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Rural Project Examples: Elderly population

Evidence-Based Examples

Telepsychology-Service Delivery for Depressed Elderly Veterans
Updated/reviewed December 2017
  • Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
  • Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
  • Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.
Fit & Strong!
Updated/reviewed August 2017
  • Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
  • Intervention: An 8-week physical activity, behavior change, and falls prevention program geared to older adults with osteoarthritis.
  • Results: Participants gained confidence with increased exercise, lessened stiffness, improved joint pain and improved lower extremity strength and mobility.

Effective Examples

funded by the Federal Office of Rural Health Policy Livingston County Help For Seniors
Updated/reviewed January 2018
  • Need: Meeting the health needs of geriatric patients in rural Livingston County, New York.
  • Intervention: The Help for Seniors program was developed and using its “vodcasts,’ local EMTs were trained in geriatric screening methods and health needs treatment.
  • Results: In addition to developing a successful model for educating EMS personnel, the program screened over 1200 individuals and identified various risks among the geriatric population.
Patient Care Connect
Updated/reviewed December 2017
  • Need: Cancer patients living in the Deep South encounter multiple barriers in accessing regular cancer treatment.
  • Intervention: The University of Alabama at Birmingham Comprehensive Cancer Center developed a program that uses lay patient navigators to support and direct patients to appropriate resources to overcome barriers to accessing care.
  • Results: The program has become a model for improving cancer care quality, decreasing unnecessary utilization (ER visits and hospitalizations), removing barriers to care, and enhancing patient satisfaction.
LIFE - Living (well through) Intergenerational Fitness and Exercise
Updated/reviewed November 2017
  • Need: Rural-residing older adults in Iowa have inadequate access to physical activity specialists and/or exercise facilities, which limits their ability to remain sufficiently active.
  • Intervention: Iowa State University implemented an intergenerational “exergaming” program to encourage fun and safe physical fitness among rural older adults.
  • Results: Pilot studies showed that older adults demonstrated increases in strength, flexibility, activity levels, and confidence in their ability to be physically active. Younger adults experienced reduced ageism and increased knowledge and expectations of aging.

Promising Examples

funded by the Federal Office of Rural Health Policy SD eResidential Facilities Healthcare Services Access Project
Updated/reviewed January 2018
  • Need: To bring more local health services to rural, elderly populations in long-term care facilities located in four Midwest states near a tertiary care organization.
  • Intervention: Implementation of telemedicine services to reach patients at their respective sites.
  • Results: The program increased local care evidenced by yearly avoidable provider-determined transfer data: 33%, 50%, 63% program years 1 through 3, respectively.
funded by the Federal Office of Rural Health Policy Community Health Coaches for Successful Care Transitions
Updated/reviewed September 2017
  • Need: To help older patients with chronic conditions learn to manage their illnesses and thereby reduce hospital readmissions in Oconee County, South Carolina.
  • Intervention: Community volunteers trained as health coaches mentor discharged patients with certain chronic conditions, to help them transition from home health care to self-care.
  • Results: Participants had improved health behaviors and reduced readmissions.
Reducing Hospitalizations in Medicare Beneficiaries
Added June 2017
  • Need: To reduce hospital readmissions for Medicare patients in rural Kentucky and Tennessee.
  • Intervention: Two quality improvement tools called IMPACT and INTERACT helped older patients transition from Vanderbilt University Medical Center to a skilled nursing facility.
  • Results: Practitioner follow-up visits have increased, while emergency department visits have decreased.
Northland PACE (Program of All-Inclusive Care for the Elderly)
Updated/reviewed January 2017
  • Need: Older adults who are nursing home eligible need assistance in order to remain living safely and independently in their own homes.
  • Intervention: Northland PACE (Program of All-Inclusive Care for the Elderly) offers, plans, and coordinates a wide range of healthcare, in-home, and day center services to promote independence at home.
  • Results: Older adults remain safely in their homes for a longer period of time with this support. The PACE program sites in North Dakota work to preserve, enhance, and, in many cases, restore the independence, health, and well-being of their participants.

Other Project Examples

Right Side Up Falls Prevention
Updated/reviewed January 2018
  • Need: Falling is one of the leading causes of morbidity and mortality in adults over the age of 65.
  • Intervention: The Right Side Up program was implemented in rural Otter Tail County to address the prevention and management of falls and risk for falls through in-home assessments given by interdisciplinary healthcare professionals and students.
  • Results: Short-term outcomes revealed 100% of participants found the visit and recommendations for falls prevention to be helpful, and 78% implemented these recommendations.