scholarly journals TECHNOLOGICALLY MEDIATED INTERVENTIONS IN HOSPICE AND PALLIATIVE CARE: CONSIDERATIONS FOR RURAL ELDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S199-S200
Author(s):  
Karla T Washington
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Spiritual Support ◽  
Technological Infrastructure ◽  
Hospice And Palliative Care ◽  
Rural Elders

Abstract Rural communities are home to a disproportionate number of older adults, many of whom are living with a serious illness or providing care to a seriously ill family member or friend. For these individuals, hospice and palliative care services can provide much-needed biopsychosocial and spiritual support, leading to an enhanced quality of life. Technologically-mediated interventions hold promise as a strategy to bridge geographic distances between healthcare providers and rural elders; however, the effect of such interventions may be greater when they are designed in a manner congruent with rural culture and compatible with the technological infrastructure common in rural areas. Informed by lessons learned during a pilot study of a telehealth intervention in one Midwestern state (R21CA191165), this presentation includes a discussion of strategies to more effectively recruit, engage, and retain rural older adults into studies testing technologically-mediated interventions for hospice and palliative care patients and their families.

scholarly journals INNOVATIVE STRATEGIES TO SUPPORT OLDER ADULTS AND THEIR FAMILIES IN HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S199-S199
Author(s):  
George Demiris ◽  
Karen Hirschman
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Hospice Care ◽  
Geographic Distance ◽  
Smart Phone ◽  
Evidence Base ◽  
Lessons Learned ◽  
Ethical Challenges ◽  
Rural Settings ◽  
Hospice And Palliative Care

Abstract In order to better support older adults with life-limiting illness and their families, many initiatives utilize information technology and other innovative platforms to increase access to supportive services and bridge geographic distance. Such technologies cover a broad range of systems ranging from smart phone applications to wearables and traditional telehealth platforms. There is a growing evidence base for such interventions but technical, clinical and ethical challenges remain when utilizing technology in the context of hospice and palliative care especially for older adults, including the concerns for caregiver burden, privacy, security, confidentiality, obtrusiveness and accessibility. In this symposium we provide an overview of innovative tools available for interventions in palliative and hospice care designed for patients and/or family caregivers in urban and rural settings. We provide lessons learned from three NIH funded studies testing different technology-based interventions in various settings including home hospice and outpatient palliative care. Discussion will follow focused on the clinical, ethical and practical challenges of innovation and the unique considerations for technology-mediated intervention design in a variety of palliative and hospice care settings. This symposium aims to provide: 1. an overview of existing technology-based interventions for older adults and their families in palliative care and hospice 2. evidence-based recommendations resulting from clinical trials in urban and rural settings for the design and implementation of innovative tools in hospice and palliative care 3. a discussion of challenges and opportunities for the use of technology to support older adults and their families

scholarly journals Older Adults and Opioid Education: Lessons Learned From Experiences in Rural Arkansas

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Robin McAtee ◽  
Leah Tobey ◽  
Corey Hayes ◽  
Laura Spradley ◽  
Sajni Kumpuris
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Rural Areas ◽  
Term Treatment ◽  
Lessons Learned ◽  
Opioid Use ◽  
Farm Bureau ◽  
Department Of Health ◽  
Long Term Treatment ◽  
Agricultural Areas

Abstract Nearly one-third of all Medicare participants were prescribed an opioid by their physician in 2015 (AARP, 2017) and in 2017, Arkansas had the 2nd highest opioid prescribing rate in the nation (CDC, 2019). Approaching older adults (OA) about opioids and pain management can be a sensitive topic. Educating and altering long-term treatment with opioids is especially challenging in rural areas where literacy, especially health literacy, is suboptimal. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with an objective to improve health outcomes including an emphasis to decrease the misuse and abuse of opioids among older Arkansans. To address this crisis, the AGEC partnered with local leaders such as the AR Drug Director, academia, Department of Health and Human Services, and multiple community based organizations to create age-tailored educational programs. Unique aspects of approaching and educating rural OA about opioids and pain management will be reviewed. Outcomes will be discussed such as their lack of knowledge about: what is an opioid, why they were prescribed, and what are viable alternatives. Also discussed will be lessons learned that resulted in more effective methods of reaching and teaching rural OA. Partnering with the AR Farm Bureau helped the AGEC reach 100’s of farmers in the extremely rural and mostly agricultural areas. Learning to not use the word opioid resulted in more participants and in a more positive attitude and outlook on attempts to change the culture of opioid use, misuse and abuse among older Arkansans.

