An Unlikely Duo Working Together to Address Transportation Challenges for Older Adults

In this episode, we explore an unlikely but powerful partnership between Terry Kostyna, a "get-shit-done" (GSD) entrepreneur and small-town mayor, and  Dr. Jacob Al Hassan, an academic researcher focused on health equity. Together, they discuss their work with the Health Quality Council’s "Thrive at Home" initiative, specifically focusing on how rural communities can innovate to provide sustainable transportation for seniors. From volunteer-run shuttles to specialized software, Terry and Jacob share how they are working to bridge the gap between research and action to ensure older adults can age in place with dignity.

Resources 

• Health Quality Council's Thrive at Home Initiative
• A Call for a Transportation Strategy
• Prince George's Social Prescribing Initiative
• Drive Happiness (Alberta)
• Gravelbourg Cares Shuttle

Transcript

SPEAKER_01 0:11

Welcome to this episode where we dive into a partnership described as a marriage made in heaven, a collaboration aimed at solving the transportation gaps that prevent rural seniors from aging in place. Today we meet two individuals from vastly different backgrounds. Terry Costina is an entrepreneur and former mayor who brings a get shit done or GSD business mentality to the table, and Dr. Jacob Al-Hassan, an academic researcher who studies how politics impacts public health. Together, they are working within the Health Quality Council's Thrive at Home initiative to prove that transportation is not just a logistics issue, but a critical social determinant of health. In this conversation, we explore the productive tension between entrepreneurial speed and academic rigor, which my guests credit as the magic necessary for them to achieve true innovation. From an environmental scan identifying 92 local initiatives to testing specialized transportation software, Terry and Jacob share how they're using their unique skills and perspectives to advocate for simple small-town solutions to advance health equity for older adults in rural communities. What I find most fascinating about this conversation is not what they are doing, but how they are navigating their way through the different lenses on how they see the world. Jacob asks, how does politics make us sick? Terry asks, how can politics make us well? Jacob wants to understand how we got to where we are, while Terry wants to move fast to break things. Together they collaborate to find something in the middle, and that's where the magic often lives. Also, I want to give credit to the Health Quality Council for building a structure and learning community which brought these individuals together under their Thrive at Home program. I think their approach of using impact networks is very innovative, and they deserve a lot of credit for what they have built. Here's my conversation with Terry and Jacob. So, Terry, tell me about you and give me a little bit of your background and how you got to this work.

SPEAKER_02 2:05

Sure, let's go. I'm a business person. I'm an entrepreneur. I'm not involved in healthcare, never have been. Uh I've been a frequent flyer, so to speak, because I'm involved in motorsports, skiing, those kind of things. So I've had my share of emergency room visits, and uh so I understand how that works. In addition, um, my wife spent 34 years uh working in uh emergency services as a nurse, like you. Uh so I I got an in-depth inside vision, but not being there. And um, so she was in emergency services trauma um and finally with Saskatchewan Air Ambulance as clinical coordinator, and and so dealt with trauma and emergency. Um, and I got to spend a lot of time with people that did work in emergency health care. Um, along the way, um, developing my business throughout the years, I was in the trucking and transportation business, logistics, and throughout the years, I was always interested in doing things differently. Um, and so quality improvement is about change. So I was always about quality improvement in in that area. In my role as a transportation logistics business owner, um I had people approach me and said, Hey, you ought to be involved in um the Saskatchewan Association, the association that advocates for the trucking industry. So I stuck my hand up and said, Okay, I guess I could help out. And I wound up 10 years on the executive and concluded uh my term there when I sold my business as the president of the STA, lobbying their uh governments for improvements in safety, improvements in in things that the industry needed to grow, to change, to do things. So that's my background. We moved to Candle Lake, and here I am. Now I'm a home builder, but then somebody said, you know, you should run for council. Uh, you know, our little village needs some things that probably could be improved. So uh I stuck my hand up and I said, Well, if I'm gonna do that, I'll run for mayor. So I got elected and was very fortunate to have an awesome council elected with me, and we facilitated change. So now we've got Candle Lake organized, it's a thriving, growing community. Uh and then my wife was retired, and I said, you know, Miriam, we've got a lot of things going on, we've got things changing, things are improving, we've got a uh funding for a new lagoon, we've got funding for a new infrastructure, funding for um a hall renovation, uh, we've got all kinds of things organized. Um, uh, but we've got a little health committee that's kind of struggling. And uh, you know, they're doing letter writing campaigns, and our little clinic was pretty well staffed uh up till five or ten years ago, and now it's just struggling along. Uh, and uh so geez, Marianne, you might be interested in joining that little health committee. So she did, and I came home and I asked her how it went, and she said, Well, I think it went well. I said, Well, so what'd you learn? Well, I learned that I'm the new chairperson, and that's the way it works, yeah. And and so um she did that, and and we worked together, the mayor and her, and then we had uh some new additions to that health committee, and we came up with a strategy and we said, you know, we've got to change something, something needs to work with the SHA. We were having little meetings with the SHA. We went to the ministry and said, you know, what would it take for us to get a little more engaged with you? And and uh what if we asked you a different question? Our question was, and this should be a question for every small town. Our question was, is there a greater role for rural communities to support or enhance health and wellness right in their own backyard? So that's how we've moved. So we're engaging um and now with volunteers uh to work with the system to improve health and wellness. And in our case, it's especially for seniors. So that's my brief little story.

