Sign Up to Receive PHI Alerts

How PHI’s Coaching Approach® Training Helps Rural Aging Interventions

By Emily Dieppa Colo (she/her) | August 29, 2023

Emily Dieppa, Vice President of Workforce Innovations, PHI

In rural communities across the U.S., where almost a quarter of the nation’s older adult population resides, aging can be complex and multifaceted. Many individuals in these areas have lived in these areas for numerous years, yet they encounter unique obstacles such as limited healthcare, transportation, and other vital services. Despite these challenges, opportunities exist to enhance the well-being and health of older adults living in rural communities.

To bridge this gap, Lutheran Services in America launched the Rural Aging Action Network (RAAN) in 2015. As a national collaborative, RAAN’s mission is to expand sustainable community-based services and supports for underserved older adults in rural communities and currently is present in Minnesota, Montana, North Dakota, and South Dakota. To strengthen the capacity of RAAN leaders, Lutheran Services in America brings together various strategic partners, including PHI, to build rural leaders’ skillset in empowering older adults to age with independence, dignity, and purpose.

A Different Approach: RAAN’s SDOH Assessment Tool

Ashley Washington, Senior Director of Aging Initiatives, Lutheran Services in America

Through RAAN, local staff meet with older adults to build trusting relationships and identify opportunities for introducing services and support that address negative social determinants of health (SDOH), such as housing, transportation, and more. Early in the program’s implementation, RAAN leaders realized that traditional SDOH assessment tools often focus on deficits and challenges, causing older adults to disengage from the conversation.

In response, RAAN developed strengths-based questions to add onto evidence-based tools that transforms the assessment experience into a conversation, tapping into the unique preferences, joys, and experiences of each older adult. Using open-ended questions and active listening, staff can build on older adults’ strengths and abilities to address unmet social, emotional, and health-related needs.

Training with Intention

Given RAAN’s departure from traditional deficit-based assessments, and the focus on communication and relationship building, Lutheran Services in America knew they needed to train and support RAAN coordinators, ensuring they had the necessary tools and skills to be successful in their roles. Partnering with PHI, the two organizations designed a custom 2-part, online training series rooted in PHI’s Coaching Approach® skills.

To design the training, PHI held individual interviews with several coordinators, listening and learning from their successes and challenges within RAAN. This step was critical because it allowed PHI to contextualize the training materials so they were relevant for coordinators and allowed them to practice and apply new skills using real-life scenarios and role plays. The first training focused on active listening, self-awareness, and self-management, while the second training built on those skills to identify and manage resistance in a strengths-based way.

RAAN coordinators’ feedback on the training program was overwhelmingly positive, with one learner saying, “This was one of the best trainings to date. The facilitator did their research and understood the project. As a result, the scenarios were tailored to our program, which was very much appreciated – they were spot on.” Moving forward, PHI and Lutheran Services in America will continue working with coordinators to identify additional opportunities for training as new challenges emerge.

Stories from the Field

Stories from RAAN coordinators’ interactions with older adults showcase the ultimate impact of this program. Older adults who participated in a focus group said, “I consider her [the RAAN coordinator] a friend” and “I am so happy, so relaxed,” two comments that underscore the emotional connection that coordinators developed with older adults.

Additionally, a recent meeting with an older adult who initially resisted the program ended with him embracing community food resources due to the coordinators’ ability to tap into his personal interests, such as hunting, through a strengths-based approach. For RAAN, the focus is not solely on providing services but on fostering understanding, empathy, and caring relationships.

Informing Direct Care Workforce Innovations

RAAN’s approach offers critical insights and lessons for the direct care workforce field and other comparable programs for older adults in rural communities:

  • Even though team members are highly accomplished and experienced, they will need training and support to try new approaches. Developing high-quality, contextualized training is critical for successfully modifying systemwide norms.
  • PHI’s approach to collaborative, adult-learner-centered training fosters innovation through peer exchange. It provides an opportunity to share strategies and lessons learned when developing or implementing a new type of approach.
  • Assessment tools and conversations are more effective when they reflect the individual history, culture, and sense of identity within the community. For example, the assessment tool includes initial conversation questions such as, “How long have you lived in this community,” “What brought you here?” and “What do you love most about this community?” These questions recognize that many rural residents have deep ties to their homes and neighborhoods that impact their sense of self.
  • Be patient—building trust takes time. It can take several interactions with people to earn their trust, understand what’s important to them, and provide support after they’re willing to receive help.


The RAAN initiative exemplifies an innovative and compassionate approach to enhancing the lives of older adults in rural communities across Minnesota, Montana, North Dakota, and South Dakota. By embracing a strengths-based perspective and fostering genuine relationships, RAAN coordinates an approach that values the unique experiences and desires of each individual.

This focus on empowerment, dignity, and intentional connection has transformed the traditional deficit-based assessment process and nurtured a sense of community and self-respect among participants. By collaborating with PHI and dedicating itself to ongoing training and adaptability, Lutheran Services in America and the RAAN collaborative have demonstrated a commitment to continuous learning and growth, which will assist all older adults to live in good health in these rural areas.

Contributing Authors
Ashley Washington, Senior Director of Aging Initiatives at Lutheran Services in America

Caring for the Future

Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.