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Excerpt: The focus of this paper is 1)to provide an overview and brief analysis of the current status of rural communities, rural elder health, policy, and practice, and further 2)to suggest guidance/recommendations for future policy based on a systems approach which incorporates sustainability, best practice, quality, efficiency, effectiveness, with a conceptual basis for care within the context of people and place which constitutes rural America.

The purpose of this study was to describe the experiences of rural community-dwelling older adults with heart failure who required assistance with activities of daily living (ADLs) and instrumental ADLs (IADLs). The context of the study was a rural area in a southern U.S. state. Twenty older adults with ADL/IADL needs living in the rural area were recruited during hospitalization and interviewed in their homes after discharge. The semi-structured interview focused on ADLs/IADLs and community resources. This qualitative descriptive study used hermeneutic methods for analysis. Four themes were identified: Accepting Limitations, Disappointments and Unmet Expectations, Figure It Out, and Complex Connections. The findings indicate that despite the older adults’ medical conditions, they were able to set up complex arrangements, which allowed them to remain in their homes. Understanding the help older adults require after discharge will assist nurses in developing programs that are available, accessible, and acceptable to older adults who live in rural areas.

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Purpose of study: This is a descriptive study to ascertain the Hepatitis C Virus (HCV) prevalence and usefulness of screening in medical outreach settings (MO) compared to indigent healthcare clinics (IHC) in northeast Tennessee. Methods used: Between April 2017 – February 2019, routine, opt-out HCV testing was performed in 4 IHC and 3 MO sites in the Tri-Cities, TN region. During screening, demographic information was collected and the de-identified data were analyzed. Summary of results: Among 212 clients screened 26 (12.26%) were HCV antibody positive. Of all clients screened 107 (50.47%) were young adults, born after 1965 compared to 99 (46.7%) participants born between 1945-1965. The percentage of HCV antibody cases were 16 (61.54%) and 8(30.77%) for young adults and baby boomers respectively. The percentage of males and females screened were 46.7% and 53.3% respectively, with equal proportion of HCV antibody cases (50%; P=0.7186). Non-Hispanic whites and African Americans made up 90.57% and 9.43% respectively of all clients screened; 96.15% (P=0.2980) of the positive cases were ascribed to non-Hispanic whites. Screening occurredin seven testing locations, 3 MO events and 4 IHCs. A total of 25 (96.15%; P=0.0056) HCV-antibody positive cases were found in the IHCs compared to 1(3.85%) found in a MO event. Conclusion: This analysis shows the higher yield of targeted screening at IHCs. Targeted HCV screening is critical in the era of opioid epidemic especially since direct-acting antiviral agents (DAAs) who offer a Sustained Virologic Response (SVR) rate of more than 90% are available.

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No description available.