ADDRESSING RURAL AND 

SOCIAL CONNECTION NEEDS 

OF RURAL OLDER ADULTS 

DURING THE COVID-19 

EMERGENCY
INTRODUCTIONS

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OPENING 

REMARKS

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STILL WORKING HARD FOR CHATHAM SENIORS 

AND THEIR FAMILIES

Dennis W. Streets, MPH, MAT, LNHA

July 15, 2020
@NRCNA_engAging

CHATHAM COUNTY COUNCIL ON AGING

• Celebrated our 46th anniversary as nonprofit on July 8th as the

primary local portal for seniors and their families

• Mission: Promote independent living and the physical and

mental wellness of seniors, and support their family caregivers

through a wide array of services & opportunities

• Primarily serve socially & economically needy, not eligible for

Medicaid

• Chatham is a geographically large, rural county that is

economically and culturally diverse—bordering our state’s

capital and the University of North Carolina at Chapel Hill

• A third (about 24,500) of our county’s population is aged 60

and older—far outnumbering those aged <17

• In a typical month, we serve about 1,200 persons in some

manner.

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CHATHAM’S COVID-19 STORY

• Became concerned about COVID-19 in mid-February and began

emphasizing importance of good public health practices—

producing a flyer approved by the State DHHS

• Placed our 1st large shelf-stable meals order in late February

• Became integral part of County COVID-19 Response Team in

early March

• Encouraged NC Association on Aging to hold a workshop on

COVID-19 at its annual training conference in Wilmington

• NC’s 2nd COVID case was confirmed in Chatham in the morning

of March 6th – during NCAOA conference

• Closed our centers’ doors to the public on March 16th—at the

start of our planned March for Meals campaign

• NC DHHS confirmed community transmission on March 18th

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NUTRITION SERVICES OVERVIEW

• Nutrition services include: Congregate [Senior Center] Meals;

Home-Delivered [Meals-on-Wheels] Frozen/Shelf-stable Meals;

In-Home Aide Personal Care; and partnership with local food

pantries

• Our kitchen in Siler City produces our meals.

• A retired RD/RN (Board member) prepares our menus.

• We have 110+ MOW volunteers (mostly seniors) staffing 12

routes; we stopped using them in early April.

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NUTRITION SERVICES: COVID-19 RESPONSE

• Delivery and pick-up of shelf-stable and/or frozen

meals and many other needed items

• Use of contracted transit provider to deliver

congregate meals each week to folks who previously

were transported to our centers for meals and

activities

• Used other community partners to deliver meals to

homebound every 3-4 weeks (i.e., Public Health,

Parks & Recreation, Sheriff’s Office, County

Manager’s Office, UNC medical students)—now using

contracted transit provider

• Writing of multiple grants and appealing to the

community for funding to support efforts

• Assisting local food pantry with provision of fresh

produce

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SOCIALIZATION & SUPPORTIVE SERVICES OVERVIEW

❑ Friendly check-in calls

❑ Peer-support calls via our volunteer Community

Ambassadors

❑ Friday morning conference calls with COA ED &

guests

❑ Collecting, producing & distributing a wide array

of materials (e.g. reading materials, puzzles,

exercise bands)

❑ Providing incontinence supplies

❑ Offering pet supplies and other supplies upon

request

❑ Offering assistive equipment

❑ Providing in-home personal care and family

caregiver respite

❑ Arranging rides to essential medical appointments

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SOCIALIZATION SERVICES OVERVIEW

▪ Extensive online and virtual classes and

activities—see www.chathamcoa.org

One participant said early on that she was "tired of watching TV". After she 

has her coffee in the morning, she does her exercise, because she can "hear 

your (Jackie's) big mouth telling me to raise this arm, raise the 

other"...Jackie added that it was hysterical to hear her, but also rewarding 

to know that Jackie's exercise classes can still have an impact when we 

aren't together and that they are helping the participant take care of 

herself in this time of uncertainty. This congregate participant has been 

properly following the advice of physical distancing (she hasn't been away 

from her house since March 12th) and she can't wait until she can return to 

the center. This person is now a regular participant in various virtual 

activities.

▪ Continued online & print versions of our

newsletter with input from community

partners—see www.chathamcoa.org

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CHALLENGES TO DELIVERING SERVICES

• Providing nutritious meals

• Avoiding putting older volunteers at risk

while keeping them interested and

supportive of COA—finding substitutes

resulted in new partnerships

• Discovering ways to help those most

vulnerable (e.g., seniors aged 85+ living

alone in a rural community)

• Overcoming the lack of Internet access &

technological capability

• Discovering ways to replace lost

discretionary income (e.g., facility rental

income, group events)

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CHALLENGES TO DELIVERING SERVICES

• Seeking funding sources for renovation of facility space to allow

for greater physical distancing

• Identifying activities that might interest older men

• Inability to provide some services (e.g., VITA, SHIIP/Health

Insurance Counseling)

• Combatting ageism

➢People of all ages can make a mark during this difficult time

➢Mother’s Day: More meaningful, yet difficult, during COVID-19

➢Layton Long, Dennis Streets share advice, ways to help seniors in

Chatham through COVID-19

➢Making a Difference by Wearing a Mask

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COVID-19 PIVOTS TO KEEP

• Continue working relationship with The Rural

Interprofessional Longitudinal Scholars (RIPLS) Program

at UNC to seek ways to realize potential of telehealth

and other initiatives

• UNC med students assisting Chatham COA during

COVID-19

• Virtual & Online Exercise & Activity Classes: “My

husband and I are very impressed with the efforts being

made to help seniors in Chatham County during this

COVID-19 pandemic. The online exercise classes with

Jackie are fantastic. I am attending more classes than I

used to attend in person. Thank you so much.”