SPEAKER_01 6:38

Wow, and I love that you've got the heart of an improver, you know. You think of quality improvement in healthcare, but there's people with the heart of improvement in all kinds of places in our society, and it's really cool when they join forces together. That's awesome. And Dr. Al-Hassan, your I love that you guys also have found each other because your paths are quite different, and yet you've kind of converged into this like collaboration and partnership. So tell me about your background and how you got to this work.

SPEAKER_00 7:09

Absolutely, thank you very much. And um, yeah, you're absolutely right. Just listening to Terry. I see how you know different our backgrounds are, but also how similar um they are in that we're you know doing something together now, which is um fantastic. So um I I came here, and by here I mean to Saskatchewan 10 years ago. So I'm originally from Ghana where I was born and raised. Um, I grew up in a small rural community, I would say, um, in a very, very different social, economic, political sort of context than this place. Um, and growing up, I did see lots of things that would have inspired in me a desire to change and improve my society. So, you know, we're talking women dying um while trying to give birth, um, we're talking, you know, children walking very long distances to get to um school, um, and we're talking like health system infrastructure that is crumbling, and part of that was tied to lots of political and economic um policies. So that background was what inspired me to actually pursue a degree in health administration um in Ghana. So I was most of my former classmates are managing hospitals in the country um right now. So that was my original um interest in understanding and improving health systems. And um, I went, I got that training, and honestly, as part of my training, the one of the big things I started to understand was that health systems exist in political systems, and so politics and political decisions determine and influence how the health systems themselves function, and so this insight actually pushed me to pursue another degree in global health, so moving from managing a hospital to like understanding the global health system. Um, and so that became my passion, right? So I moved to England, did that degree, and became all about that. And when I was there, I kind of decided to move to Canada to pursue a PhD, um, and that's what brought me to Saskatchewan. And so at the time, you know, immediately I landed here, I was actually more interested in um the health of immigrants because I am an immigrant, and so that was one of the first things that I cared about, and I was very excited. I wrote a proposal, I was like ready to pursue a PhD thesis in that, but I I arrived here on September 2nd of 2017, and then I think the next day there was like a protest in the city um because the government had just shut down the STC in May of that year, right?

SPEAKER_01 9:44

And STT STC is the Saskatchewan Transportation Company.

