Linda R. - Facilitator

We'll do a mic check. Sure. 1234-5678 910. I do.

1234-5678 910 sounds good.

Sure does.

I might be too close.

No, the closer the better.

Oh, okay.

Yeah, yeah. The closer the better. And if you want to scoot in, just get comfortable.

Good.

All right, I'll pull this back.

And.

Good job. How are you today?

I'm good. Good.

Can you please share your name and a little bit about yourself?

Sure. I'm Linda Ratter. I've been a nurse for, let's see, since 1980, so that's, I think, 44 years. I worked in hospitals for quite a while, and then in 2004, discovered parish nursing, which has now become faith community nursing. It's being a nurse in a church or churches, and so I've done that since 2004. So that's 20 years. Right now, I'm on the northwest side of Milwaukee at three catholic churches. I'm trying to semi retire, so I work three days a week.

I teach a lot of the classes that we're going to be talking about and do home visits, visit sick and shut ins, things like that.

Okay. How do you like nursing?

I love nursing. I would tell anyone to be a nurse because I'm 67 years old and I can still be a nurse. I mean, there are ways to be a nurse for a long time.

Yeah. Okay. Okay. Are you from Milwaukee?

No.

No. Where are you from?

I'm originally from two rivers.

Okay.

It's right up north, about 90 miles north, right along Lake Michigan. Our nickname is the coolest spot in Wisconsin.

Okay. Coolest spot.

Not cool as in neat or, you know, cool like cold? Yes, cool.

Frigid.

Okay, I got you.

When did you get here?

So I came to Milwaukee in 2004. Otherwise, I had spent a lot of my nursing career in Cheboygan, Wisconsin.

What side of town did you grow up on? Or were you kind of working in right now when you first came here in 2004?

Well, when I came here, my first parish nurse position was at Cross Lutheran church, which is on 16th and walnut, and I was there until the end of 2022.

Okay. Oh, that was a long time.

I did 18 years there. It's hard work, and as you get older, you know, you don't want to work quite as hard. And also, you need volunteers. You need good helpers. You need. And that was hard sometimes. So I just. I wanted to still keep working because I love the teaching and I love running programs, but I had to find out how to do it in a different way.

Right. Makes sense. Can you share your journey facilitating health programs for older adults. And what motivates you in this role?

Yeah, so I was trying to think about that this morning, because I was sure you would have ask me when I started doing all this. I have to think that I started doing it soon after I started the faith community role. So I would think 2004, 2005, something like that. So 15 ish years, almost 20 years, maybe doing this, too. There probably were not as many classes at the time as far as the opportunity to learn to be a preceptor for the classes. I certainly always had people who wanted to attend the classes, though.

Was it something about older adults that kind of drew you, as opposed to, like, other groups?

Well, we didn't just market it to older adults.

Okay.

We had what we call the senior center, but they were 50 and over. But I also ran a women's group, and they weren't all seniors either, but they all wanted the knowledge of living with diabetes or how not to fall. So I wouldn't say at cross. It was particularly directed to seniors, although that was one part of the group. Now, the parishes are three parishes with probably an age of 70 and older. We have very few kids. I mean, we have some, but. So now it's really been a focus for older adults.

So in the last, I would say, ten years.

Okay. Is there a personal story or experience that inspired you to focus on health and wellness in older adults?

Well, my dad and my sister both had diabetes, so that one really resonates for me. My dad ended up being a double amputee. He was a type two diabetic, though, an older adult when he got it. My sister was ten, and she was, like, the third child, I think, out of six. So our whole family had to change how we ate, you know, how everything kind of revolved around her. She was meticulous about taking care of herself. She was one of the first people I knew who had an insulin pump. And so that goes right into your skin, and it pumps the insulin right into your body instead of having to give yourself injections all the time.

It's continuous.

Gotcha.

And so. But she, too, the ravages of diabetes. Even though she took good care of herself after 40 years of diabetes, it just got to her and she passed away. So, yeah. Thank you. So both of those people have influenced, certainly decision to teach the healthy living with diabetes. I also have seen way too many people in the hospital or in a home visit who have fallen, and so to see how the falls have changed their whole lives, they may end up not being able to stay home may have to go to a nursing home or assisted living. So therefore, too, if I can do anything and teach people, and they can teach others about how not to fall, it's major.