scholarly journals Exploring Daily Activity Patterns on the Typical Day of Older Adults for Supporting Aging-in-Place in China’s Rural Environment

2020 ◽  
Vol 17 (22) ◽  
pp. 8416
Author(s):  
Ziqi Zhang ◽  
Zhi Qiu
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Rural Areas ◽  
Rural China ◽  
Activity Patterns ◽  
Real Life ◽  
Working Hours ◽  
Economic Security ◽  
Paid Work ◽  
Definition Of

Severe aging in rural China is prompting communities to promote support for older people to age in place. The study of the daily life of older adults in rural areas is conducive to understanding their real life and demands, as well as the way they interact with their environment, to develop feasible strategies. In this study, 171 older adults over 60 years old in two different types of villages in Northern Zhejiang Province were investigated and analyzed in terms of the temporal and spatial features of daily activities, as well as their relationship with population attributes, personal competence, and subjective demands. The results show that: (1) significant association can be seen between working hours and the demand for health services, housework hours and gender and age, as well as leisure hours and ADL and the demand for recreational services. (2) The older adults appear to have inter-group homogeneity in some aspects: basic living activities, leisure hours, the gender difference in housework hours, and recreational preference, while they have higher average paid work hours and fewer leisure alternatives than their urban counterparts. Their definitions of paid work, housework, and leisure activities are vague. (3) The definition of home by the older adults in rural places sometimes seems to go beyond the scope of their own house, and the extensive definition of home may change their recognitions of some activities. They also inclined to assign meaning to a place through frequent use rather than through external definitions. (4) The weak consciousness on buying services and deteriorated financial situation hinders the older adults in rural communities from expressing their real demands. Unspoken demands include economic security, recreational choices, and assistance in housework. The results will help to provide references for the improvement of eldercare services and the community environment.

Development of a Palliative Care Education Program in Rural Long-Term Care Facilities

2007 ◽  
Vol 23 (3) ◽  
pp. 154-162 ◽  
Author(s):  
Kathy Kortes-Miller ◽  
Sonja Habjan ◽  
Mary Lou Kelley ◽  
Marilyn Fortier
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care ◽  
Care Education ◽  
Palliative Care Education ◽  
Age Cohort

In North America, people 85 years and older are the fastest growing age cohort and long-term care homes are increasingly becoming the place of end-of-life care. This is especially true in rural communities where services are lacking. Staff in long-term care homes lack education about palliative care, but in rural areas, accessing education and the lack of relevant curricula are barriers. The focus of this paper is to describe an approach to developing and delivering a research-based palliative care education curriculum in rural long-term care homes. The approach included conducting a detailed assessment of staffs’ educational needs and preferred educational formats; developing a 15-hour interprofessional curriculum tailored to the identified needs; and delivering the curriculum on site in rural long-term care homes. Staff confidence and participation in delivering palliative care increased. Based on work in northwestern Ontario, Canada, this approach can serve as a model for palliative care education in other rural areas.

Among neighbors: An ethnographic account of responsibilities in rural palliative care

2013 ◽  
Vol 12 (2) ◽  
pp. 127-138 ◽  
Author(s):  
Barbara Pesut ◽  
Carole A. Robinson ◽  
Joan L. Bottorff
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Care Delivery ◽  
Participant Observation ◽  
Careful Analysis ◽  
Ethnographic Study ◽  
Cultural Dimensions ◽  
Direct Care ◽  
High Quality

AbstractObjective:Building high quality palliative care in rural areas must take into account the cultural dimensions of the rural context. The purpose of this qualitative study was to conduct an exploration of rural palliative care, with a particular focus on the responsibilities that support good palliative care from rural participants’ perspectives.Method:This ethnographic study was conducted in four rural communities in Western Canada between June 2009 and September 2010. Data included 51 days of field work, 95 semistructured interviews, and 74 hours of direct participant observation. Thematic analysis was used to provide a descriptive account of rural palliative care responsibilities.Results:Findings focus on the complex web of responsibilities involving family, healthcare professionals, and administrators. Family practices of responsibility included provision of direct care, managing and coordinating care, and advocacy. Healthcare professional practices of responsibility consisted of interpreting their own competency in relation to palliative care, negotiating their role in relation to that interpretation, and individualizing care through a bureaucratic system. Administrators had three primary responsibilities in relation to palliative care delivery in their community: navigating the politics of palliative care, understanding the culture of the community, and communicating with the community.Significance of results:Findings provide important insights into the complex ways rurality influences understandings of responsibility in palliative care. Families, healthcare providers, and administrators work together in fluid ways to support high quality palliative care in their communities. However, the very fluidity of these responsibilities can also work against high quality care, and are easily disrupted by healthcare changes. Proposed healthcare policy and practice changes, particularly those that originate from outside of the community, should undergo a careful analysis of their potential impact on the longstanding negotiated responsibilities.