SPEAKER_00 9:49

That's right, yeah. So this was the main intercity bus system that they had. Um, and so that was the first time I ever heard of that, right? I didn't know anything about that company, and you know, but my supervisor and those that I had just met in Saskatchewan, because I again at that point I was all about how politics makes actually my former master's thesis supervisor wrote a book titled How Politics Makes Us Sick, because they're all always connected. So that's how I got into the world of like transportation and transportation as a social determinant of health, because we already knew that housing, transportation, food insecurity, all these things make people sick or not sick. So that's how transportation became one of the potential things. So I went to a few of those protests, saw people, understood their cause, what they were talking about. I I saw I met lots of people, some people who were blind and couldn't drive, some people who had relied on you know that system their whole lives, and there were other things that they were protesting. And so I had decided at that point that I was going to um investigate how government decision to end access to transport or close down a company, how that might affect the health system, how that might affect the health of individuals, how that might affect the health of people and communities. And so that became my new passion, and that you know, the struggles that I was seeing here were not that different from those struggles that I had seen in Ghana, where people might, like I was saying, die on the way to hospital because they couldn't get there. Um, and so for me, it was that wherever I am, I am home and I can um align myself with people who are trying to improve systems um in those contexts. And so that background and that work led me to writing a thesis, right? So I ended up doing writing a 300-page PhD dissertation about the decision to shut down the STC, the health impacts of that. Um, I became a bit of a transport expert. Um, so my world is primarily how does politics make us sick? Um, and I do that investigation through research in different aspects. Um, headed to the World Health Organization headquarters in Geneva next month as part of the World Health Assembly, because that's like the global level. This is like how politics makes us sick at that level, but also local, because we always must do the global and the local together. Um, and so the HQC um work kind of emerged in that more and more people were seeing what I was producing with others about how transportation is a big social determinant of health, and so they reached out to me at the time that they were um creating the Thrive at Home community because they had identified transportation as one of the big pillars um for improving the health system, but also improving um people's ability to age in place and things like that. And so that's how I got pulled into this work, and it has been a great opportunity both to continue to share what I have learned from my research, um, but also engage with folks who are trying to solve the same problem that I have seen, which is the problem of not being able to get where you need to go, um, whether it's to the hospital, but also whether it's to see your family and friends, because a lot of the time when people hear the transport health connection, they just think more about you can't go to hospital, so you're sick, and that's the bad thing. But it's obviously much more complicated than that, it's more like you can't go see your family that leads to you being lonely, can't get the coffee roll, yeah, the big part of rural life, yeah. Yes, so all the way from you know those things to loneliness to isolation and depression and things like that, to you being sick, and that leading you to the hospital, and that leading to the hospital having to take care of you more than it needed to or intended to. So that those are some of the things that I have been doing, and that's the path that kind of led me to um the thrive at home work that I'm involved in now. Yeah.

SPEAKER_01 13:49

Amazing. And so, Terry, I remember you from sitting at my table a couple years ago at a workshop that the Health Quality Council had put together, and their initiative was called Thrive at Home, and it was about helping older adults age in place and thinking about what everybody could do and uh work together to advance that work in the province. So, can you tell me about your journey in participating or linking up with the Thrive at Home initiative and then how that connected you to Dr. Al-Hassan?

SPEAKER_02 14:22

Um, yeah, how that connected me to Jacob. Um, it was actually really interesting, and I I value our connection. Uh again, Jacob said that we come from different perspectives often, but we more often we have the same goals.

SPEAKER_01 14:42

Right. So that's you're connected in a shared purpose almost.

SPEAKER_02 14:46

One of the very first things that we did uh when we started speaking to the ministry, if you'll recall that, way back when we were having some really good dialogues with them, and they were encouraging us, and they got politicians involved, and the politicians helped us. So, in our particular case, and and and Jacob, you know, how does politics make us sick? But I take a different approach to things. I understand politics can do that, but how can politics help us? And that's what I've always done. And I've worked with so many politicians from every, well, both flavors of the government in Saskatchewan over the years to facilitate change. So uh we got connected by the Ministry of Health. They said, you know what, you're onto something here. And we just heard about a program that's being done by the Health Quality Council called Thrive at Home. Uh, you folks need to be connected. So they connected us, and uh, it's been, let's just call it almost a marriage made in heaven, because we were looking for uh the things that small towns could do. And what we didn't realize is that there were dozens and dozens of other small towns, small organizations that were looking to be connected, and everybody was working on their own little thing. Everybody was talking to their local politician or having their own little letter writing campaign, or they were just struggling along. And uh, so we took that opportunity, got connected with the HQC, uh, and we started moving our program forward. Now, then we got into actually a formal agreement. Uh, we have a pretty simple MOU with HQC related to the Thrive at Home project. And we said, you know what, if you help us out just a little bit, um, then we will only do things to the best of our ability that can be templated that can work across the province. So our transportation little initiative is one of those things, but we're also we have initiatives on uh the three pillars of Thrive at home, transportation being one, home supports being another, uh, navigation through the system being the third.

SPEAKER_03 17:03

Okay.

SPEAKER_02 17:04

And then somewhere along the line, somebody figured out I had a transportation background, and I got a call and said, Hey, we've got one really good uh leader, all of our hubs have two. Um, would you uh be willing to be one as well? And I said, sure. And then I met Jacob, and here we go, and we've had fun.

SPEAKER_01 17:27

And what were those initial conversations like? What came out as your common goal or what you wanted to work on? How did that come about?

