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Livingston County Help For Seniors

Summary 
  • 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.

Evidence-level

Effective (About evidence-level criteria)

Description

In 2006, Livingston County, New York, was a designated medically underserved area with a growing elderly population. In general, older adults have a higher disease burden, higher risk for disability, limited financial resources, and difficulty accessing care, demographics making them an ideal population to screen in home and provide further care as needed.

Since Emergency Medical Technicians (EMTs) were providing the default care for the county's aging population, they raised awareness around their geriatric training gap.

In response, the Help For Seniors (HFS) project was developed, intervening at 2 points in the healthcare continuum: screening older adults for unmet healthcare needs and educating EMTs on geriatric care using vodcast trainings through YouTube videos.

The initial project lasted 18 months, but components have continued under the supervision of the Livingston County Office for Aging. Funding was provided by a Federal Office of Rural Health Policy Rural Health Care Services Outreach grant.

Services offered

The Help for Seniors program utilized the Livingston EMS to implement basic assessments geared to improving the health of Livingston County seniors:

  • Additional screening provided for older adults after EMS care for falls, depression, and medication management
  • Referral of older adults with ongoing care needs to case managers
  • Development and dissemination of a geriatric care training program for EMTs in order to better understand the specific needs of older adults

Results

The following results were found during the program's active screening of 1,231 patients:

  • 33% screened positive for depression
  • 68% screened positive for risk of falls
  • 90% screened positive for medication management problems
  • 90% of patients served were satisfied with the program

Another evaluation found the EMS "vodcast" training to be very successful as they received over 6,000 views. In all, 187 EMTs were trained and gave almost entirely positive feedback regarding the trainings' usefulness.

HFS was cited as a "Program Champion" by the Administration on Aging in 2008.

Journal articles that reference the Help for Seniors program:

Caprio, TV., Karuza, J., Katz, PR., Smith, K., Cypher, P., Shah, MN. (2008). Home-based screening of rural community dwelling older adults by Emergency Medical Services and referral to Transitional Case Management. Annual Meeting of the American Geriatrics Society Poster Presentation, May 2008.

Shah, MN., Caprio, T., Swanson, P., Rajasekaran, K., Ellison, J., Smith, K., Frame, P., Cypher, P., Karuza, J., Katz, P. (2010). A Novel Emergency Medical Services Based Program to Identify and Assist Older Adults in a Rural Community. Journal of the American Geriatrics Society, 58(11), 2205-2211.

Shah, MN., Swanson, PA., Nobay, F., Peterson, LK., Caprio, TV., Karuza, J. (2012). A Novel Internet-based Geriatric Education Program for Emergency Medical Services Providers. Journal of the American Geriatrics Society, 60(9), 1749-54.

Barriers

After screening, some seniors expressed initial reluctance to agree to further follow-up visits. For instance, 73% of patients refused to have follow-up home visits for various reasons. However, with time and widespread use of the HFS program, the county's seniors became much more accepting of the multi-stage intervention process.

Since grant funding ended, there are reduced resources for follow-up, impacting engagement and effectiveness.

Replication

The Livingston County Help for Seniors program has many components that can be replicated or adapted, including the complete EMS online training.

Contact Information

Karen Dewar, Director
Livingston County Emergency Medical Services
Livingston County Office for the Aging
585.243.7596
kdewar@co.livingston.ny.us

Topics
Aging and aging-related services
Community paramedics
Elderly population
Health screening
Health workforce education and training

States served
New York

Date added
January 22, 2007

Date updated or reviewed
April 16, 2019


Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.