(upbeat music) - Hello, and welcome to Prairie Pulse.

Coming up a little bit later in the show, we'll see another artifact spotlight, but first, joining me now is Tracee Capron, the executive director of Hospice of the Red River Valley.

Tracee, thanks for joining us today.

- Thank you for having me, John.

- As we get started, we always ask, tell the folks a little bit about yourself and maybe your background.

- I am originally from the Pennsylvania Ohio area.

I was a special education teacher and became a nurse and fell in love with hospice care, working as a oncology nurse and here I am today.

- So how long have you been in this role?

- Six years in North Dakota.

- Okay, so what got you interested in hospice?

- Well, when I was working on the oncology unit at the hospital, I got a personal call from my grandmother and she called me while she was in the hospital and she said please come and get me out of here.

I wanna go home.

And that was almost 30 years ago, and at that time, I didn't understand hospice, know what hospice was, didn't recognize the value.

I went there.

The doctor said you can take her home with hospice and I thought ugh, but you know what?

We had an incredible year.

She was able to live her life the way she wanted in her home with the support of hospice services.

I saw her family come together.

I saw love, selfless love.

It was all about her and her goals and dreams and I was like this is how it should be for people.

- Okay.

So tell us for the folks out there, what is Hospice of the Red River Valley?

- Hospice of the Red River Valley is a community-owned, you own it, we all own it, we're the only one in the state, meaning that all of our decisions that are made are based by our board of directors and our staff.

So we take all of our resources and our care and we give it to the patients.

- Okay.

So how many employees do you have?

- Over 250.

- 250, and how are you funded?

- We are funded, we get Medicare dollars, Medicaid, private insurance.

We also take anyone, regardless of their ability to pay, so our donors are a huge asset to us.

Their donations allow us to provide care anywhere or to anyone, regardless of their ability to pay.

- Hospice of the Red River Valley, how was it founded?

- Volunteers.

And I was fortunate enough.

I got to meet the first executive director about two months ago, and it was incredible because she was a nurse too, I'm a nurse, and their vision and dream back then, a group of volunteers free, knowing that we needed to take care of end-of-life care in a different way, and we needed to honor what people needed and wanted.

Her goals were the same.

Her goal was the make sure that North Dakota, anyone in Minnesota, could receive care.

Our dream's still that today and we're still working on it.

- Well, I understand you're celebrating a 40th anniversary of Hospice of the Red River Valley.

Can you talk about the observance, what's gonna happen, or?

- Oh, media, obviously.

I get to meet with you and share that.

A lot more education to the community.

With COVID, obviously, it looks a little different, our celebrations, lot more media presence, stories from our patients and families, and we wanna celebrate that.

- Okay.

Well, can you explain how hospice has changed and sort of evolved over the years?

- Yeah, what I've seen, because I've been in it pretty much from the beginning and what I have watched is we do so much more than they did in the beginning.

They didn't know what all they could do for a patient.

You know, cares, being able to still see your primary doctors, you know, making sure that we have medications and treatments to treat all the diseases, we pay for them all too.

- Can you walk us through, maybe, how a family goes about contacting you and then signing up, I guess, for your services?

- Well, there's lots of ways.

They can reach out themselves to gain information.

We'll meet with them, we'll talk to them.

They can talk to their physician and request a referral.

If they're in a care facility, they can request it from their care team.

Alls you have to do is reach out and basically ask.

I would say, we plan everything in life.

Why don't we plan our whole life, and know what our goals and our wishes are through our life and share those with others?

And have a plan?

- Well, related to insurance, you mentioned that, can it get tricky or even difficult sometimes, maybe regarding when to call in hospice?

- It can.

Medicare, there's a timeline they put on it.

It's like six months, but who can say what six months looks like?

So we have our doctor and their doctor evaluate that and nurse goes out, and we assess and I always say, if you see that things are changing in your life and there's declining happening or you have symptoms out of control, reach out and help.

- Can you talk about the area that you serve?

- Oh yeah.

We serve 44,000 square miles.

We serve the majority, well, we're trying to serve the majority of North Dakota and Western Minnesota.

We are currently on a mission and that's part of the original mission.

A third of our state has no home services.

So we are reaching, well, people are reaching out to us saying can you please come help?

We just had a call recently from Baudette County, and it reminded me of hospice 40 years ago.

A group of volunteers in that community, people coming together and saying please, please, help us bring this care here so our community can stay in the community.

And what I say is, you know, rural farm America, if you've been on your porch or your farm your whole life, you should be able to stay there.

And how can we help you?

So we are growing and expanding to provide that care throughout our region.

- You know, can you talk about some of the feedback you've gotten from families who've utilized your services?

- The number one thing is we wish we would've called you sooner.

We had no idea.

