Caring for San Juan’s Older Adults while Advancing Next-Gen Leaders

VOA | AMERICORPS | PUERTO RICO |

by: Maggie Allard, MD MPH

Since 2021, Public Health AmeriCorps (PHA) has sought to increase our nation’s public health workforce in order to bridge care gaps, address disparities, and improve outcomes especially in vulnerable communities.? Volunteers of America (VOA), known for its unparalleled experience in caring for and housing complex populations, has become an optimal partner for PHA in Puerto Rico.? Here, the focus has been on poor, older adults in independent living, and the results have been transformational.? “It’s huge for us,” says Alberto Maldonado, the Regional Director of Business Development and Services for VOA-PR.? In less than two years, Maldonado has grown the program from four to ten CHWs across five sites serving nearly 600 clients in Greater San Juan.

The secret to this success lies in the trust between Maldonado and his staff, and subsequently between the staff and their older clients.? This trust is only deepened by the commonalities of language and culture as all of Alberto’s team are native Spanish speakers, hailing from Latino communities.? His team has found that when working with older adults, many of whom feel forgotten and unseen, simply being present and helping with the small things speaks volumes.? In Puerto Rico, these clients suffer from high rates of loneliness and isolation due in part to family members relocating for jobs off the island.? They may feel like frequent calls or requests place a burden on their families. ?Alberto’s team has found that for these older adults a connection often starts with a conversation, a cup of coffee, bringing groceries up to an apartment, or even opening a stuck jar. ?

Even so, it is not only the clients who have been impacted by the program.? Due to the breadth of public health training, leadership development, and a competitive salary, Alberto finds that “people are excited to work with VOA and AmeriCorps,” especially since the program is designed to be a pathway to careers in public health and social services.? In fact, two recent program graduates went on to employment in social work and counseling, and CHWs program wide have experienced substantial personal and professional growth.?

Prior to becoming a VOA-AmeriCorps CHW, Jesus Nieves held numerous jobs from waiter to cook to medical assistant and billing specialist, but Jesus feels, “This is the happiest I’ve ever been.” ?Not only does he enjoy the warmth of the older adult community at Villa Providencia, he has also found his own voice while learning to communicate with his clients and address their needs.? As well, he is now able to set limits, resulting in better work-life balance, which both he and his family appreciate.? Though Jesus has faced many difficulties and did not have the best role models growing up, VOA-AmeriCorps and Alberto’s mentorship have developed him into a young leader with a positive outlook.? Jesus now “wants to be a beacon” to communities who feel lost or are suffering.

Similarly, for Jhon K. Rivera Bocachica , a CHW at Luis Munoz Marin, the VOA-AmeriCorps program has been “a life-changing experience.”? Previously, Jhon worked in a surf shop in retail sales, but he admits that he was shy and less confident.? The program has taught Rivera “to be up front and take charge.”? As well, the surf shop “didn’t create lasting relationships,” whereas now he develops client relationships “easily and with great peace.”? Jhon’s clients often “are lonely or may feel abandoned,” but one of the best things he can do is just “show up for them.”? He has found that simple acts of kindness have decreased barriers and built trust.

One resident, Marcella, due to her anxiety, waits for Jhon to escort her up the elevator to her room.? Another resident, Julio, a veteran, was initially serious and reserved.? Now, he visits Jhon daily just to say hello and chat.? Through conversation, Jhon found out that Julio feels lonely and has little communication with his children and family.? So Jhon helps Julio with the “little things which seem to be just an excuse to have company.” ?Jhon and his team primarily help clients coordinate care and navigate the health system.? For these older adults, paperwork and online tasks are especially troublesome, so Jhon gathers the necessary documents to help complete forms and online activities.? This assistance has caused residents to tear up.? “The residents are so grateful for our service. ?It’s amazing to be helping others,” and this the thankfulness from his clients only further blesses Jhon.?

At Villa Providencia, Jesus and his team are engaged in similar work such as care coordination, systems navigation, form completion, and with the assistance of social work, adherence to medication regimens.? Nonetheless, Jesus feels that “the emotional support is the most valued assistance that I give.”? When Carmen, one of the residents, was closed off and isolated, Jesus slowly forged a relationship with her, and over time she has opened up about her life to him and began interacting with the other residents.? On visiting Villa Providencia, Yilka López , another VOA-AmeriCorps CHW, encountered resident after resident who praised Jesus and recounted his impact on their life.?

In July, when a traumatic incident shook one of the independent living sites, it was an all-hands-on-deck moment.? Alberto Maldonado called CHWs and staff from across the sites to go to the affected one.? As trusted caregivers, the CHWs were able to reassure clients just by being present.? Per Maldonado, “Jesus Nieves was the MVP.? Even if family didn’t show up, the CHWs were present to assist and comfort.” ?Nieves, who is studying naturopathic sciences at EDP University in San Juan, felt the clients were comforted and recovered quicker because of the immediate attention of program staff.? One woman in particular, Sandra, was feeling upset as she was unable to walk down the stairs that week to be blessed during the site’s weekly church service.? Hearing this, Jesus spoke directly to the ministry about Sandra’s situation which caused the church to start visiting Sandra directly in her apartment to impart prayers and blessings.

As Director, Maldonado feels that standardized, tech-enabled care delivery through the VOA-AmeriCorps program has been tremendously effective in creating systems change.? We’ve taken “advantage of the technology and everything else.? It’s a gamechanger for the island.”? Out of approximately 60% (348) of the residents across five sites who were managed on a platform, in 18 months, the VOA-AmeriCorps CHWs reached out to clients nearly 700 times, navigated services over 130 times, coached clients over 80 times, and connected clients to services nearly 900 times.

Maldonado’s vision for the island is grand.? He would like to raise up the next generation of proactive, empathetic leaders who can equip communities in Puerto Rico to thrive.? Like his staff, Alberto’s professional journey was deeply impacted by Volunteers of America.? In 2008, Maldonado started on at the ground level on the night shift at the Residential Reentry Center, a VOA Inc program funded through a Federal Bureau of Prisons grant.? Five promotions later, Alberto became the Director of the Residential Reentry Center (RRC), and in 2022, when VOA National Services expanded in Puerto Rico, Alberto was tapped to be the Regional Director of Business Development and Services for VOA Inc.? His vision is to create jobs and effective programs while expanding the VOA brand in Puerto Rico to include reentry, youth, older adults, and other populations.? Alberto would also like to develop partnerships with health care facilities, local churches, and others to reach more communities.? Recently, Maldonado partnered with local churches on a back-to-school drive where 50 court-involved residents from a half-way house sat side-by-side with their children and grandchildren to fill backpacks with school supplies for students in their communities.? For Alberto, this is success.? Through leadership, faith, and determination, Alberto and his team hope to further this vision for their island.
        

People that make this possible: Cindy C. Kathi Higgins Wendy Soto Barbara Banaszynski