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Rural Project Examples: Elderly population

Evidence-Based Examples

Telepsychology-Service Delivery for Depressed Elderly Veterans
Updated/reviewed December 2019
  • 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 2018
  • 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

Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2019
  • Need: To provide Lakota elders with tools and opportunities for advance care planning.
  • Intervention: An outreach program in South Dakota helps Lakota elders with advance care planning and wills by providing bilingual brochures and advance directive coaches.
  • Results: Care for Our Elders saw an increase in the number of Lakota elders understanding the differences between a will and a living will and the need to have end-of-life discussions with family and healthcare providers.
funded by the Federal Office of Rural Health Policy Livingston County Help For Seniors
Updated/reviewed April 2019
  • 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.
LIFE - Living (well through) Intergenerational Fitness and Exercise
Updated/reviewed December 2018
  • Need: Older adults in rural 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.
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.

Promising Examples

funded by the Federal Office of Rural Health Policy SD eResidential Facilities Healthcare Services Access Project
Updated/reviewed July 2019
  • 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.
Reducing Hospitalizations in Medicare Beneficiaries
Updated/reviewed June 2019
  • 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 increased, while emergency department visits decreased.
funded by the Federal Office of Rural Health Policy ARcare Aging Well Outreach Network
Updated/reviewed March 2019
  • Need: To reduce falls and improve chronic care management for adults 50 or older in rural Cross County, Arkansas.
  • Intervention: The ARcare Aging Well Outreach Network, run by an FQHC, provides services like falls prevention assessments, transportation to appointments, medication management, and senior-specific exercise opportunities.
  • Results: From May 2015 to December 2017, the network served 584 patients.
SASH® (Support and Services at Home)
Updated/reviewed December 2018
  • Need: In Vermont, the growing population of older adults, coupled with a lack of a decentralized, home-based system of care management, posed significant challenges for those who wanted to remain living independently at home.
  • Intervention: SASH® (Support and Services at Home), based in affordable-housing communities throughout the state, works with community partners to help older adults and people with disabilities receive the care they need so they can continue living safely at home.
  • Results: Compared to their non-SASH peers, SASH participants report better health outcomes, including fewer falls, lower rates of hospitalizations, fewer emergency room visits, and the completion of more advance directives – all of which has the potential of saving millions of dollars.