Where people get stuck is nobody wants to talk about it.

But the fact of it is we need to talk about it and we need to talk about what their goals and wishes are, and how we're gonna honor and support them.

- What services do you provide other than hospice care?

- Well, we are, Hospice in Red River Valley is a 501(c)(3) non-profit.

We have another sister company called Red River Valley Healthcare and under Red River Valley Healthcare, we have two service lines.

House calls, which does home-based primary care, meaning Marcus Welby, from Little House on the Prairie, the old black-bag doctor that comes to you door, we have that and we have palliative care.

Palliative care and home-based primary care can take place in any phase of someone's illness.

So, what we focus on is goal planning, symptom management, we work with the patient's primary care doctors.

We put the puzzle together for them.

You know, what's your care look like and what do you want it to be like?

- So, do you get a lot of people that understand that or do you need to educate people more on that?

- They don't understand it because they think hospice is really about dying and hospice is about living.

And that's what I learned a long time ago.

It's every moment of your life matters and it's all about you and self-determination.

What do you want it to look like?

We'll give you the tools and the information and you get to make the decision and we get to support you.

- You mentioned community-owned.

Talk in more about what's the importance of being community-owned.

- Well, our sole focus is the community.

Meaning, our care is provided in the community where someone calls home.

We are not a health system or a facility, their care is in-patient.

We are strictly out-patient care or post-acute care is what they call it, so that's really important.

Community-owned means that community of volunteers, they get to help direct our course in action.

We, what's so unique about us is, a lot of hospices will and cannot travel the distance that we travel.

When you think of 44,000 square miles and the infrastructure and the resources, our board has made a decision that's what we'll do, and we use those resources that we have to reach those rural regions and it's very expensive to do that and very, very important.

- Can you talk a little bit about what end-of-life care looked like before hospice came along?

- People weren't at home.

They weren't where they wanted to be.

I always say, if I ask you when you're healthy and well, where do you wanna be and who do you wanna be with?

Okay, people didn't have the choices, and we still have areas where they don't have a choice, where they don't get to go home or back to their home, and that's what we wanna do.

The other thing is is we're very aggressive in our symptom management.

I can't fix, or we can't fix someone's diseases, but we can fix their symptoms so that they live well, as long as they're here.

- Okay.

So when did hospice care start nationally about?

- In the 80s.

So our hospice was the first one to bill Medicare, was the Mississippi.

So it's not been around that long.

People have... People's life, people pass and have forever, right, but we've now just recognized, in the last 40 years, that there's a different way and different treatments and different options that people need.

- Yeah, can you talk a bit more about some of the stories you've encountered along the way?

You mentioned a little bit that maybe a little more detail about what you really get back from people?

- One of my biggest lessons in life and I can go back and I can use his name 'cause the family allowed that and it was Milton and it was when I was working as a case manager in hospice care, that's how I started.

And Milton had end-stage cancer, didn't want treatment, was in a wheelchair when I met him, his wife had passed.

He was living with his family.

And we got him to the point that he wasn't in his wheelchair and I spent two years with Milton, and we would, I call it musical hospice, because he still met criteria and we were able to transfer him to his sons' and daughters' home.

One was in Harlingen, one was in Arizona, and he'd come back to me in Ohio.

He spent his days with his grandchildren.

So the last few weeks of his life, he was delivering meals on wheels.

And he had someone carry them.

He couldn't get up the steps and that, but he lived his life, and he lived it well and I thought wow, look what we can do.

- Wow.

You know, talk about, tell me about, what's the difference between pain and symptom management?

What does that mean?

- Pain and symptom management is different for everybody and there's so many things.

It could be anxiety, it could be nausea, vomiting.

Aches and pains that are uncontrolled.

We wanna get those things to what people feel are reasonable to them, and tolerable.

And control them.

Because when they're controlled, it's like when you have an infection.

You take an antibiotic.

You don't feel good when you have the infection, but you treat it and you feel better.

And that's what we try to do is make people feel better.

- You talked about, you had 250 employees, and I assume that's because, what, 44,000 square miles that you cover, but I mean, on staff, what do you have?

Are they doctors, nurses?

Who's on staff?

- We have, and this is what's so wonderful about hospice care, it's a team, teams make the decision.

You have your medical director, nurse practitioners, regular nurses, home health aids, social workers, chaplains, counselors, plus all the insular support staff to make the business run, are all important.

We offer also bereavement services and that is, to anybody in our community and our board and our organization, they made a decision, if someone has a loss or is dealing with something, even if they haven't had a hospice, we will offer those services to them free of charge.

- Can you tell me what respite care is?

- Hospice has different levels of care that we have to provide, and respite is, when you're a caregiver, and I've been a caregiver four times with hospice, it's hard, it's hard work.

