. We, and it's part of, I think, the conversation that this country needs to be having, as far as making sure that infrastructure around aging services is there to support all of us that are aging. And so this is a whole other topic that I love to talk about. - Yeah. - And so just being in aging services, I have been saying, and others, pretty much all of us in aging services are, we're not ready. We're not ready for those that are aging into the system. We don't have, we don't have the staffing, and we don't have the funding. The infrastructure's not there. And it's not just here in Buncombe County, in North Carolina. It's really across the United States and across the country, same thing. And across really Western European countries, there was a WHO, a World Health Organization webinar that I attended a few months ago. And so the World Health Organization named, I don't remember, you can look it up if it's necessary, but it was like the decade, they just put aging services, aging as a top priority, and they made some declaration of, we need to be supporting this work and sure came up with a plan on how to be doing this. And so they were giving an update. They've been doing the work for a year. And so some of the things that they were just citing in this worldwide WHO, looking at where we are as a world on the population shifts that's coming, and has already started as already impacting labor, as already impacting healthcare, looking at where an AARP international was also part of that work. And countries don't have, a minimal countries have aging plans, even half of the countries that have aging plans are not funding those aging plans, another half of those don't have, they might have funding, but it's not like a full time person that's doing that work. So the aging plan might be something on the website, it might be something in a file drawer, it might be something in a binder, but if you don't have staff, if you don't have funding, those aging plans are gonna get implemented. - So just one of the counties here, they, it's astonishing to me how the cities and municipalities are slow to understanding the need. One of the positions here locally, they have adult protective services under them, and they also have homelessness under them. In addition to aging, it's a lot. - It's a lot, a lot, a lot of work, and that's only one of the counties that I know that actually have something funded there. And there is an aging coordinator, an age-friendly coordinator that is providing 40 hours of support to the age-friendly initiative, but that position's been there for maybe a year and a half versus five years ago, 10 years ago, and so they're doing great work, and it's, thank goodness they're there, but we're all, and it's not just, we're all behind the eight ball. - Yeah, there's so many pieces to that too to unpack, and I don't know if we're getting too off of the topic of just mountain care, but let me just kind of ask you, in some cultures where living with or bringing your aging parents into your household is just common practice, and then your kids grow up with their grandparents in the house, and so you have like this, not only built in childcare and in support, but then when they start aging, and like you mentioned, that process of wonder and what comes next, and it is a beautiful time. It's a sad time, but it's also a really educational time for those of us who are going to follow in their footsteps eventually, right? So we don't have a lot of that in American culture. We are influenced by it by other people who have come to America as immigrants and demonstrate that, I think, for us really well, but it's more rare to do that. - And part of that is that we have created a culture that's a two income families, and so you don't have traditionally the woman that's staying at home to be caring for the children and then caring for the parents. I mean, that's the shift, right? Like there's a biological driven timeline, and if we're sending folks out of the home and they're not able to be there, and even just like if you think about, I mean, just agriculturally based society where the men typically are working on the land near, so like if dad needs help getting into whatever, there's a second set of hands there if needed. Going, yeah, so there's lots of things that are shifting the way that we care for those that are aging. A lot of it is, I don't know if you've read being mortal. - I have, yeah. - Yeah, so I mean, a lot of it is just the medical interventions that we're able to do now, and how the life expectancy has so increased that there's more of us that are aging, which means that I shouldn't say there's more of us. We're living longer. There's more possible physical cognitive ailments that can be happening to us, and then there's also so many more people that are doing that and that we don't have the folks to be taking care of us if it's in our home or hiring someone. So going back to the, why would people utilize adult day? Why would they come here adding a little bit to the conversation and what, and to that answering that question? So some of the reason why people come here is because there's a social aspect, so there's folks that want to be out in the community and want to still be contributing and want to be part of a community, and so we really tried to create that. So that goes back to we want people to want to come here and so not everyone wants to retire and play bingo. Like, I mean, people want to still have purpose. And if you were like a lifelong volunteer person, you still want to give to your community. You still want to be doing those kinds of things. And so we really put a lot of work into creating that community for folks. Some of that is social. I think one thing that COVID has taught us is the difference between being a person with people and that the energy exchange is that there's, it's not maybe something that can be measured, but if you're paying attention, it's really different. - Yes, yes. - Being with someone energetically, then being isolated and how social