SPEAKER_00 17:35

I can take a crack at it. Um, it's been a while now, but I will say that so for the most part, the good thing about Thrive at Home has been that they have had such a solid structure that it has been very easy for us to navigate the path forward without necessarily having to um determine too much on our own, right? So we have had to bring resources, we have had to figure out and chart a path to some extent, but they have had such a solid structure, um, like a working group that is already set up for us. We they have a support person who has facilitated the meetings and everything. Um, but I think you know, when we first met, we kind of had conversations around just transport as an issue and how it affects the well-being of older adults, particularly in rural contexts. Um, I learned more about Terry's background, um, you know, in local politics, in his community, and some of the things that they were already doing. And I think one of the things that, you know, came through very early in our conversations was you know, Terry's interest, often in kind of thinking about solutions as much as possible. Right. So, you know, for me, like I'm an academic, so my interest is solutions, of course, but I'm also very interested in understanding why we got to where we are in the first place. Right. So even when I say how politics makes us sick, it doesn't mean politics cannot make us well, right? When governments spend the right way, if governments put money in the right place, if governments think of people's health not from the perspective of profit or business per se, but more from the perspective of human rights and things like that, I think it makes a difference. And so we have to always understand that as clearly as possible.

SPEAKER_02 19:11

You know, from my perspective, and I'm sure Jacob would share this, um, but I'm a little less delicate than him. Uh and that's that's meant in the in a positive way. But um, I said, okay, well, we're coming at this from a couple of different angles. I'm an entrepreneur. Um, I've learned by a lot of mistakes. I'm not an academic, but I've done some pretty successful things. And um, but I have what I call uh letters behind my name. One of some of those would be GSD. Uh I I get shit done. I try to. You don't always do it right, but if you don't try something, you don't know. And you know, like so now we're talking about quality improvement. We're talking about in our transportation hub testing things. Well, I don't know how many times did uh Thomas Edison test a light bulb. That's right.

SPEAKER_01 20:11

Continuous learning and improvement, continuous learning and improvement.

SPEAKER_02 20:14

And fail and fail and fail. You know, fall down, get up again. So that's you know, that's where I come from. And it was pretty apparent pretty pretty early on that we were we were coming at this from a couple of different things. Uh Jacob was looking into the past to analyze um what had happened and the impacts of those things. But I heard something about a race car driver once that said, what's behind you is not important. You can learn from it, but you know, just move ahead. Uh, and so that's where I go. That's kind of how I approach things. So it can be scary for people and it can get me in a lot of trouble. But um, you know, what what I'm really valuing now is Jacob and I are learning from each other.

unknown 21:03

Yeah.

SPEAKER_02 21:04

Like I'm learning from his different, perhaps wiser approach to things, uh, as opposed to my just stumble ahead and see what happens.

SPEAKER_01 21:18

Well, to me, this is, and then this is what I saw at the March workshop is that you guys are so different, and yet you're appreciating the learning that you get from each other, and you almost find something that works more in the middle between the two ways of doing it. There's kind of like a third way that's really working well for you and this initiative. So, Jacob.

SPEAKER_02 21:38

I I have a I have a friend that often says, you know what? If if two of us thought exactly the same, we wouldn't need one of us.

SPEAKER_01 21:45

That's right. That's right. Yeah, that's great. So, Jacob, I really was interested in the way you applied your academic research. I think you hired maybe a research assistant to do a bit of analysis that focused. Focused on learning about what the province was doing. Can you tell me about what you did with that?

SPEAKER_00 22:05

Absolutely. And you know, just before that, I just wanted to agree as well that, you know, having different perspectives is absolutely essential and it has come through in our successes, I would say. So, you know, like there are connections that Terry has that I don't have that have been very valuable to us. There are insights and methods and approaches to finding things that I have that Terry might not have that has given us access as well to information that we might not have. So I I deeply um enjoy working with Terry in that we're, you know, it's not always going to be easy, obviously, because we have a different perspective, but the results speak for themselves, the things we produce speak for themselves. Like we have things to show for um our collaboration. But essentially, the thing, the part, so you you know, as we're giving you the background of how we ended up working together and we didn't thrive at home. Um, the idea was, you know, like what strengths could I bring to this project, and what strengths could Terry bring to the project? So my part was, you know, if you're an academic, the things you do are you write grants, you do research analysis, you analyze data, you can write stuff up, you can disseminate them, you can show insights, you can see patterns that might be harder to see. So that was the first thing I did within the Thrive at Home was to lead us to um obtain research funding um to be able to do an environmental scan of transportation initiatives that exist in Saskatchewan. That's one of the things we really wanted to know as a group was, you know, so Terry has talked about. We wanted to sort of try some promising practices and see if we could even test something that works to be able to say, see, this works. But we said before we do that, right? So it's the same tension about the past and the future. Right. You know, I was more thinking, okay, let's get this, let's get the current state of affairs before we can test anything. Like, let's see a wide range of what is available and then pick one of them as a really good example and potentially like test it and tell people, see, this works. So we got the money. Um, we, you know, very thankful to the Saskatchewan Health Research Foundation because we applied for a grant, they gave us the money. I hired a master's student um from within my department, and we use the methodology that I will say, you know, we we wrote a paper um for a different project using a very similar methodology, and it's a very useful way for us to kind of get a sense of what's working. So we basically develop a search strength, so like a series of words that would potentially help us identify transportation-related initiatives. So, like, think of all the different ways you could say transportation, right? So bus, rides, rides, shuttle, all the different ways of saying that. Then we um essentially use that to um write a code. So we looked on Facebook, we use like Google, um, we use like two, three, three, we just use all the possible places, and so through that we got like a whole bunch of hits, and then the research assistant would clean this data. That means like he would look through and actually delete the things that are just false hits or they're not a real thing, right?

