Document Detail


A novel emergency medical services-based program to identify and assist older adults in a rural community.
MedLine Citation:
PMID:  21054301     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rural-dwelling older adults experience unique challenges related to accessing medical and social services. This article describes the development, implementation, and experience of a novel, community-based program to identify rural-dwelling older adults with unmet medical and social needs that leveraged the existing emergency medical services (EMS) system. The program specifically included geriatrics training for EMS providers; screening of older adult EMS patients for falls, depression, and medication management strategies by EMS providers; communication of EMS findings to community-based case managers; in-home evaluation by case managers; and referral to community resources for medical and social interventions. Measures used to evaluate the program included patient needs identified by EMS or the in-home assessment, referrals provided to patients, and patient satisfaction. EMS screened 1,231 of 1,444 visits to older patients (85%). Of those receiving specific screens, 45% had fall-related, 69% medication management-related, and 20% depression-related needs identified. One hundred and seventy-one eligible EMS patients who could be contacted accepted the in-home assessment. Of the 153 individuals completing the assessment, 91% had identified needs and received referrals or interventions. This project demonstrated that screening by EMS during emergency care for common geriatric syndromes and linkage to case managers is feasible in this rural community, although many will refuse the services. Further patient evaluations by case managers, with subsequent interventions by existing service providers as required, can facilitate the needed linkages between vulnerable rural-dwelling older adults and needed community-based social and medical services.
Authors:
Manish N Shah; Thomas V Caprio; Peter Swanson; Karthik Rajasekaran; Joan H Ellison; Kaaren Smith; Paul Frame; Paul Cypher; Jurgis Karuza; Paul Katz
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  58     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-02     Revised Date:  2011-11-01    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2205-11     Citation Subset:  IM    
Copyright Information:
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
Affiliation:
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA. manish.shah@rochester.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Emergency Medical Services / organization & administration*
Female
Health Services for the Aged / organization & administration*
Humans
Male
New York
Program Evaluation
Rural Health Services / organization & administration*
Grant Support
ID/Acronym/Agency:
1K23AG028942/AG/NIA NIH HHS; D04RH04491//PHS HHS; D31HP08811//PHS HHS; K01 HP00034//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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