Download Mecosta - Stacey Swartzendruber, RN

Elderly Support
in
Mecosta
County
Molly Bach-Bullen
Sarah Delaat
Jennifer Hales
Kristin Stahl
Stacey Swartzendruber
• As a vulnerable
population in Mecosta
County, Michigan, the
elderly population may
face unique health
risks and barriers to
care, requiring
enhanced services and
targeted strategies for
outreach and case
management.
ANALYSIS
PRESENTATION
TITLE
Mecosta
County
Error
Margin
National
Benchmark*
Michigan
Health Outcomes
27
Mortality
Subtitle
(Optional)
Premature death
6,392 5,494-7,291
21
5,564
7,387
Morbidity
Poor or fair health
Poor physical
health days
Poor mental
health days
Rank
(of 82)
38
15%
10-22%
10%
15%
4.6
2.9-6.3
2.6
3.5
2.5-5.1
2.3
3.7
6.0%
8.2%
3.8
Your Name
Company Name
Date
Low birthweight
6.3%
Location /Seminar Title
5.5-7.2%
http://www.countyhealthrankings.org/michigan/mecosta
Mecosta
County
Error
Margin
National
Benchmark*
Michigan
35
Clinical Care
Uninsured
adults
Primary
care
providers
Rank
(of 82)
16% 13-20%
1,194:1
13%
14%
631:1
874:1
Preventab
le hospital
stays
62
57-67
52
74
Diabetic
screening
91%
79100%
89%
83%
Mammogr
aphy
screening
72% 59-84%
74%
69%
http://www.countyhealthrankings.org/michigan/mecosta
Mecosta
County
Error
Margin
National
Benchmark*
Michigan
24
Physical Environment
Air pollutionparticulate
matter days
2
0
5
Air pollutionozone days
2
0
3
Access to
healthy foods
75%
92%
73%
10
17
10
Access to
recreational
facilities
Rank
(of 82)
http://www.countyhealthrankings.org/michigan/mecosta
> 65 yrs. old
Mecosta
Michigan
Nationally
15.9%
13.4%
12.9%
32.7%
30.1%
Living
Independently
Nursing Home
Residents
65+ Living
below
Poverty line
6.3%
5%
11.5%
10.4%
Developmental Tasks of Aging
Adjustment to :










Retirement
Reduced income
Death of friends
Death of spouse
Physical changes
Loss of independence
Creating new friendships and relationships
Loss of vitality
Integrating life experiences
Preparation for death
Commission on Aging
The purpose of the Mecosta
County Commission on Aging
(COA) is to improve the quality
of life of the county's 60-plus
population. The agency's goal is
to support Seniors in their
efforts to remain in their own
homes, maintaining
independence, health, dignity,
and self-respect. Eligibility for
services will be determined on a
priority basis
www.co.mecosta.mi.us/coa.asp
Health Promotion Programs in Mecosta County
Evidence-based Health
Promotion programs continue
to be a region-wide
focus as individuals and
organizations begin to change
the way we age by
concentrating on disease
prevention and healthy aging.
http://www.aaawm.org
Evidence-based Health Promotion
Programs
In FY 2008 the following
evidence-based programs
were offered:
• EnhanceFitness®- Ionia, Kent and
Mecosta counties
• A Matter of Balance - Allegan,
Ionia, Kent, Lake, Mason, Mecosta
and Montcalm counties
• PATH - Ionia, Kent, Mason,
Mecosta and Montcalm counties
• Arthritis Foundation Exercise
Program - Kent County
http://www.aaawm.org
DIAGNOSIS
Risk of ineffective
health maintenance
among the elderly
population of Mecosta
County related to
inadequate resources
and/or support.
PLAN
“The majority of men meet with
failure because of their lack of
persistence in creating new plans
to take the place of those which
fail.” Napoleon Hill
Healthy Senior
• A non-profit senior center that makes
vaccines and appointments for cancer
screenings available.
Nearly 90% of Medicare beneficiaries visit a physician
at least once a year and make an average of six visits
during the year, many do not receive the full range of
recommended covered preventive services.
Healthy Senior
• Goals of the Healthy Senior Center:
– “The Senior Center's goal is to help area Seniors remain healthy and
active through participation in recreational, educational and leisure
activities. The Senior Center and Commission on Aging encourage the
community to share their skills and at the same time enrich their own
lives by gaining knowledge through their volunteer experience.”