connections are really important to our physical and mental health. And so not wanting to isolate in a home with home health. - Yeah. - But possibly for the introvert, maybe that's what they want and need. And they're happy as a clam to be there. The other part of that is maybe the person that's caring for the person that's aging. Maybe they need the house to themselves, to clean. - Right. - Maybe they don't want someone in their house. There's also that. Some people are really like, you know, weird about stuff like that. Oh, it's their personal space. They don't want to be having other people in that space or feel uncomfortable in that space or not safe having a stranger come in to take care of mom and dad. Is mom and dad going to be safe there? Then there's also the labor issue. So just recently someone was talking to me about their mother-in-law. So I think they said they called like six home health agencies. And this is a person who has the means to hire whomever they need and want. So that was not a restriction financially. They called six home health agency. Three of the agencies never called them back. One of the agency called back and said they didn't have availability. And then the other two agencies did call back with availability, but not to fit the schedule that they needed. So it was basically, that's what's happened. There's not the help to come in. It takes, in order to have everyone age in place. So like 80%, I think of people when surveyed, they want to age in place. They want to age in home. They want to age in community. So what that means is that there needs to be a labor infrastructure that's going to support those people who are aging. And not everybody needs that. So like I just want to acknowledge that, there's 80 year olds that are outplaying tennis and hiking and physically and cognitively are doing great. And there's good genetics and taking care of your body and your mind for your life. You can have a long, healthy life, but there's also a lot of other folks that are needing something as they age. And so we really feel that we're part of the aging in place infrastructure that needs to be there in order to allow people to age at home and age in community because of the expense, because of the social community aspect of it, expense, social community aspect of it. And because of the labor issues. - Speaking to that labor issue, how do we get more people interested in this kind of work? Where does that, I work with home service professionals and they're in the same boat of, nobody wants to learn how to become a plumber anymore because we've all been sort of, which I left college. You just explained that you left college. I've talked to a lot of people that have left college, but we were, we all started it 'cause we were told that's what we should do to rise above our parents' generation. And some of us found out that wasn't our path to success, but that's still the mindset of the culture. And it's not as promoted to go into something like end of life care or even nonprofit work. So how do we, where do we start with that? How do we re-engage the youth into being part of this? - I don't know. (laughs) It's a good question. Yeah, but I'm not sure, I'm not sure how to, yeah, yeah. I mean, it's just conversations like this, conversations that lots of people are having, being books like being mortal. There's more to life than what we've been told, what the past that have been laid out that we've been told lead to happiness and success and allowing for different paths to get there. And then also having a better understanding of what success and happiness looks like. I think it's been a very narrow path in lots of ways of what's acceptable and very ill-defined. And I think more and more people, I don't know if that's really true. I can't really quantify it, but it feels like there's shifting and new awareness. And I think a lot of it's the rising cost of college and university and it just feels like that was another, it was another part of capitalism that we were sold as a product and we're now rejecting capitalism in a way that I feel like I was shouting about when I was dropped out of college in the late 80s. Now, I think it has bigger traction, there's a bigger conversation around it. A lot of people have tried the capitalist route, tried the money route, saw that it didn't lead to success, it didn't lead to happiness. One of the, I think, reasons, I grew up in a pretty affluent town. People had money and I saw that people weren't happy. I saw that there was not real satisfaction. There was something that just wasn't right. And I remember learning. It was a doctor and his wife prominent, by all means happy, white picket fence, beautiful kids, beautiful house, everything. And then I learned that she was like self-medicating herself just to get through the day. And it was just, yeah, this, so what's wrong with you? You're telling me that this is what happiness is, this is where I wanna go, this is what I need to pursue. Well, I'm seeing someone that has all this and they're not happy. How comes no one's explaining to me that what's going on here, it's not making sense. And I feel like that has really expanded and that so many of us know that that's not happiness or success. Yeah, and I think you're spot on with that of to our culture has become to just like bright, shiny things, right? Like whatever's fun or funny on TikTok or whatever looks pretty on Instagram. And this kind of work is probably the opposite of that. And also you have the disadvantage of you can't really highlight the beautiful part of this work when an individual that comes here for care is laughing and joyous 'cause they're with community and they're creating a memory or they say something brilliant out of nowhere or they, whatever it is, because you can't, unless you have the consent of these people, you can't really highlight the joy that you get to experience. Again, even though it may be sad when you're working on these individuals, right? So it's like, how do you highlight this work in a way that's