• Online Listen & Learn and Couch to Couch series —

building off our in-person Senior Education Conference

and our previous music events

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LESSONS LEARNED AND AFFIRMED

• We don’t have to do it all ourselves—there are many

willing partners (old and new)

• "Physical Distancing" does not have to mean "Social

Isolation"

• Be open to new ways of serving

• Importance of providing reliable information about

community resources—production of Chatham Aging

Navigator (CAN) tools

• Importance of equity and social justice as key guiding

principles:

As UNC-Greensboro Graduate Gerontology Program 

Coordinator Elise Eifert reminds us “Aging begins at birth and is 

influenced by many things, including racism, over the life 

course. If we want people to have the opportunity to live long, 

successful lives, we must do the work to create a society that 

fights against social injustice and truly becomes anti-racist."

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THANK YOU

Dennis W. Streets

Executive Director

Chatham County Council on Aging

919-542-4512

Dennis.Streets@ChathamCOA.org

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SENIOR NUTRITION PROGRAMS: 

ADDRESSING THE IMPACT OF COVID-19 IN 

MICHIGAN’S UPPER PENINSULA

Tammy Rosa

July 15, 2020
@NRCNA_engAging

July 15, 2020

INTRODUCTION
@NRCNA_engAging

UPPER PENINSULA AREA AGENCY ON AGING/UPCAP 

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▪ Region XI Area Agency on

Aging

▪ Regional Focal Point for all

Aging and Caregiver Support

Programs.

▪ Population 302, 981

▪ 1/3 Land Mass of State of

Michigan

▪ 3% of State Population
@NRCNA_engAging

COVID-19 IMPACT ON OLDER ADULTS IN THE COMMUNITY

▪ Challenges accessing food

▪ Reduced transportation

▪ Increased isolation

▪ Decreased Assistance from family

and friends

▪ Increased Risk for Individuals with

Dementia Living alone

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COVID-19 IMPACT ON AGENCY

▪ Increased need for meal services in areas not currently

serviced by providers

▪ Staff working from home and re-directing job duties based

on need

▪ Increased need for additional

network partners

▪ Increased level of outreach

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NUTRITION SERVICES OVERVIEW

▪ 6 Nutrition Providers

▪ Serve 15 Counties

▪ 75 HDM Routes

▪ 57 Congregate Meal Sites

▪ Serve over 2000 clients

daily throughout the U.P.

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NUTRITION SERVICES OVERVIEW 

▪ Meal service provided in a variety of settings

▪ Meal routes up to 5x per week

▪ Hot and cold as well as emergency meals available

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SOCIALIZATION TO PREVENT ISOLATION

▪ “Lunch with Friends” Program

▪ Caregiver Support Programs (Telephonic)

▪ Friendly Reassurance calls

▪ Health Promotion Workshops (Virtual)

▪ Adult Day Services

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CHALLENGES TO DELIVERING SERVICES

▪ Increased Need for food/meals in extreme rural

▪ Decreased staffing

▪ Decreased routes

▪ Increased social isolation

▪ Technology Needs (Providers/Participants)

▪ Lack of transportation options

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This Photo by Unknown Author is licensed under CC BY-NC

COVID-19 PIVOTS

▪ Increased contact with HDM and Congregate Meal

participants

▪ Drop ship meals into extreme rural areas

▪ Partnered with Michigan Aging and Adult Services/AASA to

provide fresh produce/dairy

▪ Increased caregiver support resources

▪ Take-out meals at congregate sites

▪ Virtual programs added
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PIVOTS TO KEEP

▪ Increased service areas

▪ Take-out meals in addition to congregate

▪ Increasing additional food supplies into extreme “food

desert” areas

▪ Maintaining increased volunteer network

▪ Increased virtual programming

▪ Strong caregiver support resources

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LESSONS LEARNED ...

▪ Increased access to virtual programs/collaboration

▪ Large need for food in some rural areas

▪ Need for increased contact with participants

▪ Adaptability of staff

▪ Value of telecommuting option

▪ “Power of Community”

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THANK YOU

Tammy Rosa

Nutrition Program Manager

Upper Peninsula Area Agency on Aging/UPCAP

rosat@upcap.org

906-217-3021

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KIOWA “GKOY-GKOOT” RURAL NEEDS

Darin Zotigh, ACA/BA

July 15, 2020
@NRCNA_engAging

OVERVIEW OF ORGANIZATION

• The Kiowa Administration on Aging (AOA) offers

congregate and home delivered meals located in left

lower part of Southwest Oklahoma.