• Based on a study of Brazilian elderly women who participated
in classes of recreation and walking practice 3 times per week
for a 4 month period– “Concluded that recreation and regular and guided walking can
improve physical, social and psychological aspects of the elderly
individual, and, in consequence, the functional autonomy: more
precisely the daily life activities.”
www.co.mecoata.mi.us/seniorcenter.asp.
Getting Started
• File Articles of Incorporation with the Secretary of State’s
office to protect employees and board members of the NonProfit agency.
• File for 501(c)(3) status with the Internal Revenue Service to
brand the non-profit entity as tax exempt on all revenues it
earns.
• Research local and state regulations in order to comply with
codes.
• Meet with experts in the field at meetings and conferences
and learn from their knowledge and experience.
• Find the best location for the center.
• Discuss fundraising activities and promotion opportunities.
Clinical Preventive Services
• The following slide presents recent state and national
data on the use of eight clinical preventive services:
two vaccinations that protect against influenza and
pneumococcal disease; five screenings for early
detection of breast cancer, colorectal cancer, diabetes,
lipid disorders, and osteoporosis; and one counseling
service for smoking cessation.
• These Clinical preventive services are
recommended for adults aged 65 and older by the U.S.
Preventive Services Task Force or by the Advisory
Committee on Immunization Practices.
Vaccinations in Adults Aged 65 years
INFLUENZA
*85% of deaths and 63% of hospitalizations occur in person 65
years of age and older
*Influenza vaccination of adults aged 65 to 79 reduces
hospitalizations and lowers costs, also decreasing the number
of deaths
PNEUMOCOCCAL
* “Associated with improved survival, decreased chance of
respiratory failure or other complications, and decreased length
of stay among hospitalized patients with community-acquired
pneumonia.”
* “Recent analyses indicate that pneumococcal vaccine is costeffective and potentially cost-saving among adults aged 65 and
older in the prevention of bacteremia.”
Screenings in Adults Aged 65 years
BREAST CANCER SCREENING
* “Almost half of all new cases and nearly two-thirds of deaths from breast cancer
occur in women 65 years of age and older. “
* “Mammography screening every two years for women aged 65 to 74 has been
shown to reduce mortality.”
COLORECTAL SCREENING
* “The number of people diagnosed with colorectal cancer is predicted to increase
over 50% by the year 2020 due to the aging of the population. Currently, twothirds of all new cases of colorectal cancer are in people aged 65 years and older.”
DIABETES SCREENING
* “Diabetes is very common in older adults, affecting almost 12 million adults
aged 60 years and older. Having diabetes more than doubles a person’s risk of
numerous complications, including vascular problems, geriatric syndromes, and
disability.”
* “Efficient detection of diabetes among older enables the provision of effective
interventions that can prevent the progress of certain diabetes-related
complications, improve glycemic control, and reduce vascular risk factors.”
Screenings continued
LIPID DISORDER SCREENING
* “High serum cholesterol is a major risk factor for heart disease
and stroke.”
* “Screening for lipid disorders can prevent premature mortality
from coronary heart disease and avert substantial disability,
distress, and pain.”
OSTEOPOROSIS SCREENING
* “At some point in their lifetime, 30 to 50% of women and 15 to
30% of men will experience an osteoporotic fracture.”
* “Osteoporosis screening with hip DEXA scans and follow-up
management in older adults has been shown in a large
population-based cohort study to be associated with 36% fewer
incident hip fractures over six years compared with usual
medical care. “
http://www.cdc.gov/aging/pdf/Clinical_Preventive_Services_Closing_the_Gap_Report.pdf
•
•
•
•
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Benefits of Physical Activity
bullets from the AHA
“According to the American Heart Association, people become less physically
active as they get older. Nearly 40% of people over the age of 55 report no physical
exercise.”
“Studies have revealed that increased levels of physical activity are associated with
a reduced incidence of coronary heart disease, hypertension, non-insulindependent Type 2 diabetes, colon cancer, depression and anxiety.”
“Active people with high blood pressure, high blood cholesterol, diabetes or other
chronic diseases are less likely to die prematurely than inactive people with these
conditions.”