not, what's the word I'm looking for? Like taking advantage of the individuals that are under your care, but also showing that they're human beings that led these, you know, we all have fascinating stories. I had no idea you wanted to start a commune before coming in here today and it's probably not what I expected to hear, right? But we don't know until we ask questions and we see it and we hear it. So I think that's interesting. Like if there was a way we could almost day in the life of a caregiver in something like this and be very transparent about the highs and lows of it, I think it might change a little bit. - Yeah, so some of, I really like the concept of like an adult date without walls. So just, we love bringing people in. I mean, this is how you have that experience of it's both. I think that's, for me, that's one of like the huge lessons of life of that I didn't learn until my fifties of it's, there needs to be happiness and sadness together in order for there to be happiness and sadness. And they're both okay and you can't just grasp for one because it just leads to sadness, interestingly. And so this, so coming here and it's getting to experience and seeing all of us have both, like seeing us have the joy and seeing us have like the real authentic, beautiful, amazing connections, the person who speaks out of brilliance, just whatever it is. And then also the sadness of you're losing this person, they're families losing this person, they're having confusion or I mean, or they're having sadness and you're needing to hold that. And it takes both of those. And I think the only way you get that is being around us and being here and not having aging have been behind closed doors and siloed and not having people connect to that process. And it's, you know, it's one interesting thing. I've been talking to a few friends around this and I've just, like there's the people that are being impacted by folks who are having cognitive issues just continues to grow. The people that are being impacted by people aging, parents, grandparents, aunts and uncles, like everybody. And I don't know if it's my perspective, but it's just growing because the population is really growing. And so into me, I've, is consciousness evolving intentionally in this way that we're all getting to have this other experience of the other side. I don't know if that makes sense. - Yeah, it does, yeah. - But it feels to me like it's an intentional force of consciousness of bringing this lesson to us, to consciousness of, yeah, it's a shift. - Yeah, yeah, that's really interesting. - Yeah, we don't, in American culture, spend a lot of time thinking about death. It's not, that's why books like Being Mortal, when they do kind of have this breakthrough success, you're like, okay, good. 'Cause we should be thinking about this. But also the things I loved about that book and I'll have to link to it in the show notes for other people too, but just kind of his breakdown too of the facilities that we have for people who are aging and what's happening within the four walls, something as simple as I think he talks about one that had a cat, right? Like they had a cat in the facility and how much of a difference that made by putting in that one variable and not doing anything else. It wasn't that they had to remodel the whole facility. They didn't need to put in skylights or do something crazy. They put a cat in. And that energy exchange and that emotional support that comes from having a pet just increased the happiness and the joy of that of that place. And that's just remarkable to kind of think about those things when people are, even if you are caring for somebody at home, what did they love in life? That doesn't stop just because some things they might not remember to do anymore. Right, right. Yeah, it's, I mean, it's one of the things that we try to do here of bringing all of that in. Like we're a really family-oriented place. All of the moms, I shouldn't say all the moms, most of the moms that work here all bring their kids here during the summer. And so it's just, and it's the same thing with, we try to get as many animals and dogs and it's 'cause it's life, right? It's that we need to bring all of that in to be living a life that feels good and just having it normal, right? Like it's lovely, it's so cool to see, we just had, school just started. So we only have one child here now who's just amazing. And I mean, she's sitting at the table with a bunch of people that are aging that have cognitive issues. It's normal to her now, right? Like it's not something that's happening behind closed doors. It's not something that's happening in a nursing home. It's not something that's happening in her grandmother's house where she doesn't go 'cause there's a home health aid or whatever, you know, like, yeah, like it's just, it's having it be like a normal and more people are exposed to it and seeing it and part of it. And there is a lot of shifting with that when being mortal and death-dwellers and the, before I die, walls and yeah. What, if any services are you providing additionally for the caregivers, is there meetings of, hey, we're all going through the same thing? What, here are some best practices or here are some ways to cope? Are you providing any services like that or is that something outside of here? So, yeah, so we sometimes, I often say, sometimes we support the caregiver more and sometimes we support the participant more. So, participant could be super social, happy as a clam, coming here, happy to hang out, has some friends here doing great. And the caregiver can be just be like, oh my gosh, I can't do this anymore. This is so hard taking dad or my care of dad or my husband or whatever. And so, it's a huge learning curve of how to take care of someone with cognitive issues or just aging. And so, we really, really, really try to help with that learning curve. We have caregiver support groups that are really well attended. We try to connect and make, we try to create a community for the caregiver too. Like, we're here to