Bridging Generations, Solving Problems: An Interview with IOA’s Director of Quality Improvement

How do you make lives better? How do you improve the way that older adults live, every day? How do you make things easier on families or caregivers trying to balance their own lives with the needs of those they are caring for? For Sandra Nuñez, IOA’s Director of Quality Improvement, it meant going straight to the source—and asking questions of the people most directly impacted by IOA’s programs and services.
By creating a survey that provides a comprehensive overview of the efficacy and quality of IOA’s programs, Sandra found a way to help improve aspects of the organization’s mission-driven services. And, perhaps just as importantly, she did so by recruiting a team of high school volunteers to oversee the project. This led to an incredible flowering of cross-generational interaction—and possibly changed the way the students viewed aging, older adults, and the impact they could have in the community. It’s just one more way that Sandra’s programs make lives better.

A Rigorous Survey Powered by Compassion

Sandra has always been fascinated by research. As a psychology and sociology double major with a background in Measurement Analysis and Outcome Research, Sandra wanted to see how she could capture true human experiences in the form of a survey. She has worked with older adults for 14 years now—coming to IOA as the Director of Quality Improvement helped her combine her intrinsic compassion, and a drive for social change, with her background in quality improvement and rigorous analytics. In doing so, she launched the first system-wide satisfaction survey for IOA last year.
These surveys were informed by IOA’s clients—older adults and their caregivers—who had used the organization’s comprehensive lineup of programs and services, including the Friendship Line. When asked what she hoped to glean from the collected data, Sandra explained that IOA wanted to learn about the many components of the organization’s various support services. “We asked questions about social workers and about case management. We were interested in finding out the overall perception of quality of services.”

IOA research team quality improvement
Sandra’s team of junior social scientists from the MYEEP program

It isn’t always easy for IOA’s clients to have a voice, like if an older adult is suffering from dementia, but as Sandra explained, in those cases, they would talk to the client’s caregiver. For example, to learn about the impacts of the day program, Sandra and her team of high schoolers interviewed caregivers “because the program is for people with memory loss. We asked if they were happy with the available hours, or the days offered, or really, all components of the program.”
When asked how she managed to find answers in what could be a subjective field—especially one compounded by the reality of memory loss, dementia, and an experience filtered through another party—Sandra explained that her team would open up the conversation at the end of the phone call so that the client had “an opportunity to talk to them in a more open-ended format.” That gave respondents a chance to really open up to their interviewers.

From One Generation to the Next, and the One After

But who was this team conducting the interviews? Through her survey and research work with IOA, Sandra has been able to build a junior social scientist program. That’s right, a junior team: she turned to teenagers. Her goal for these students was to help them “learn how to evaluate surveys, and to understand the complexity of putting a survey together.”
The team was made up of local Inner Richmond students who work through the Mayor’s Youth Employment and Education Program (MYEEP), a city-funded service that matches students with organizations like IOA to provide project assistance. And Sandra did need help with a project of this size—her group contacted 1400 clients this year alone.
But it was also a risk. These were students who had never done anything like this before, and who, in many cases, had never really interacted with an older adult outside their family. Sandra soon realized, though, that she was onto something special.

Student thank you for IOA's Quality Improvement Survey Team
Sandra believes her young students’ lives were changed for the better, along with the lives of IOA’s aging clients’.

“These are very engaged students. They get 18 hours of training before jumping into data collection, but by the second week, they take ownership of the program. They set priorities, run the daily debriefing meetings, and handle data entry. You can really start to see leadership skills in certain students. With the appropriate training, they really start to develop. They start to foster their own personalities for their approach on the phone. What we do is cover communication, and tell them how it’s listening 80% of the time.”
Listening carefully might seem a tall order for young people, but Sandra has been surprised—and deeply impressed—by their dedication. “They are very receptive and open-minded. And respectful with elderly and disabled. I really want to have that intergenerational connection in the same community.”
Sandra’s in-depth work with an aging population means she knows firsthand that talking to young people can bring older adults great joy. In fact, many of her young assistants received lunch invitations to clients’ homes. And that connection goes both ways. She sees her students develop an incredible level of “patience and increased compassion on the phone. When a student hears that they are the ‘first person I have talked to this week’, it really makes them think.” She hopes that it will also encourage them to consider a future career in community-based work for aging adults.

Building On the Results

Sandra believes there were two different kinds of results from the survey. The first is the data collected that will help IOA improve its services for older adults and disabled in San Francisco, and throughout the Bay Area. The second is her team’s growth in understanding and compassion towards aging.
Of course, the goal of IOA is to better the lives of older adults. And that’s done, in large part, by changing the way our culture and society treats aging—to get us all past seeing aging as a sickness, as a problem, as a point where life is essentially already over. Sandra knows that involves changing attitudes, and including the next generation on her survey team did just that.
For a month and a half, Sandra not only collected valuable data to improve IOA’s robust support services, but watched in awe as her team of high school students experienced immense growth in their understanding of life as an older adult. She notes that they “were particularly impacted by the Friendship Line clients. It gave them a greater appreciation for the social support they have, and for an aging population.” Thanks to Sandra’s work, the mission of IOA is constantly improving, and already taking root in the next generation.
If you are seeking support in your role as a caregiver for an aging loved one, IOA offers a wide range of programs and services to help. Contact us today to find out more.

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