This article describes the process, approaches, and selected outcomes of a rural care management outreach intervention for older African Americans in South Carolina. The model is a community-academic partnership between a federally qualified community health center, a rural health clinic, and the Medical University of South Carolina. Its aim is to improve access to and utilization of health care and social services to enhance the quality of life of older African Americans. This is being accomplished by using paid, trained outreach workers (called geriatric coordinators), who function as advocates in linking clients to needed health and social services through activities such as arranging transportation to health care, rescheduling missed medical appointments, providing health promotion, and making referrals to public benefits and indigent drug programs. Outcomes demonstrated that the use of geriatric coordinators as care managers is a feasible way of increasing quality of life for older African Americans. The most notable outcome showed that 54% of clients who were eligible but not receiving benefits prior to this intervention were signed on for programs such as Supplemental Security Income, Specified Low-Income Medicare Beneficiary (SLMB), Qualified Medicare Beneficiary (QMB), disability, railroad pensions, and Veterans Administration benefits. Health centers realized an increase in reimbursable services and new clients. Increased capacity for older adult services is being accomplished through geriatric-coordinator-directed collaborations with social service agencies and participation in community events and committees.
The purpose of this pilot study was to develop and evaluate a training program for volunteer peer educators of Alzheimer's disease caregivers. Curriculum development included a literature review and a focus group needs assessment with 25 caregivers. Eight former caregivers participated in pilot testing of a 10-unit, 30-hour training program to develop knowledge regarding Alzheimer's disease, caregiving, services, resources, and skills for effective communication. Qualitative and quantitative evaluation revealed gains in skills and knowledge, a high level of participant satisfaction, and suggestions for future training. This study suggests that former caregivers who are no longer actively involved in caregiving can acquire new knowledge and skills as peer educators and work with professionals to provide education, support and referral.
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