SPEAKER_01 25:26

Like you you took out the rough riders football team.

SPEAKER_00 25:30

Yeah, exactly. Yeah, exactly. If there's anything like that, we'll like remove those, and then we ended up with a list of potential initiatives that are um in the province right now, okay, and possibly offering um transportation for uh for people within the province. So these are like a very wide range of initiatives. We identified 92 initiatives in like 75 communities in Saskatchewan where there was some kind of initiative that we could find using our methods. So we found those ones and then we collated it into a big Excel sheet, which we shared with our partners as a group. So then we then went through a process of trying to phone up as many of these organizations as possible to verify are they still there, are they still operating, what challenges might they have, um, and things like that. So that's kind of the approach we use, and it helped us to really get a sense of what is happening right now in terms of communities responding to transport gaps and barriers in the province.

SPEAKER_01 26:30

Okay. And so after you phoned all of these places and learned all about that, what kind of rose to the top in terms of your learning and understanding? What did it tell you?

SPEAKER_02 26:41

Um, so what I learned and looking through it, and I I made a couple of those calls myself, we found that there were a lot of programs operating in the province. A lot of them were a typical Saskatchewan, might be across the country as well, but oftentimes a handy bus tied to a facility, a care home, perhaps funded partially by foundations in the community, in some cases, perhaps with a little bit of SHA funding, sometimes with paid drivers, but some of the little community ones were using volunteer drivers with their own vehicle. We found that many of them were functioning okay, could be better, their vehicles were getting a little older, but we also found that ridership wasn't necessarily huge. Um, or it perhaps wasn't the right vehicle at the right time for the right place. Um from my perspective, um what was missing was something that was nimble, and that continues to be for me something that needs to be addressed or considered. We need to be nimble, you know. So um, so that's what what we're beginning to learn. We haven't done the deepest dive into that yet, Jacob. I think you'd agree. Um, and uh, but we did identify some really cool promising practices.

SPEAKER_01 28:17

Okay. What's one example of a promising practice that you've seen, like a community that's really impressed you or where it seems like it's working really, really well?

SPEAKER_02 28:25

So on January 22nd, we presented the results that Jacob and uh student Bernard did and uh to a group, and it was it was well attended. It was uh you know over 30 people, but they were kind of the right people from a broad mix across the community. And uh so we talked about Jacob's uh report and the data, um, but then we talked about some of the promising practices that were emerging. One or two communities had already emerged um by buying or funding in some way their own minivans or an SUV, five, six passengers. So in in those cases, they were spending between 80 and $100,000 and then put together a volunteer organization to run and operate those vehicles.

SPEAKER_03 29:10

Okay.

SPEAKER_02 29:11

Um, so they were doing that, and then they were coordinating rides, booking the rides in advance so that people as individuals could get to the next largest community. So one of those examples was Gravelburg in Saskatchewan, and they have something called the Gravelberg Cares Shuttle. That's operated by a group of volunteers. They're funded by fundraising. They got some initial funding from Health Canada uh to set it up, but they have no sustainable funding, so they continue to struggle. From that model came another community that said, hey, that seemed like a good idea, and that was Indian Head. So Indian Head um absolutely copied uh shamelessly the model that was in Gravelberg. Gravelberg helped them out, and and they went out and they uh they bought a minivan and they are doing the same thing. And so they book that thing two, three days in advance. They have a little dispatch system, they're struggling with that a little bit because you know they use a combination of Google Sheets and a bunch of other things, and and and they coordinate that. So that was one of the promising practices, but the other one that was really promising and affordable was what's going on in Strasbourg, Saskatchewan. Okay, and that program has been going on for over three decades uh and it's been successful. Uh so they have a program where volunteers much prefer to drive their own vehicles, and so um over the course of time, and I don't know how many years that's been, um, they have a program now where volunteers provide their own vehicles. The clients book their rides three days in advance, but the volunteers use their own vehicles. So, what that is, and what that's identified to me as something that's affordable for a small town to do, that it might gain some support from the government or the SHA, and uh from my estimation, almost certainly will, because it's almost free. And there's nothing that will pique a politician's interest, then it's almost free. And our research um after that led us to do some more research um across the country to find out what programs there are, how they're facilitated, how they deal with things, even for example, like insurance, and what can we do to uh put together a program here in Saskatchewan?

