ENC Health Currents: Addressing Health Care Access For Seniors In Rural ENC

Sep 5, 2018

Dr. Ken Steinweg (MD) and Dr. Candace Harrington (Nurse Practitioner) with patient Mrs. Charity Hall.
Credit ECU College of Nursing

East Carolina University's Geriatric Workforce Enhancement Program recently recieved funding to expand their program to help senoir citizens in 41 North Carolina counties access health care.  The program provides community-based education through health screenings and training for physicians and medical students who specifically treat elderly patients. 

There are many challenges when it comes to providing health care in rural and underserved areas of Eastern North Carolina, especially for seniors.  Rural areas tend to have fewer resources and a shortage of physicians.  Director of Rural Health at the State Department of Health and Human Services Maggie Sauer says those living in rural communities can find themselves in “medical deserts.”

“There are fewer folks there, there tend to be fewer services available and people are having to travel further to get to some of those services.  So if you look at that upper sort of northeastern quadrant of Eastern North Carolina, that tends to be where that happens.”

Proper training for addressing a patient’s needs and transportation to and from appointments are common issues affecting seniors who live in rural communities.  Sauer says the Office of Rural Health is trying to address these issues through collaborations with Campbell University and East Carolina University to recruit and retain physicians and health care providers that can specifically assist seniors.

“If they train in those communities and in rural settings, there’s a higher likelihood that they’re going to return or stay in, for instance, Eastern North Carolina.  So there’s a big part of training and retention that is really important to making sure people have the services they need.”

One program at ECU is aimed at improving care for aging adults in 41 rural Eastern North Carolina counties.  Project Director Dr. Donna Roberson says they recently received an $880,000 grant from the U.S. Department of Health and Human Services to fund the fourth year of their Geriatric Workforce Enhancement Program, also known as GWEP.

“We offer training and education on the needs of aging adults with primary care providers, so that would be physicians, nurse practitioners, physician assistants.  We also do outreach to communities, so caregivers of people living with dementia.”    

Dr. Sonya Hardin (Nurse Practitioner and original principal investigator/project director of the grant) and patient Geraldine McCombs
Credit ECU College of Nursing

Roberson says they’ve provided education to more than 3,000 family dementia caregivers.  The program also trains physicians and nurse practitioner students, physician assistant students and medical students who deal with patients who have Alzheimer’s disease and dementia.  The students are able to get first-hand experience while working in federally qualified health care centers as well as individual practices in rural areas.  Roberson says part of their training focuses on working with people in other health disciplines, such as social work, pharmacy and dental medicine.

“All these roles are very, very critical to the effective care of an older person.  And so it's, some of the activities that we do not only help up these learners understand more about the aging adult, but they also learn how to work with each other and what each other brings to that care of that patient.”

Another aspect of the ECU program is outreach into rural areas.  GWEP has partnered with other agencies to provide health screenings at community events.  Roberson says they’ve screened 1,500 residents to evaluate those at risk of falling, cognitive impairment and depression.

“We’ve been to an annual gathering of loggers, people working in the logging industry.  We are reaching out to fishers and trying to attend some of their events so that we can do some health screenings and provide some information for reducing fall risk and keeping your brain healthy.”

Roberson says they’re targeting people in these occupations because they’re typically underserved groups and often go without regular health checkups.  She says they’ve also provided screenings for people in the agricultural industry. 

Now that GWEP has received funding to continue for a fourth year, the program will focus on more remote, problematic areas including southeastern North Carolina, northeastern North Carolina and the Outer Banks.  The grant will support a partnership with Goshen Medical Center to provide a mobile medical van that will transport medical equipment and healthcare providers to rural communities in Eastern North Carolina.

"We’re going to help them sort of get that off the ground, help them with the mobilization of the mobile unit, if you will.  And we will help them find communities that are in need of that service.”

Roberson says they’ll soon ramp up programs that assist dementia caregivers and those with family members in assisted living facilities.   In the meantime, nurses with the GWEP program will continue to hold screenings and presentations at senior centers across Eastern North Carolina each week. 

September 18, 2018 – College of Nursing, ECU – Alzheimer’s Disease and Dementia Care Seminar.  This seminar is for health care professions and front-line staff who work in the health care industry

November 6, 2018 – Caregiver conference, Doubletree Hotel, New Bern, NC.  This caregiver conference is open to the public.

November 9, 2018 – Annual Aging Conference, Elizabeth City State University, Kermit E. White Center.  This conference is open to the public, registration is required, for health care professionals and caregivers.

November 14, 2018 – Dementia Caregiver Workshop – Lois G. Britt Building, Duplin Commons, Kenansville, N.C.  This caregiver workshop is open to the public.