It's the best work I've ever done and the most rewarding and memorable, every moment matters, right, but sometimes you need a break.

Sometimes the patient needs a break.

Sometimes things happen in life that you're like, I need to know that my, for instance, my mom is cared for.

And hospice can arrange respite, well, I take care of what I need to do.

And Medicare pays for those, I call it five days, five nights stay, to do that.

So we work with the social worker and the nurse works with the family to help with respite care.

- You mentioned that your organization, Hospice of the Red River Valley, you work with the insurance people too.

So do you help the families in all that role or walk them through all that?

- Absolutely.

Because what we wanna do is, I always say, there's enough stress and burdens when dealing with an illness, right?

It's not just the patient, it's the whole family.

That's one of the last things and it's just overwhelming sometimes so our social workers can kick in and help.

I've made calls and I said hey, you know, which looks better to you?

We have gotten really good at providing maximum service at a low cost, and they recognize that when you speak numbers and you speak quality, and you talk about what the patient needs and wants.

- Okay.

You mentioned bereavement, I think.

What does grief support include?

- It looks different for everyone.

We help within our schools here.

Businesses that have suffered a loss.

Patients and families.

Medicare requires that we provide it for 13 months.

We've had people longer.

You don't know when grief's gonna hit you or what you're gonna need.

Our support groups are huge for a lot of people.

They come together and they build friendships with people that have had similar experiences.

They have a commonality now and they are able to support each other and our staff is able to give them tools to help do that.

- Do your people employ, so I'm talking about your employees, work a long time?

'Cause it sounds like you've been in this for quite a while but it seems like it'd be also stressful.

- It is, but every day, I always say, even on the roughest day, I can find such joy in seeing these families.

I mean, you're at the most...

I would say hospice care, it's about experience like love in its rawest form and you're invited into someone's home or life to help them, I mean, it's so rewarding.

It's like a blessing.

So people that do hospice fall in love with it and they appreciate it.

It is stressful.

It's hard dealing with it every day.

It's not for every one, but the people that are in it and that do the work are great at it and they love it and they stay doing it.

- Do you have volunteers with your organization?

- A lot.

Thankfully, and I'm so thankful to our volunteers.

We couldn't do it.

Medicare not only requires that we have 5% of our work in volunteers, but, and that's at the bedside, or with patient care, but to run our organization and be able to do it cost-effectively, we need our volunteers.

And I see that talents of the people that come in could be office support, could be seeing our patients, could be running supplies to another part of the town.

Anything that's a gift and talent of someone can be used in hospice care.

- So how can people get involved and volunteer?

- Call, reach out on our website.

Www.hrrv.org.

You can call our phone number.

We have an entire volunteer team and volunteer coordinators that work, work with volunteers to find out what they wanna do and then we train them.

What does that look for them and then they can decide how much work they wanna do for us.

- Can people donate to hospice, did you say?

- Absolutely.

Our community is so generous.

Their generosity allows us to do this work so we have a large base of donors and once you've had the service, you appreciate it even more and realize you want more people to have it so they give from their hearts and we're very fortunate.

- Do you ever find that families are scared, almost, to contact hospice because of the reality of what that means?

- Yeah, and I can tell you from personal experience.

Every time, it's still, you have to start thinking okay, I have a time, I don't know how much time that is, that I know that someone I love isn't gonna be here, but I always go back and say, then I stop and say, how do I want it to look, how do they want it to look?

What do they need and when?

Then it's easier.

It's much easier.

Yeah, but the reality is, we're all gonna pass at some point, it's just when.

And I always say, how do you want it to be?

Because that's what we're about is making it about their goals and wishes.

So yeah, it's hard.

- Yeah.

What are the greatest needs that you have in your organization today?

- Oh.

Probably, I would say the volunteers, and the donations so that we can continue to grow and expand our services.

Volunteers in rural communities is huge for us too.

When we're in there, we don't stay with the patient 24/7.

Family provides the care, but they need a break.

I had an instance, gosh, it was last month in Detroit Lakes, and it was a couple and they needed support.

One of them needed to be able to get to the store and needed to do this weekend help but having set volunteers coming in allows them some freedoms to do their things in life that they need to do.

So we need volunteers.

Funding is always important because it's expensive to provide this kind of care everywhere and anywhere.

- Tell me again, and maybe you hit on this earlier but the services you provide, it's not all just a medical, giving your pills or helping you, talk about that.

- I'm a nurse and I would say, yeah, I can give you a pill, but what we do really well is we take care of the whole family.

What's most important to a patient is their family.

What's most important to the family is the patient, right, and the psychosocial piece, the emotional support.

Knowing you have a plan and someone to rely on is huge.