SPEAKER_01 31:46

Okay. So now are you guys focused on sharing these results, giving examples to people, encouraging them to connect with each other to learn and develop in their own communities, or what's your next steps, Dr. Allison?

SPEAKER_00 32:03

Yeah, that's a good question. And you know, like Terry said, we've identified so many initiatives. Sadly, we haven't had the opportunity to talk to every single one, which is very unfortunate because you know, there was also like this Court of First Nation Transportation Service that we found, which was uh a transport service that is within a First Nations community. So there's like all these variations. Some of the services we have found are like literally free, like completely free to use, which is you know very, very significant for people who may be facing cost barriers. So we're trying to figure out a way of supporting our community partners as much as possible. We're starting, um, working on creating a how-to sort of guide for communities that might want to start something. Um, and I think, you know, Terry, we will hopefully spend some more time to think this through. But there are lots of things to think through about you know, where are you gonna get the funding from? So we will try to get a list of resources that we have come across that might help people, you know, you could apply to this, you could apply to that. Um, and I think as well, Terry, some of the things you're saying about some of the organizations in terms of like the ones that may have challenges with tracking the information, or um, there might there are things we could create, and I think we will work together to try to create little templates here and there that we could hand to a community. Okay, this is where you could potentially look for money, these are the challenges you can expect potentially. Um, if you start having people, this is how you could track who is using the service. Like we'll try to provide a suite of um resources like that so that communities that are interested, and we have partners from Aberdeen who don't have this and have been following. We have a colleague, Colette, who has been part of this work and is like lobbying and working and trying to get something going in her small community. So, for someone like that, like the resource we would create, she could take it as a template and she could look at what's really on the ground in Aberdeen and then decide okay, this makes sense for our context, but then we would be able to um use some of those resources. Um, and we are sharing as much. A big part of the reason we're talking to you is that we're trying to disseminate what we have found and let more people know what we have found. Because I think a lot of people don't know as much about what's out there, most people just know what's happening in their community specifically, you know, that they have or do not have a transportation initiative, but they don't know if most initiatives are phone-based for booking or online. They don't know how many exist, they don't know what's the proportion of rural versus urban, they don't know what challenges everyone seems to be running into. So having a resource like the one we created, the environmental scan we ended up doing, it culminated in a report that's almost 20 pages. And so it has like a lot of what we learned so far. And the new thing we're gonna create, which is the how-to guide, will be a more practical resource for those who are at the stage of trying to start something. So we'll have to figure out the best way of sharing that guide as well, so that more communities across the province who have the capacity and the interest and the need will be able to work together to draw on the guide to be able to start initiatives, but also more importantly, to sustain those initiatives because a lot of the time starting something and sustaining it are two different and I hear a lot of your work focuses on the local and maybe at the municipal level, but as you said, health is political.

SPEAKER_01 35:34

Um, are you also looking at, you know, lobbying efforts at a provincial level or advocating for infrastructure that can keep these programs sustainable to develop them or sustain them?

SPEAKER_02 35:48

For me that Go ahead. Go ahead, Terry. For me, that's that's absolutely a long-term goal. And I talk about sustainability often. Like if we get this guide and we're working on that, um, we almost need funding for the guide. But I think we're we've got a path to get something started here. Um, Health Quality Council is very engaged in working with us now on uh, you know, we've established just at a recent meeting what are our next steps, and the guide has become a priority. But in order to have the sustainability for these programs going forward, we need data. We need to be able to prove to the politicians, to prove to those people that might fund something in the future, what's working, what's missing. It's hard to measure something that hasn't happened. Yeah, so we we have that issue. Like, uh, okay, so Mrs. Smith didn't get to her doctor's appointment. How you know, how do we know how that affected her?

SPEAKER_03 36:46

Right.