That's awesome. From your experience, what are the most significant benefits participants gain from these programs?

Yeah, and this one has kind of changed in my mind in the last few years, and I'll tell you why. I used to be worried about, did they get the knowledge? And I still worry about that. And most of the time they do. They can reiterate it back to me. However, what we're finding out is a lot of people come to classes cause they're lonely. So Aurora Healthcare, who I work for, is actually gonna start a program called connect to thrive. Its nickname is the loneliness project. And we're gonna be going out in the communities on the northwest side of Milwaukee and just having classes for them to learn how not to be lonely.

And it's not necessarily being around people. It's just knowing yourself and what makes you happy. But the surgeon general has said it's one of the most recent epidemics, and it's taking over everything. Seniors, the young people in school. I mean, it's everywhere. So that was interesting. Those words or hearing about the loneliness was one of the reasons they came. Sort of just feeds into the whole idea that we really need to tackle this loneliness thing, too.

Have you seen any kind of impactful instances of that? Anything that kind of tugged at your heartstrings where you were like, okay, I kind of see why you were involved in this.

Yeah, well, what I really like is how they like, let's say I teach a class, and they really like the class, so they go and tell others, or like, I'm in the front of church for the masses, greeting people when they come. And a lot of them, we do this thing called the side step exercise, and they'll do it in front of me as they're walking in. So I know it makes an impact. This is weeks later, and they're still thinking about it and doing, you know, what they were taught. So I hope that when I teach people, they go and teach others. I still want people to come to the class, obviously, because those numbers are important. But even the little tidbits of information they can get from others, I think, is very important.

What challenges have you encountered in engaging older adults, particularly with african american communities?

Yeah, for me, obviously, I'm not african american, but so I learned a lot when I was at cross. Cross Lutheran is right in the inner city. I would say half of that parish is african american. The people we served in most of the programs were african american. So at first they would take a look at me and be skeptical, and I can't blame them. But most often, once people get to know me or, you know, see me teaching or whatever, this isn't going to probably come off right, but I don't care what color they are. I mean, no disrespect, but I mean, I want everybody to get this information.

Gotcha.

I think the barriers are barriers. Were you at the meeting on last week? You were at the. Oh, okay. I wasn't. So we talked a bit about the barriers for seniors. And so the barriers I felt were often the same. First of all, having the time to come to class, having the transportation to come to class. What if you have little ones or you're a grandma and you're watching kids? I mean, all those things.

The incentives, I think, are really important that people get too, you know, if you have another reason for coming beside the knowledge. But I've been fortunate. Usually once people get to know me, we get along fine.

How do you feel about the incentives? Like, do you feel like that's.

So. That's been a struggle? There's a lady I know who I really admire, and so over years I thought the incentives were really cool. And then she had me start to think about them a little differently. As far as. I don't know, it seemed almost as if you were buying the people's time or she made it. So I always think. I think about that. I guess I'll just say it that way.

Where at first, what I thought was really cool in some of the cases felt like they were paying people to do experiments or something.

Do you still feel that way?

No, not so much about the classes. I think these were more about studies that the medical college was doing or somebody was doing. And obviously that is, you know, looking at a population or whatever and gleaning information and kind of taking some dignity away or something, or. I don't know. I was glad, though, that she brought it up. I still struggle with it a little. You know, what's a good incentive? What's not a good incentive? What's so.

Yeah, okay. How do you approach overcoming the challenges that, you know, african american communities might face to enhance participant engagement?

Yeah. So I wish we could give like a stipend or something so that if transportation was an issue, you know, we could help with that. Or maybe, you know, if taking care of kids was an issue, could they bring the kids for that two and a half hours. And could we have a nursery or somebody to watch the kids or something? Or I suppose all of this has licensure issues or, you know, things like that. There's always a barrier. It seems like when you try to do something, which is unfortunate, right? It's very unfortunate, yeah. And so I think we have to be more holistic about all that. We can provide as many classes as we want, but if they're not the right time or you can't get there or you don't have childcare or, you know, I could name maybe five other things.