• The headquarters are located in the town of Carnegie,

Oklahoma.

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KIOWA “GKOY-GKOOT” SERVICES....... 

• Supportive Services, Respite Care & Fastrans Passes

• Loan Closet-Handicap Equipment

• Residential lawn care & Light Home and Auto Repairs

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KIOWA “GKOY-GKOOT” SERVICES 

• Beauty Salon, Educational Health Presentations/Activities

• Referral Services

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KIOWA AOA COVID-19 STORY

How COVID-19 Pandemic Has Impacted Our Rural Community In 

Southwestern Oklahoma

• Pre-existing Health Conditions (diabetes, cardiovascular disease

and respiratory illness) are just one of the many impacts that has

effected our tribal elders. Less activity for congregate elders;

increase in blood sugar levels due to inactivity.

• Bad Road Conditions for Elders and AOA Staff to deliver food

(Increase van usage; more tire problems)

• Not enough staff to prepare for increase elder participation. We

had to hire temps and recruit volunteers to meet the demands.

• Overcrowding of multi-generational families (No break in privacy

with children not going to school and work)

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COVID-19 IMPACT ON OLDER ADULTS IN THE COMMUNITY

Shortage of product supply

• Increase in food prices – we developed innovative ways to

meet elder needs

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COVID-19 IMPACT ON OLDER ADULTS IN THE COMMUNITY

• Caregivers in isolation - no access to local laundromat

• Overcrowded conditions - no air conditioning

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KIOWA NUTRITION SERVICES OVERVIEW

• Pre-COVID: Monday through Thursday: Kiowa serves

lunches. Menu varies with a variety of options.

• Fridays are special with breakfast served. Each 2nd week of

the month a salad bar is served every day along with soups

and sandwiches are offered as well.

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NUTRITION SERVICES OVERVIEW

• Pre-COVID: The 3rd week of the month the Elders celebrate their

birthday for the month. A traditional meal is cooked for that day

w/cake & ice cream.

• Each elder is given a gift. Arts and Crafts are displayed and

purchased from the public and games/bingo is held after the meal.

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SOCIALIZATION SERVICES OVERVIEW

• Socialization during COVID-19 has been a challenge. However,

our AOA program has come up with activities to encourage

movement and provide socialization at a distance.

• The first activity was a Door Contest:

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SOCIALIZATION SERVICES OVERVIEW - CONTINUED

Car Activity

• Each participating elder decorated their car relating to the covid19 message. 1st, 2nd and 3rd prizes was awarded to the winner.

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SOCIALIZATION SERVICES OVERVIEW - CONTINUED

Walking Activity 

• Each participating elder wore a pedometer and kept a record log of

numbers and submitted every two weeks – we coordinated with IHS

Diabetes Coordinator.

• Winners are announced at the end of month for best garden and

canned goods.

• Elders submit products at the end of season and meet all elders who

have participated in garden project.

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CHALLENGES TO DELIVERING SERVICES

• All elders are homebound—Roads need repair

• Not enough vehicles and staff to deliver

• Staff is overworked...many volunteer time

• No adequate cooking equipment/refrigeration

• Keeping up with increased growth in participation

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COVID-19 PIVOTS TO KEEP

Changes our organization made during the COVID-19 season 

and would hope to keep going forward....

• Chicken Project, Garden Project, Ribbon Project

What new services or events are your seniors perhaps, 

looking forward to still being available after the COVID-19 

season subsides?

• Hair Salon, Door Contest for Homebound Elders, Canning

Contest-Farmers market

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LESSONS LEARNED ....

• More awareness of crowded conditions due to multigenerational living conditions, and how it effects our elders.

Some elders love being around grandchildren while some need

peace and quite. If growing older isn’t planned; then life is

challenging.

• If you live in the rural community advocacy to improve road

conditions is so essential.

• Employees and Elders need to be heard on what makes them

feel safe when they return to normalcy.

• How valuable each of your jobs are to every elder you serve.

• How valuable support staff/co-workers are to your program.

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THANK YOU AND BE SAFE!

DARIN ZOTIGH

AOA@KIOWATRIBE.ORG
Q & A
LOOKING AHEAD

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LEARNING NEEDS GOING FORWARD

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PROMISING PRACTICES HUB

• We will be adding a promising practices hub to the NRCNA

website in August. It will feature snippets from senior

nutrition programs around the country, lifting up their

good works, innovative programming and helpful peer

resources for all to see.

• Share your promising practices with us here:

https://nutritionandaging.org/contact/

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SHAPE THE FUTURE, SHARE YOUR INSIGHT

Technical Assistance and Training Needs Assessment Survey

• The NRCNA is fielding a survey to examine the educational

needs of senior nutrition program staff across the country.

• The survey findings will be used to establish recommendations

that will inform a strategy for ongoing training development by

the NRCNA for the benefit of senior nutrition program

professionals in the Aging Network.

• Visit our dedicated website to learn more, & participate:

https://nutritionandaging.org/tatnsurvey/
• Title Text

THANK YOU

– Body Level Five