“Inactive people lose muscle fiber at a rate of 3 to 5 percent every decade after
age 30. That's a 15 percent loss of muscle fiber by age 60!”
“Health experts warn that as a consequence of diminished exercise tolerance, a
large and increasing number of elderly people will be living below, at, or just above
"thresholds of physical ability." In this condition, a minor illness could make them
completely dependent on others for their daily care.”
Fitting Together Pieces of the Puzzle
•Support for Self-Care
•Chronic Disease Prevention &
•Management
•Community Participation
•Treating Acute & Episodic Illness
•Health Promotion, Illness
prevention
•Community Resources
INTERVENTIONS
1.Improve community resources for Mecosta
County’s elderly population through
enhancement of social support and affordable
programs.
2.Enhance education of available resources to
the elderly population of Mecosta County.
How to improve community
resources?
• Involve churches, physician’s offices and the Healthy Senior
Center in developing programs that include health promotion,
disease prevention as well as treatment and social outlets for
the senior population of Mecosta County.
• Events can be advertised in “The Keyhole”, the Mecosta
County Seniors Newsletter as well as city newspaper.
• Make transportation to appointments and programs more
accessible to the elderly through volunteer services.
– S.O.A.R. (Senior Outings and Recreation) offers free rides to senior
events at the Senior Center. Other involvement from the community
to offer rides to doctor’s appointments is needed (volunteers and
government funding may be needed).
•
•
•
•
•
How to improve community
resources? (cont.)
Increased involvement in seeking out the elderly of Mecosta
County who are at risk for self-care deficits, unsafe
independent living conditions due to deteriorating medical
conditions or dementia, or at risk for abuse and neglect.
Utilization of home health services as needed for those with
self-care deficits.
Development of programs for family members of the elderly
to educate them on the warning signs of dementia as well as
signs that their family member may need more assistance in
the home.
Screenings to be done through PCP’s.
Meet with case managers at local hospital to ensure adequate
information on current community programs is up to date and
being dispersed to their elderly patient population.
How to enhance education of
available resources?
• Consults available to those with financial
concerns regarding medications and health
insurance to make sure the elderly are utilizing
the health services they qualify for.
• Research local and state regulations in order
to comply with codes.
• Adequate advertising about the Healthy
Senior Center through television commercials,
mailings, bulletins at churches, doctor’s offices
and public places such as grocery stores.
EVALUATIONS
•The Healthy Senior Center will be
established and fully functioning.
•There will be an increase in the
percentage of elderly population in
Mecosta county who receive:
•Influenza vaccinations
•Pneumococcal vaccinations
• Breast cancer screening
•Colorectal cancer screening
•Diabetes screening
•Lipid disorder screening
•Osteoporosis screening
Evaluations Continued
•Send out questionnaire to elderly
population for evaluation regarding
the availability of adequate
community resources.
•Community members will contact
resources available.
•Area clinics/healthcare organizations
will distribute material /guides to
community members on available
resources.
•Modified from Ralph & Taylor (2008)
Evaluations continued
• Community members will participate in
community forums to assist further and
continued development of community
resources for the elderly based on their
perceived needs.
•Community forums to be held at 3, 6,
and 12 moths post implementation.
.
PUBLIC POLICY
Mecosta County has
very limited published
public policies in
regards to the elderly
population. The focus is
on the statewide
policies in place.
Public Policy Implications
- Because the federal government
has not jumped to deal with the
child and elder care concerns - i.e.,
the problems of cost, quality and
supply - many employers and state
and local governments will sponsor
more initiatives to help families.
Decreasing public monies available
for new initiatives and recessionary
times, however, will make it
increasingly difficult for local
governments and Michigan
businesses to do so.
http://web1.msue.msu.edu/msue/imp/modii/ii493007.html
MiRX Card
•This is a new program for middle to
low income MI residents who have no
prescription coverage.
•Provides a discount drug card that
uninsured and underinsured people can
get up to 20% off prescriptions at
participating pharmacies.
http://www.legislature.mi.gov/documents/Publications/ServicesforSeniors.pdf
(
MEDICARE
PART A
• Used for hospital insurance
• Helps pay for inpatient
hospital care, as well as
some skilled nursing care,
hospice, and some home
health care.
• Available to most seniors at
no charge.
PART B
• Assists in paying for
doctor’s services,
outpatient hospital care,
and medical supplies.