support them through this journey just as much as we're here to support the caregiver. I mean, the participant. And it goes back to the airplane, oxygen mask. The caregiver needs, if the caregiver doesn't have oxygen, like, yeah, they're not gonna be able to take care of anybody. And so, we give a lot of oxygen now. And it's sometimes it's just, yeah, this is normal. That's what happens during cognitive issues. That's what happened to an angel. Sometimes it's just listening and just being like, yeah, I don't know if we're allowed to curse on this podcast, but like, yeah, like that fucking sounds hard. Like, yeah, like, I don't know how you're doing this. Like, yeah, yes, this is amazing, tremendous. I see that it's crushing you. It should be feeling like it's crushing you 'cause it's a lot. - Yeah. - And so it's just the acknowledgement. It's just the listening, it's just being there. And then it's also resource support and, you know, trying to figure out, like, is there a way to make it easier? So, shortening the learning curve, making the learning curve more gentle with resources and all that other. - How can the local community here support your efforts? - Yeah. So I think the one, it's lots of things. So there's lots of ways to support what we're doing. One is just spreading the knowledge or just having the knowledge that adult day still exists in this community. We're not part of Mission Health System anymore. We're standing on our own. We're our own small nonprofit. We're the only one that provides adult day health in the community for aging adults. So we do that in Buncombe and Henderson County. If they want the service to continue, we were looking for financial support. We're looking for volunteer support. We're a great place to volunteer in that we love people that wanna contribute some way. And so if you tell us what your interests are and how you wanna be part of the community, we'll find a good spot for you. So love having volunteers come and work with us short-term, long-term, tons of stuff to do. And I think just coming and visiting, understanding what it is to be aging, having conversations with friends and neighbors of what it, creating an age-friendly community. There's a lot of age-friendly work that's starting to bubble up. And so be part of that conversation. And if you don't know how, get in touch with us and we can help you be part of that conversation. - If someone's listening and they're in a community, somewhere else across the country and they're going, we need this in our community. Like I am passionate about this. Where would you tell them to start if there's not something like mountain care already established in their county or their community? - Yeah, that's kind of a hard question. So there's lots of adult-day centers. There are also peace programs that are Medicaid, folks that are Medicaid-eligible can get some adult-day services through peace. There's lots of, there's a national adult-day association where if you wanted to start one, you can, there's franchises. So, I mean, I would start with their regional council on aging and ask it, have there been conversations around adult-day centers? What work has been done to create an adult-day center? What do we need to create adult-day centers? A lot of times they start out really small in like church basements, community spaces. And then they grow as the community needs it or people put resources in it. So it can be small, small, small steps. We've been here for 30 years, a long time. So it's taken a long time to create these programs that we've created, but there's lots of little small steps. There's one other tangent. So this kind of goes back to the World Health Organization work that I was kind of speaking about. So one of the other things that we've been trying to accomplish here is creating a better infrastructure for aging services. So aging service providers have been saying for a few decades of just, there's some things that work great about the aging services in Buncombe and Henderson County, but there's some challenges to that too. And I think those go to all social services. So I think those folks working with folks with addictions or the unhoused mental health issues, there's lots of great things that work about all these nonprofit models, but there's also things that could be better. So the one thing I think that's different around aging services is that the need is increasing. So we're like in this shift of, there's gonna be more folks over 65 than there are 18. And so it's a real mathematical dilemma that needs to be fixed. So the last few decades, aging providers have been talking about, hey, it's really hard to understand what services are here and how to navigate those services, particularly if you are a caregiver and are taking care of someone that has cognitive issues because that takes so much. And now you're having to figure out like, how do I get help, where do I go? And then a nonprofit business model is a difficult business model. It's difficult to keep it going and create funding and build capacity and be able to plan for the future. That's I think is the most challenging thing. We often go year to year and it's more difficult sometimes to be building capacity to get ready for what we want to be doing. Anyway, so these conversations happening around aging providers of can we be doing things more efficient? Can we be doing things better? Things are kind of siloed. How can we be working together in addition to better access for those that need services? And so we pulled together and have had a series of meetings over the years of how to accomplish that. We had an active aging center project that we brought before the county after working on it for a few years. It was a one stop shop building. It had adult day, it had a senior center, it had a thriving senior center with like a fitness component to it, like a YMCA, medical clinic, pharmacy, some meals on wheels type services. So it's in a childcare. So it's like, this is where you go. If you need aging services, this is where you, this