SPEAKER_02 36:47

So so we don't we don't know, but what we do know is what we can collect. So what we've also come across, and Jacob, I'm glad you mentioned uh Colette and the and the wonderful folks at Aberdeen, they showed up at our event. Uh Colette's trying to get um um local support. So she brought along an RM person, like the rural municipality that you know, she's trying to drum up that interest at the local level for that support. But remember, health care is not the responsibility of a municipality, and every small town mayor and counselor and administrator will say, Oh, health care, you need to talk to the province. Don't come talk to us. Right. What they don't understand that wellness is part of their community, and you know, talked about the challenges in the bigger cities around health and wellness and how it affects their policing, how it affects uh everything in their community, that social element. So that you know, that's where it's an issue. So we've uh just recently have a new person join our Thrive at Home. So we have people don't forget, I'm not from a healthcare background. Many of the people in the Thrive at Home program are involved or even paid as part of their jobs. We have a lot of little nonprofits and other people that aren't, but we also have a couple of private operators, for example, uh the folks from QualaCare in Regina are involved in uh in the probably the home supports hub as private operators. So now we have a uh a little operator in Saskatchewan that has an Uber type software program, and it's called Booker Rise. Uh so we reached out to him and said, Hey, we've heard a little bit about you. So folks in Swift Current had heard about him, and we're playing around with their seniors transportation program. We said, you know what? Can you tweak your software and can we give it a bit of a flavor that just focuses on seniors? Could it be Booker Rise for Seniors?

SPEAKER_03 38:54

Yeah.

SPEAKER_02 38:55

So here at Candle Lake, uh working on our transportation program, uh, we're working with a private provider to tweak his software, collect the data, and make sure that we have that so that we can track that. And then we're asking him to create a template that any small town in Saskatchewan can use.

SPEAKER_01 39:18

You guys, this is so interesting and exciting and innovative, and you know, there's this um concept of network weaving in in health system improvement where you take different networks of people and you you mix them all together to generate new solutions, new ideas. And I just think that what you guys have done is really sort of the best example I've heard of bringing different people together to solve an issue and sharing and learning from each other. And I just think what you're doing, I mean, it makes a lot of sense, but I think people underappreciate how much work and how much effort it takes, but it has real potential to have such a huge impact in actually changing the lives of older adults in the province and potentially across Canada. So I can't commend you enough for the work that you've done, the collaboration that you've built, the community of players that are involved. And I think this is really exciting. What's your vision of the future? What's your goal? Or how would you be happy when this is all done of what's left behind from this work?

SPEAKER_00 40:34

Well, let Terry have the last say. Um, I would say that primarily um my motivation is health equity. Yeah, I want to live in a society where everyone has the opportunity to live a healthy life, and that the governments, the people in authority, so governments at different levels, you know, families, there's all kinds of people in different levels of authority, are able to step up, and that when people become vulnerable because of age, because of disability, because of whatever reason, that we do not build systems that isolate those individuals and let them live lives that are less um desirable than they would want. And so this vision for me involves you know, governments giving resources, governments listening to um their constituents, because governments don't exist without consist constituents, right? People elect people into power, and so governments always need to bring their ear close to the people. You know, I think a big challenge that I have found in a lot of this work is you know, I'm a researcher and this is gonna surprise you, but it's not only about data, right? Like we do a lot of analysis, we do a lot of research, we gather a lot of data. In my experience, it's often when data aligns with the understanding and vision of those in authority that the change actually ends up happening. So sometimes you can gather all the data and have all the evidence and think that this is like completely incontrovertible and have nobody use it to do anything to improve well-being, right? So for me, like I think on the one hand, I know what would be good, which is the equity that people get and where they need to go, and you know, ask create in a just society where nobody, you know, because they are old or because they have a disability, cannot get there. But I think to get to that vision, it will involve whoever is going to control the resource, in most cases, the government, listening to the researchers, the community leaders, the people who have worked to move us towards this vision so that they can release the resources. And resources are all kinds of things. Even my time is resources, you know, your time is resources. So there's all kinds of resources that all of us have to release, but in most cases, it's money that someone somewhere might have to release. So let's first of all have that vision, which is equity. We want fairness, we want everybody to live a life that we can say we live in a just society. That's the first part. And then the second part is let's listen to the data and not just, you know, do anything else. Let's try as much as we can to let the data lead us and guide us. But again, it's not that black and white. In most cases, you can have data and it might not lead where you want it to go. But in the end, equity is that's the principle that um is at the heart of everything that I am doing.