I knew that night that I needed help and I'm a nurse, a good nurse, I love nursing, but I called every two hours 'cause I'm like, am I doing this right, what do I need to do?

They come and they're able to support you on that journey and it is a huge relief.

So even if you're in the medical field, I just wanted to be family, okay.

Didn't wanna be the nurse.

And I was able to do that with the support of hospice care and that was the greatest value to me.

- So, what of you think the future of hospice care is for this region and maybe for the country?

- We need to make sure that everybody throughout North Dakota and Western Minnesota can receive care in their home.

That's what needs to happen.

The other thing, we have a huge dream that we're trying to bring to reality of a free-standing hospice house.

There isn't one in this state.

There needs to be one in this state.

The value that it brings and teaching people, was something that the majority of people have never experienced.

They don't know the value.

- Explain, what is that?

- [Tracee] What is the value?

- No, what is the free-standing hospice house?

- It is a building where care can be provided.

I talked about different levels of care, and sometimes, things get really rough and you need help.

There's a higher level of care called general in-patient.

We can bring people there.

Short stay in a hospice house.

Average, like the stay is five days.

Some longer, some shorter.

Get symptoms controlled, get a plan, have people and help people get where they need to be.

- So what's it gonna take to make that happen?

- Donations.

And that's what we're working on.

We have a plan.

And I will talk a little bit about that.

I had a personal experience that I was not able to do here in North Dakota because I knew I needed a hospice house and it was a situation with COVID where a family could not be in the hospital.

We could not be there.

And we knew in that last week or weeks that that wasn't okay.

Wasn't okay for my son, it wasn't okay for me, and we were able to contact and get a hospice house and his kids were able to be there, I was able to be there, and we were a family.

Wouldn't have happened without a hospice house.

- Well, thank you for what you do.

Finally, if people want more information, where can they go, who can they contact?

- Call Hospice of the Red River Valley.

We're located off of 17th Street across from West Acres Mall, so anybody can walk in.

We're open to walk-ins into the building.

You can call 1-800-237-4629 or you can get us on the website.

There you can gain a lot of information.

- [John] Tracee, thanks for joining us today.

- Thanks for having us.

- Stay tuned for more.

(light string music) Lisa Vida of the Historical and Cultural Society of Clay Country reveals to us some forgotten artifacts from Moorhead's history, and discusses how these objects help to show the progress of the city and its history.

- Hi, I'm Lisa Vida, collections manager at the Historical and Cultural Society of Clay County at the Yumkum Center in Moorhead, Minnesota and this is my Artifact Spotlight.

(light music) Here at the museum, we have some artifacts in our collection that relate to the economic and infrastructure development of early Moorhead.

These tiles are from the Grand Pacific Hotel which was built in 1882 in Moorhead by the Great Northern Tracks at a cost of $160,000, and it was considered to be the largest hotel at that time between Minneapolis and Spokane, Washington.

It never really did make a profit, though, after it opened and it was actually torn down in the 1890s.

The motel was very grand for its time period and it has crystal chandeliers and many beautiful furnishings as you can tell on the photographs.

It had many different little balconies probably for some of the nicer rooms or dining rooms.

It had these beautiful tiles that were made and acquired from different manufacturers that were popular at the time.

So these tiles would have decorated all of the different rooms in the hotel and they were very much in the arts and crafts style which was a very popular style at the time.

So this tile, especially, has a very arts and crafts feel to it, almost a William Morris style pattern with the large leaves and there's a very intricate mosaic tile pattern on these tiles here and a really nice floral vine pattern on these border tiles and a very nice glazed look on this olive green tile with the central floral medallion.

It was kind of a boom period for Moorhead and this hotel was a big draw.

Another sign of Moorhead's development would have been paving the streets and that is what these blocks are from, paving the streets in 1896 with these cedar blocks that were covered in creasote to make them more durable and longer lasting.

Cedar blocks were used at the time as an inexpensive option and the technology wasn't developed yet for concrete or asphalt.

Creasote is a tar product that is used as a preservative for wood and it helped to prevent too much water absorption.

Paved roads would have meant much easier traveling through the streets, less dirt and mud and grime everywhere.

It would have been a lot nicer for people visiting Moorhead and especially the residents of Moorhead for the quality of life and traveling around the city.

Artifacts like these tiles from the Grand Pacific Hotel, these paving blocks from paving Moorhead streets help illustrate the optimism that people had for Moorhead's future and attracting businesses and families to help Moorhead grow and become a prosperous, great place to live.

(lively string music) - Well, that's all we have on Prairie Pulse for this week.

And as always, thanks for watching.

(upbeat music) - [Announcer] Funded by the Minnesota Arts and Cultural Heritage Fund with money from the vote of the people of Minnesota on November 4th 2008 and by the members of Prairie Public.