is the first stop. This is where you go. You do intake at one spot, tell them what's going on, and then they connect you to services either on site or in the community. So much better access for those that are needing. And then when we get in that space, how can we as aging providers be better delivering? So do we need four different organizations that all have commercial kitchens that are providing meals to seniors? And then we're having to have four nutrition coordinators and is there a way, is one commercial kitchen with one nutrition coordinator providing meals of 200 better scale, less cost, hopefully? So is there ways that we can be starting to work and do that together? The project still hopefully getting pushed through UNCA, which is the local university here, said that we could have it on their land. So we had a great partner in them, but it's kind of died. It needs a little bit more oomph. So we've kind of decided to go a different way with it. Can we accomplish these two goals differently if it's not in one building? And we've started some work, which is called the Aging Alliance. And it's five aging providers and it's Council on Aging in Henderson, Council on Aging in Buncombe, Mountain Care, Jewish Family Services and Meals on Wheels in Buncombe. And we're all just sitting at the table talking about strategic partnerships. What are, how are we struggling? What can we be doing better? What can we be doing together? Is there ways to be sharing resources? And so some of that work has already started and it's kind of exciting. So one of the challenges is because of labor changes, hiring a finance manager is difficult. So right, I'm offering $60,000 for a $90,000 job. And so I'm getting bottom of the barrel, someone who maybe doesn't have the capacity or isn't able to really do the job I need, they leave after. So now all of a sudden, three years, three different finance managers, I don't have any right. So, and other organizations are having these same things. Difficulty hiring EDs, difficulty hiring finance manager, or difficulty hiring development people because our budgets aren't increasing. We don't have more money to be hiring these people. The services are increasing. We're getting more requests for services. So where's the breaking point? So one of the things with the Council on Aging in Henderson is we've started sharing staff people and we've started being able to, for instance, we hired a finance manager together. So we're each paying her $45,000. She is a high level capacity able to do the finances for both of our organizations at a high level, give us the guidance that we need. Hopefully she stays with us for a period of time to support our strategic plan, to support our work. We're not having to bring in someone new and train them. So we're sharing a finance manager, we're sharing an HR manager. We're starting to share development in September and we're sharing me as the executive director. So I'm now the executive director of the Council on Aging in Henderson, as well as the executive director of Mountain Care. And it's just kind of the first step of how we need to be doing this differently. Like we're all struggling. We have great teams. We have people who are working hard, who want to do this work, want to get paid to do this work. And so how can we find ways to have our organizations have strength and stability in order to continue this work and actually go to the next level of what's really needed because the capacity needs to be increasing. - You have my wheel spinning, but just from a like donation standpoint too, I'm sure there's companies out there that could afford to hire one more person, but don't need that role. Donate that to support a role at a place like here, right? Like if you could afford two CPAs for your company, but you only need one, use that extra money as a donation to something like this that needs to support a high level CPA or CFO or executive director or whatever it might be. For something that you have a heart for 'cause that's a great way to help. - Yeah, yeah, yeah, yeah. That's a great idea of like targeting like, yeah, this is what you're funding. This is what we need funding for. This is what the automation for business sponsorships. Yeah, I love that idea. - Thank you so much for being a part of the podcast. One question I ask all our guests before we wrap up is if you could sit down with someone and have a conversation like you and I had today, whether living or past, who would you like to sit down with and have in-depth conversation with? - Yeah, so I cheated a little bit, so I saw this question. And so I thought about it. I was like, oh yeah, who would it be? And then I kind of thought like, you know what? I think I would just like to spin the wheel. I think I would just like to like be able to pick like any random name, hopefully someone who spoke English or there was a good translator and just like get to learn about some random person that's already passed on. - Yeah, just some regular Joe. - I love that, that's a unique answer. I really, really like that. See who I get. - Yeah. - I think it would be kind of fun just to see who you got. - Yeah, and start there. - Oh, that's so neat. Well, thank you so much for taking the time out of your busy day and sharing. I know I learned so much today and I'm sure our listeners will too. - Yeah, appreciate your time and the conversation. - Thank you. - Thanks. (upbeat music) - Thank you for joining me in conversation. To learn more about the show or to support our efforts, to elevate our local economies by advertising or sponsoring the show, please visit conversationmill.com. The business practices discussed on the podcast and the opinions shared by guests and your hosts are for entertainment and educational purposes only and does not constitute professional advice. There are no silver bullets in business or life and what works in one market may not work in another. Always engage legal or expert advice when making decisions in your business. (upbeat music) (upbeat music) (upbeat music)
