Category: Maximizing Quality of Life

16 - GWEP Nurses in Action: Impacting Rural Community-Dwelling Older Adults

GWEP Nurses in Action: Impacting Rural Community-Dwelling Older Adults


Jean Matthews MSN, RN


Rubi Merino BSN, RN


East Carolina University Geriatric Workforce Enhancement Program


Background: The health of rural community dwelling older adults in eastern North Carolina is challenged by isolation, lack of transportation, and shortage of health care providers, which leads to decreased access to preventive healthcare services.  ECU GWEP nurses embedded in FQHC’s in eastern NC concentrate on impacting health and wellbeing of older adults in the areas of falls risk, depression and cognitive function through screening, education, and referral.



Methods:
Older adults were screened using the CDC STEADI fall risk screening tool, PHQ2, and Mini-Cog screening tool.  Screenings were completed at FQHCs, community events, and senior centers. Education was provided individually and in groups.  Individuals whose scores indicated at-risk for falls, depression or cognitive concerns received preventative education and were referred to appropriate resources or specialty services. 



Results:
994 individuals were screened with 568 at-risk scores identified. 

Number of Individuals Scoring At-Risk on Each Screening Tool:

STEADI fall risk screen tool - 405


Mini-Cog screening tool - 116


PHQ2 - 47


All individuals scoring at risk received individualized education and referrals for appropriate intervention.



Conclusion:
CDC estimates the average hospitalized cost of a fall is in excess of $30,000.  Revenue saved due to GWEP fall prevention education and early intervention is estimated at $1,200,000.  Additional impacts include maintenance of independence/quality of life and prevention of death. Further evaluation and effective management of depression would yield qualitative improvement in physical, cognitive and social functioning as well as reducing the risk of morbidity and suicide.  Community based dementia screening and early therapeutic intervention would improve quality of life, maximize functional performance, positively impact patient and caregiver outcomes, and reduce health care cost by maintaining individuals at a lower dementia levels for a longer period of time and reducing time spent in more costly higher level dementia care.  If the average per person cost of dementia care is $56,000 per year and early detection and intervention reduces cost by 10% over a 10 year period, then $6,496,000 would be saved from these GWEP screenings.


 

Jean M. Matthews

Nurse Consultant
Geriatric Workforce Enhancement Program, East Carolina University - College of Nursing
Ahoskie, North Carolina

Jean Matthews has many years of health care experience in rural eastern North Carolina. Her educational background includes a MSN and FNP certificate. Her teaching experiences include 30 years of teaching nursing/health care at the baccalaureate, associate degree, and secondary education level. Clinical experiences include critical care, medical-surgical nursing, community health, case management, and geriatric nursing. Jean is currently employed as a nurse consultant with the Geriatric Workforce Enhancement Program at East Carolina University where she is embedded in a rural FQHC. She focuses on the health of older adults in the farming, logging and fishing communities of rural eastern NC, with an emphasis on assessment, education, prevention, and healthy aging. Jean has a particular interest in the health of the agricultural community and was recently named to the Board of Directors of the national AgriSafe network. Many professional honors include induction into the ECU College of Nursing Hall of Fame this past year.

Rubi Merino

Nurse Consultant
Geariatric Workforce Enhancement Program, East Carolina University - College of Nursing
Greenville, North Carolina

Rubi Merino has a great interest in health care of older adults in rural eastern North Carolina. Rubi hold a BSN and is currently completing her MSN & Psychiatric-Mental Health Nurse Practitioner Degree. Rubi’s background includes acute care, medical-surgical nursing, and geriatric nursing. Rubi is currently employed as a nurse consultant with the Geriatric Workforce Enhancement Program at East Carolina University where she is embedded in a rural FQHC. She focuses on the health of older adults in the farming, logging and fishing communities of rural eastern NC, with an emphasis on assessment, education, prevention, and healthy aging. She has a particular interest in the health of the older Latino population.