The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, has awarded Penn State's College of Nursing and its collaborators $3,750,000 to support medically underserved regions throughout rural Pennsylvania. This funding will support the development of educational programming and training for rural-based healthcare providers and caregivers, enabling them to deliver more age-friendly care.
The Center for Rural Pennsylvania reports that 48 of the 67 counties in Pennsylvania are rural, with growth projections for the entire state population at 5% by 2030. The center also predicts an increase in minority and older adult populations in these rural communities. People living in rural areas are often faced with limited resources as a result of their location. For example, an older adult in need of specialized care may experience difficulty accessing that care because rural providers are not typically trained to meet their specific needs. Older adults and people with Alzheimer’s or other forms of dementia, have unique life experiences and equally as unique healthcare related needs.
These healthcare disparities in rural communities provide an opportunity to educate rural providers on age-friendly care, with the potential of improving the quality of life in these communities.
With the funding support of the HRSA, researchers from the College of Nursing in collaboration with the College of Medicine, Primary Health Network and the College of Nursing’s Center for Geriatric Nursing Excellence have created the "PA Collaborative for Age and Dementia Friendly Care." The collaborative will be led by principal investigators, Judith Hupcey, professor of nursing and associate dean for graduate education and research, and Donna Fick, Elouise Ross Eberly professor of nursing and director of the Center of Geriatric Nursing Excellence; and co-investigator Marie Boltz, Elouise Ross Eberly and Robert Eberly Endowed Chair and professor of nursing.
“This collaborative partnership with the Primary Health Network (PHN) potentially will impact older adults and their families across PA,” said Hupcey. “PHN is the largest Federally Qualified Health Center (FQHC) in PA and has over 45 sites (29 are primary care) in 16 counties in PA (13 are rural counties). They employ a medical staff of over 150 physicians, dentists, nurse practitioners, physician assistants, and other health professionals. Annually, they reach over 118,000 patients and families. In addition, we are partnering with the Institute for Healthcare Improvement, Area Agencies on Aging, and the Alzheimer’s Association.”
The partnership's goal is to improve the availability of the best care possible for older adults, with a focus on the four elements of the “4Ms” Framework of an Age-Friendly Health System: (1) what Matters; (2) Medication; (3) Mentation; and (4) Mobility, and to integrate principles of dementia-friendly care into the care of persons living with dementia and their caregivers.
“The key to age-friendly care is to start by knowing the older adult, to assess and act on mentation (brain health), keep older adults moving and active and avoid high-risk or problematic medications. As we age, too many medications can cause problems with mobility and mentation or interfere with other health and life goals,” Fick said. “The other critical piece with training students and providers is to emphasize how to live well with Alzheimer’s disease and related dementia and document the strengths of the older adult, not just the deficits.”
The Age-Friendly Health Systems Initiative and the 4Ms Framework are national initiatives funded by the John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and Catholic Health Association of the United States. The aim of the initiative is to spread the 4Ms Framework to 20 percent of U.S. hospitals and medical practices by 2020, this new funding from HRSA will help make Pennsylvania providers more age-friendly. To learn more about the Age-Friendly Health Systems Initiative, visit the website.
Using these initiatives as a guide, the researchers said they hope to implement a curriculum to educate and support healthcare providers and caregivers, while also providing a valuable resource in these medically underserved regions of Pennsylvania.