Perceptions and Attitudes About Hospice and Palliative Care Among Community-Dwelling Older Adults

2012 ◽  
Vol 30 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Erika Manu ◽  
Terri L. Mack-Biggs ◽  
Caroline A. Vitale ◽  
Andrej Galecki ◽  
Tisha Moore ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Community Dwelling ◽  
Perceptions And Attitudes ◽  
Hospice And Palliative Care ◽  
Community Dwelling Older Adults

scholarly journals Rehabilitation of an Internet network in 40 schools in Nabón, Ecuador

2021 ◽  
Author(s):  
Ronny Israel Cabrera-Tituana ◽  
Andrea Katherine Carrión-Herrera
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Lessons Learned ◽  
School Age Children ◽  
The Internet ◽  
The Sustainable Development ◽  
Digital Gap ◽  
The Right ◽  
Internet Network

Internet access is necessary to ensure respect for the right to education, however, worldwide about 75% of school-age children in rural areas do not have access to the Internet at home, which makes it imperative the need for actions to reduce the digital gap to improve the quality of education in rural communities in Ecuador. This article describes the rehabilitation of an Internet network of 40 schools in the Nabón community, Ecuador. An earlier initiative implemented the Internet network, but lack of maintenance left it non-functional. With the support of the Municipality of Nabón, Motorola Foundation and IEEE SIGHT, a group of volunteers from IEEE Ecuador evaluated the state of the network to identify opportunities using the existing infrastructure. The commitment to the community, as well as the development of capacities, are at the center of the intervention to guarantee the sustainable development of the project. This document reports on the design, implementation, achievements and lessons learned from the rehabilitation of the Internet network.

Communication in oncology pharmacy

2017 ◽  
Author(s):  
Bethan Tranter ◽  
Simon Noble
Keyword(s):  
Palliative Care ◽  
Treatment Adherence ◽  
Drug Safety ◽  
Medication Compliance ◽  
Healthcare Providers ◽  
Optimal Drug ◽  
Treatment Medication ◽  
Hospice And Palliative Care ◽  
Timely Treatment

Pharmacists are considered to have a pivotal role in the provision of information in oncology, and in hospice and palliative care. Effective communication is essential for optimal drug safety, timely treatment, medication compliance, and education. The role of the pharmacist has expanded to offer enhanced pharmaceutical care, which serves to improve the communication between healthcare providers and the function of the multidisciplinary team. Furthermore, through optimal communication with patients there will be increased treatment adherence and improved overall care. This chapter focuses on the breadth of communication issues faced by pharmacists involved in cancer care through the full length of the cancer journey, be it curative or palliative.

scholarly journals FALL RISK BEHAVIORS AND INTRINSIC RISK FACTORS FOR FALLS IN INDIGENOUS AND NON-INDIGENOUS RURAL OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S471-S472
Author(s):  
Andre G Bouweraerts ◽  
Justus Ortega
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Rural Communities ◽  
Risk Behaviors ◽  
Rural Areas ◽  
Fall Risk ◽  
Future Studies ◽  
Fall Risk Factors ◽  
Fall Rates ◽  
Risk Factors For Falls

Abstract Within California, older adults living in rural counties have reported higher rates of falls than urban dwelling older adults. Although many Indigenous people live in rural areas, it is unclear whether the rate of falls among Indigenous older adults is similar to that of non-indigenous older adults living in rural areas. Thus, the purpose of this study was to examine fall risk behaviors and intrinsic risk factors for falls in rural dwelling Indigenous (N = 89), and non-Indigenous (N = 68) older adults 60-95 years of age living in California. Results showed that both Indigenous and non-Indigenous older adults share similarly high fall rates, but there are a much greater number of Indigenous older adults falling multiple times a year. Moreover, fall risk behaviors and intrinsic fall risk factors were significantly different between Indigenous and non-Indigenous rural-dwelling older adults. Future studies should investigate falls and fall risk factors in different tribes/locations of Indigenous older adults to better understand whether these risk factors differ among tribes. Moreover, it would be beneficial for future studies to assess the effectiveness of fall prevention exercises on fall risk in these communities. Information gained from this study helps to inform clinicians and researchers alike about the prevalence of falls and factors contributing to falls among Indigenous older adults living in rural communities; and helps to influence decisions in the future of programs for reducing fall risk in this often neglected population.

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