• Costs a monthly premium
of approximately $100.
http://www.legislature.mi.gov/documents/Publications/ServicesforSeniors.pdf)
MI Bridge Card
• Administered through the Department of
Human Services in cooperation with the U.S.
Department of Agriculture.
• Food assistance program for elderly with low
incomes (previously called the food stamp
program).
• Allows for low income elderly to purchase
nutritious foods without the extra cost to their
pocketbooks.
MI Choice
• Available in all MI counties
• Provides individual assessment and
coordination of services for the elderly such
as:
a. Assistance with ADL’s
b. Home delivered meals
c. Respite care
• -Financial and medical eligibility requirements
apply
http://www.legislature.mi.gov/documents/Publications/ServicesforSeniors.pdf
The state run
programs can be very
beneficial, but
teaching this
population how to
access the
information they
need via technology
and the internet could
be a large problem.
Commission on Aging
In conjunction with
these state offered
programs, Mecosta
County also has their
own Commission on
Aging (C.O.A.) to
assist with the elderly
population.
COMMISSION ON AGING
Transportation for those who need to get to and
from appointments is a service provided by the
C.O.A. This is largely based on volunteers and
can be somewhat difficult to coordinate for all of
those in need. Access to healthcare for those who
are housebound is incredibly difficult.
Programs for Seniors
• Mecosta County
Commission on Aging
12954 80th Ave.
Mecosta, MI 49332
(231) 972-2884
This service is designed
to provide social
stimulation and health
services to seniors who
require supervised care
• Barryton Senior Center
71 Northern
Barryton, MI 49305
(989) 382-7244
This service offers
organized daily activities
in a community based
setting along with
personal care services for
senior citizens.
References
• American Heart Association. (2011). Benefits of Physical Activity
for Older Americans. Retrieved from
http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity
/GettingActive/Benefits-of-Physical-Activity-for-OlderAmericans_UCM_308037_Article.jsp
• Area Agency on Aging of Western Michigan [AAAWM]. (2011).
Area agency on aging. Retrieved from: http://www.aaawm.org
• Centers for Disease Control and Prevention, Administration on
Aging, Agency for Healthcare Research and Quality, and Centers
for Medicare and Medicaid Services. (2011). Enhancing Use of
Clinical Preventive Services Among Older Adults. Washington, DC:
AAR. Retrieved from
http://www.cdc.gov/aging/pdf/Clinical_Preventive_Services_Closi
ng_the_Gap_Report.pdf
References (continued)
• Citymelt.com. (2011). Mecosta county Michigan: a complete analysis.
Retrieved from:
http://www.citymelt.com/county/Michigan/Mecosta+County-MI.html
• County Health Rankings. (2011). Mecosta, Michigan. Retrieved from:
http://www.countyhealthrankings.org/michigan/mecosta
• Fraga, M., Cader, S., Ferreira, M., Giani, T., & Dantas, E. (2011).
Aerobic resistance, functional autonomy and quality of life (QoL) of
elderly women impacted by a recreation and walking program.
Archives of Gerontology & Geriatrics, 52(1), 40-43.
• Mecosta County Michigan. (2003). Commission on Aging and Senior
Center. Retrieved from: www.co.mecosta.mi.us/coa.asp
•Mecosta County Michigan. (2003). Senior Center. Retrieved from:
www.co.mecosta.mi.us/seniorcenter.asp
References (continued)
• Michigan State University Extension. (1999). Focus on Michigan’s
future: changing family and household patterns. Retrieved from:
http://web1.msue.msu.edu/msue/imp/modii/ii493007.html
• Michigan Legislature. (2010).Services for Seniors: Laws and programs
for senior adults. Retrieved from:
http://www.legislature.mi.gov/documents/Publications/ServicesforSeni
ors.pdf
•Ozminkowski, R., Goetzel R., Shechter, D., Stapleton, D., Baser, O., &
Lapin P. (2006). Predictors of preventive service use among Medicare
beneficiaries. Health Care Financing Review. 27(3), 5-23
•Ralph, S., & Taylor, C. (2008). Nursing diagnosis reference manual (7th
edition). Philadelphia: Lippencott Williams & Wilkins.
•U.S. Census Bureau. (2010). State and county quick facts. Retrieved
from: http://quickfacts.census.gov/qfd/states/00000.html