SPEAKER_01 43:27

Yeah, and I hear you saying too that as a public, we need to speak up too and tell our leaders that this is important, this is a priority, that they want to see resources invested in this, or they need this service in their community. And that's a powerful tool that we should mobilize as well. Yeah. And Terry, last word to you.

SPEAKER_02 43:48

Okay, well start with that. So uh we need to tell every politician will tell you that they have armchair engineers, armchair consultants, everybody wants to tell them something. Um, but I think it's important that we need to show them something.

SPEAKER_03 44:06

Okay.

SPEAKER_02 44:07

And uh so for me, what success looks like in the coming months in a few short years, because uh I'll be a senior soon. I will be an older adult soon. I'm only 70 right now, and there will come a time when when I'm going to need those services. So I'm in it for me, along with my other older friends. But so we need to show them some success stories. So what I would like to see over the next little while are some of these small little, and I call them simple small-town solutions. At a meeting with uh SHA executive uh once out here at Candle Lake, and one of their senior directors said, you know what you're proposing, Terry, this sounds like it could be a quick win. You know, so everybody, every politician is looking for a quick win. Yeah, something that, oh, we did this. Um, so if we think about this, Jacob and Kyla, as uh we're going to battle here. We're going to battle for seniors and those people that that have a transportation issue. Um, and and we have a mission that's to improve the situation for them. And that we have to do that by facilitating change. Um, what's our ammunition? That's where we go back to our data. So if we find a politician or if we find a political initiative uh that seems to be of interest to them, we just have to keep asking questions. Does this interest you? Does that interest you? What about this? What about that? Uh, would would you like it better if it was almost free? And and when you get that, and you get that interest, then you can say, Oh, we have data on that. Would you like to see it? And then you don't flood them with a whole bunch of stuff, just what they're interested in, and and you move from there. So it's it's about innovation and creating some quick, simple wins, some simple small-town solutions for those of us in rural Saskatchewan, and and doing that, and then it's about constantly thinking about quality but doing things. GSD. Yeah, so we need to innovate, we need to move forward quickly. And I I wrote this down the other day as I was preparing for this, Kyla. I said, you know, quality doesn't improve by having meetings, by constantly talking about things. Uh, quality improves by changing things, by doing things, by looking for simple, quick little wins, simple small town solutions, testing things, not by overthinking and being frozen in time or being frozen even in bureaucracy.

SPEAKER_01 46:44

So yeah, yeah, amazing. Thank you guys so much for sharing your story and your collaboration. And I'm gonna link whatever resources I can find, whatever you guys have created, I'm gonna put those in the show notes. So if anybody wants to learn more, um, they can read your reports and hopefully connect with you to get access to toolkits and keep the conversation going and keep the momentum going. So thank you so much for all the work that you've done. And I know money is a resource for sure, but like you said, time and energy and all that you've done to commit to this work is also appreciated too and shouldn't be undercounted for the impact that it had. So thank you guys both. Thank you so much, Kayla.

SPEAKER_02 47:24

It's been an absolute pleasure. Thank you.

SPEAKER_01 47:30

Thanks so much to Terry and Jacob. Their work and partnership reminds us that transportation is more than just a ride. It's a vital social determinant of health and human right that ensures no one is left alone and isolated in their community. Speaking of, for today's shift shout-out, we're highlighting Prince George, British Columbia, a community that is leading the way in a transformational healthcare initiative called Social Prescribing. In Prince George, the Council of Senior Society is proving that the best medicine isn't always found in a pharmacy. Social prescribing allows doctors and other healthcare professionals to refer patients to non-medical services like walk-in groups, art lessons, or community clubs to address practical and emotional needs that traditional medicine might miss. It's a holistic approach that views the community as a vital partner for wellness. What's happening in Prince George is truly remarkable. Participation in their social prescribing program has rocketed, growing from 48 participants to the peak of 144 in just over a year. The Prince George Council of Senior staff has delivered more than 2,800 individual supports, including navigation assistance and follow-ups. They manage to take an initial wait list and bring it down to zero, ensuring seniors get the help they need without delay. Prince George now stands out as one of the most active social prescribing hubs in the North. This work is part of a broader provincial movement led by the United Way BC and the Ministry of Health, which recognizes that tackling socialization is just as critical to health as treating physical symptoms. So a huge shift shout out to the team in Prince George and the BC senior services sector. You're showing the rest of Canada how to innovate at the community level to help our older adults stay active, connected, and independent. Keep shifting the system narrative on what healthcare can be. And remember, systems don't change unless we do. This is shift. See you next time.