You're not gonna come. No matter how good it is, no matter how nice I am, no matter whatever, you have business to take care of. Yeah.

And I know you just kind of touched on it, but in your mind, what does a more holistic approach look like, you know, for the communities that you've served thus far?

Yeah. So I think, you know, a lot what I said, really, you know, we do all kind of surveys. We do a baseline survey that the Wisconsin Institute for Healthy aging once, I don't think once it asks, then there are any of them, what are any of the barriers for you to come to class? So maybe even just that baseline survey, or not just, but a beginning point could be that baseline survey. Okay. You can give them all the information you need, you know, or they can give you. But then can you get more information about what they need? Yeah. And that's very interesting. I never really thought about it, but I'm gonna have to keep this up here for a little while yet, so I can write it down and tell somebody, because that.

I think that will be very important. We get all this data, but it's not really telling the barriers to coming to class.

Right. And then what are we doing after that?

Right, well, and that's a whole other thing. Now, some of the programs do, like stepping on does have a home visit after. However, a lot of people don't want you in their home. You know, maybe they didn't clean up that day, maybe the dog left hair all over or who knows? I mean, we. So we've a little bit cheated on that. And excuse me, because I'm at the parishes a lot, I get to see a lot of the people who come to the classes. I'll just say, hey, how's everything going? You know, did you pick up your throw rug and get it out of the way? Or, you know, because doing home visit is very intrusive.

It is.

You know, you have to clean your house if people are coming. Right? I mean, or you have to try to clean your house or. Yeah, it's like you're ahead now. You're in their personal space. That is not maybe what they signed up for.

Yeah, that makes sense. That makes sense. Based on your experience, what improvements or changes would you recommend for these evidence based programs to better serve older adults and specifically address the needs of african american communities? So, based on your experience.

Yeah, so I think a lot of the things we just said, the other thing I think they're working on this is trying to get more people of color to be instructors so that when people come right away, that's one barrier that can be gone. You know, I don't know how successful it's been, though, but for a while, there was a whole group, I think, working on that. I know Jennifer, who's in charge of the department of aging here in Milwaukee, or one of the big players in the department of aging, has made an effort to be in churches, in primarily african american churches. So I think it's the baptist church, maybe, who's become a big player in some of the hypertension programs, and I think there just was a stepping on program somewhere in the inner city. So that's good. They probably have to do a lot more of that, though. And I think to do that, even myself, I'm finding. So I'm over on the northwest side of Milwaukee, there's a lot of really active black churches, but, you know, I have to get in the door somehow, and then they have to trust me.

And then. And so one of my supervisors is african american, and so I'm trying to tell her, why don't you make the first step? And I think once we get in the door, it'll all be okay. But I think they have to see you first and hear why this is important, or maybe we do it together.

Or, I don't know, kind of like a warm handoff. Yeah.

Yeah, that's a good. I don't know that term, but that sounds good. Like, okay, now I made the way. Right.

I'm here. This is my friend.

Exactly. And you can trust her and. Right. Yeah. Just by.

So you feel like mistrust is huge when it comes to these programs. In a way.

I wouldn't say specifically for these programs. I would say historically, what I've heard is that care for african american people, medical care, is not the same. People get doubted about their symptoms over and over again, or is this really happening to you? And also just the fact that maybe they don't have health insurance or the health insurance that many other people have. And so they get disregarded, I think, a little bit, by even what health insurance they have or don't have or. Yeah. So, yeah, okay.

For someone you're trying to encourage to become a facilitator, what would you tell them about the role and why they should consider it?

We have fun. We really do. A friend of mine, she retired from nursing, and I don't think she had taught these classes before, and she still wants to do stuff. And I said, well, why don't you come teach the classes with me? And she's like, well, okay. And she gets a little stipend for doing it. We have so much fun. I mean, the people look at us and, like, our I. They're having way too much fun, you know, like, for this to be work.

I mean, we really do. And we didn't practice a header because, like, you know, one person takes one section, one person takes another, then you go again, you reverse. Ta da. You know, so you're not always teaching the same thing every week or. And somehow we just. I don't know. It's really been amazing. It's been so.

