Community Connections for Health Care

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by Joan Bachman

Griswold (Home): a rural farming community in eastern North Dakota with strong Lutheran community-wide family values that translate into expecting and supporting youngsters - and each other - to reach for and gain “possibilities” with encouragement, discipline, and love. From this background of wrap-around security, I made it successfully through the usual complications of building a family and a professional career. There was always a close family or community member available to coach and assist as needed.

Strange to think that starting life in a place such as Griswold might be a hazard to the well-being of others in this world; however, this secure beginning in life blinded me to the reality of people who came from other places and situations. I was fortunate to live in locations with different environments and people with different life circumstances to expand my world view. Those experiences introduced me to people who began life with much less security and acceptance than I had.

For the first 57 years of my life, I believed that everyone should be responsible to get a job and earn enough to purchase food, shelter and clothing. Then, in 1995, I met the 17 year old mother of a 6 month old baby who had spent her life living with various relatives, most recently with her Grandma who had just died. “Jane’s” extended family was willing to offer her another temporary home. This was the beginning of my learning about generational poverty and family dynamics much different from my experience. That information isn’t relevant here, except to understand that Jane began life in circumstances absolutely foreign to me. I offered to support her efforts to put her life together, and she was willing to trust me.

My family and I helped Jane set up apartments; sometimes she stayed with me. She did not, of course, own a vehicle and the town had very limited public transportation. She usually walked the many blocks down the hill and back again with the baby in a stroller for appointments, shopping, and to work. I sometimes drove her to and from her job, appointments with state agencies, and to visit relatives, both hers and mine. She was part of my life.

As a newly homeless Mom, Jane was “entitled” to services offered by Federal and State government programs. The subsidized housing available was on a steep hill away from the town’s business center; the WIC office, Job Service office, Social Services office, and others were in central locations at the bottom of the hill, each on a different street, available weekdays, excluding holidays. Appointments were scheduled irregularly by the individual agencies, seldom coordinated. One discouraging example of “service”: three agencies disagreed during a meeting as to the actions required of Jane – work or school/school or work. I had accompanied her to the meeting as an advocate, and we were both chastised for demanding clarification and resolution at the meeting to know next compliant steps. “The system” may be intended to provide a boost to independence, but I observed its failure to generate self-sufficiency over too many years.

Jane was unskilled, had no high school diploma, and so was limited to a small pool of jobs which paid minimum wage. She was a capable and willing worker. Getting settled with subsidized housing and childcare, food stamps, free health services, and a job should provide a good start. However, I observed that to be far from true. Very soon after securing minimum wage employment (I remember the time frame as 2 months), the subsidies for housing and childcare were decreased or discontinued, resulting in near impossibility to pay for rent and childcare in addition to food, diapers, household supplies, and transportation on such little income. When the baby was sick, or childcare or transportation not reliable, Jane had to miss work because she had no backup. Missing scheduled work hours is a justified reason to terminate employment and Jane was no exception. Each time she lost a job, she had to re-apply to “the system” for services as in the beginning, knowing that resources would be temporary again. Eventually, it seemed there was no hope for self-sufficiency as the cycle kept repeating, and looking forward seemed useless.

Federal laws authorizing “the system” are obviously designed to keep people in poverty despite what State or local agencies might attempt to do. There seem to be inadequate resources to provide case managers who would teach budgeting, homemaking, and shopping; or adequate financial support for a period long enough for an individual to establish personal security. This promotes generational poverty.

Because of my beginnings that included security and developing life skills, I always knew I could be self-sufficient and reach goals. Because of Jane’s beginnings, she had little sense of security or examples for how to proceed to independence. She had a strong desire for personal success but had no idea of what it might look like or how to get there. With my experience here and with others that are similar, I discovered there is much to learn before making judgements about someone else’s lifestyle. That learning comes with personal investments of listening and time. The idea is not to “do for”, but to “do with” and be an advocate and cheerleader.

I’m happy to report that Jane and her family are managing quite well after about 20 years. There were many obstacles and difficulties along the way, but determination has paid off.

About the Author

Joan Bachman

Joan Bachman is a Registered Nurse, Licensed Nursing Home Administrator, Registered Health Information Technician, and Faith Community Nurse. She earned a Bachelor of Science degree in Business Administration. Joan has experience as a Nurse, Administrator, Developer, Trainer, Grant Writer, and served as Administrator of SD State Survey Agency. She has consulted with health care facilities and nonprofit organizations and presented leadership training. Joan is the author of Guidebook for Assisted Living Facilities and Senior Service Providers and Guidebook for Physician Services in the Nursing Facility, and she has published in professional journals.

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