North Carolina’s geriatric population is the fastest growing segment of the state’s population. If projections hold, the number of adults over the age of 65 living here will double by 2030.
To help address the pressure these demographic shifts will put on the state’s health care system, the U.S. Department of Health and Human Services is giving the East Carolina University College of Nursing a three-year, $2.5 million grant through its Geriatrics Workforce Enhancement Program. The grant will allow ECU to implement an interprofessional education model focusing on geriatrics, train primary care providers to meet the specific needs of elderly patients, and deliver community-based programs that address the needs of older adults and their families.
Drs. Ken Steinweg, left, and Candace Harrington, center, treat patient Charity Holland at Cypress Glenn Retirement Community. (Photo by Gretchen Baugh)
“We’re building a comprehensive approach to caring for our region’s older adults,” said Dr. Sonya Hardin, the grant’s primary investigator and interim associate dean for graduate programs in the College of Nursing.
“We’ve lacked this in primary care and it’s going to become very important as we have more patients with chronic illnesses needing more specialized resources.”
The College of Nursing will partner with the Brody School of Medicine Division of Geriatrics, the Department of Physician Assistant Studies, the ECU-based North Carolina Agromedicine Institute and multiple regional partners. Together, their work will focus on eastern North Carolina – a rural, underserved region where citizens are in poorer health than the rest of the state. Although the state ranks 38th in premature mortality, if only the 41 counties of eastern North Carolina were represented, it would rank 45th nationally.
“This grant is designed to bring together stakeholders who have an interest in geriatrics so we can educate our frontline practitioners to give the tailored care that this growing population needs,” said Hardin.
Aging patients present specific challenges for the health care system. They often have multiple co-morbidities, or additional diseases that can complicate treatment. Geriatric patients also tend to take more routine medications, lack support systems and be at heightened risk for injury or death from accidents such as unintentional falls.
“This is a tough group of folks to take care of,” Geriatrics Division Director Dr. Kenneth Steinweg said. “They’re very frail, and they have reduced reserves so you have to be very careful making adjustments for that.”
Objectives of the ECU program are:
Implementing Interprofessional Education
A cadre of nurse practitioner, physician assistant and medical students will treat patients together at Greenville retirement community Cypress Glen, Roanoke Chowan Community Health Center in Ahoskie, and one additional to-be-determined primary care site. The students also will work on virtual cases online and see simulated patients as a team. Traditionally, each discipline receives geriatric education separately; the interprofessional approach will encourage members of each field to respect the others’ strengths for better collaboration to treat patients.
Training Primary Care Providers
ECU grant participants will set up two geriatric screening offices at regional facilities where nursing professionals will assess elderly community members and refer them for additional care as needed. Working with partners at the Eastern Area Health Education Center (AHEC), ECU will organize conferences and publish podcasts on geriatrics. The continuing education resources will serve health care providers who have limited access to professional education resources due to their rural location.
Providing Community-Based Education for Agromedicine
Older farmers, loggers and fishermen are special needs populations in North Carolina, where there are 50,000 farms, 1,400 loggers and 3,375 miles of coastline. Farmers, for instance, are known to continue working well past the normal retirement age. Workers older than 55 account for about half of all farming deaths. Partnering with the Agromedicine Institute, the College of Nursing will perform needs assessments for farmers, loggers and fishermen and provide education based on the results of that research.
Extending Dementia and Alzheimer’s Resources
Working with the Alzheimer Association of eastern North Carolina and sub-contractors at the University of North Carolina at Chapel Hill, ECU will provide dementia and related disorders education to students, faculty and the primary workforce of the region. Offerings will include workshops and daylong training events.
In addition to Hardin and Steinweg, faculty members involved in the grant include Dr. Candace Harrington, clinical associate professor of nursing; Dr. Ann King, clinical associate professor of nursing; Dr. Balaji Pabu, clinical assistant professor in family medicine and geriatrics; Dr. Janice Daugherty, associate professor of family medicine and geriatrics; Dr. Alan Gindoff, clinical associate professor and chair of the Department of Physician Assistant Studies; C. Kim Stokes, clinical coordinator and clinical assistant professor in the Department of Physician Assistant Studies; and Jessica Wilburn, AgriSafety Nurse from the Agromedicine Institute. The College of Nursing’s Office of Research and Creative Activities played an integral role in the grant submission process and will provide assistance with the grant.
ECU is one of 44 organizations in 29 states to receive a total of $35.7 million as part of the federal program to support improving health outcomes for older Americans, Health and Human Service Secretary Sylvia Burwell announced at the White House Conference on Aging in July.
“Transforming the health of those living in our region is the College of Nursing’s founding mission,” said College of Nursing Dean Dr. Sylvia Brown. “Awards like this one allow us to pursue that mission and change lives in our community.”