Because we weren't. I wouldn't say we were really tight, good friends, but we knew each other. We could joke around a little, but we didn't do things together. We didn't. But now we even do fun things together outside of teaching the classes. Well, so, like, go to the art museum or just go out for lunch, or. We're actually going on a riverboat cruise in April in Spain and Portugal. I love that there's gonna be vineyards and.

Yeah. So, I mean, our friendship really even has grown. So I guess I got a lot out of teaching these, too, but I always did. I love teaching, so I. Give me anything to teach. I'll try it.

Right.

As long as I have, like, a manuscript or, you know, something to go on.

Right.

Yeah, exactly. Yeah.

I want to ask this closing question. Do you have, like, a story or anything like that that really kind of touched you over the years that kind of stuck with you, with your participants or any specific participant that kind of really just kind of left an impression on you?

I'm trying to remember. I don't really have, like, one specific. I know. Several of the people have told me there's one scenario in the stepping on class, which is the program to be ren falling, that teaches you how to get up from a fall. And so many people have told me how helpful that's been, that they've actually fallen, but that they knew what to do when they did fall. And because of what we taught or what we suggested, they perhaps had a lifeline that they could push a button if they couldn't get up, or they had their cell phone in their pocket so they could make a call. So it would be something like that. As far as diabetes, again, nothing specific from one person, but how, just generally, they think more about what they're eating, you know, and how important exercise is and the timing of the exercise.

And so. And then I love that they teach others or they try to help others or, like, they do that exercise in front of me. Like I said, when they come in church, you know, I mean, it shows they're still thinking about it and they've retained some of it.

Yeah.

So I can't think of anything like, whoa. That saved their life. But, yeah, I mean, certainly impacts have been made.

Yeah, for sure. Okay. You have any closing kind of comments that you want to make?

No, not really. Just as fun as this is, this is a lot of work, too, and so it's good to feel appreciated. It's good. They're just really good classes, and I would recommend anybody take them. Like, sometimes they fuss. Seven weeks. I don't have seven weeks. I said, I think you do.

I said, and if you can't come all seven, come four or five, and then maybe you'll realize you want to come to six and seven or, you know, or if you have to make an appointment in between or something. I mean, we all have lives. I know they get busy and they. But, you know, I just always encourage them. Come. You'll learn something, you know, I know you will. And you'll have fun. And we have snacks.

You could step one and print this.

Right? And you can keep practicing in church. But, yeah, they get a nice book that talks. I forget the name of it, but they update it every couple years. And it has really good things about a lot of things, not only diabetes, but heart health. So they get this nice book, which I think is worth about $20. And in the stepping on class, they get weights, so that in case they're really pros at doing all the exercises already, like lifting the legs and this and that, they can put weights on to even make them stronger, you know, so they get. They get things.

There are goodies.

There are goodies, yes. Yeah. So I think you have to make it enjoyable. You have to help them realize that they're getting something from this. And then I get the joy from watching after hearing their stories, like oh, Miss Linda, I almost fell, but I remembered something. Or, you know, I'm like, yes, good, good.

All right, Miss Linden. Well, I appreciate you today. It sounds like you're doing some great work.

Well, it's someone people. So I have this camp of friends. They're either. Well, many are becoming retired now. Some are still working. But the retired ones are like, what's the matter with you? Well, I hope this isn't. Well, whatever. You can cut this off, right? So they're like, what's the matter with you? Why don't you retire? I said, why would I retire? I said, this is so fun to teach these classes.

And what would I do all day? I said, I'll just volunteer, probably. So why don't I just do this? You know, I'm enjoying it. I can get paid for it. There's no tv on during the day. I mean, I would go out and spend money. I mean, why would I? But there's this camp, sort of of the retired and the non retired. And the retired people feel sorry for the non retired. I said, you don't have to feel sorry for me.

Right.

I'll retire when I'm ready.

I'm having a good time.

I'm having a good time.

Okay. Well, this will conclude the interview. I appreciate you stopping by.

Sure. Thank you. I'm glad to know this is a nice building.

Yeah.

I'm really impressed.