Project: Research project

Project Details


For frail, rural dwelling elders and their families, hospitalization
represents a crisis of the most ominous nature. Not only must these
older patients cope with acute illness problems, but they must do so
in the context of health care cost containment. For elderly persons
residing in rural areas such as those found in Pennsylvania, this
crisis does not resolve when they exit the hospital, often
prematurely, and return home to continue recuperating. Although
numerous studies have shown that the post-discharge period is a
pivotal one for older patients, conventional reimbursement strategies
do not provide for and additional health care services so necessary
for recovery. Consequently, readmissions to the hospital and
adverse outcomes after discharge are the highest in persons who are
elderly and frail impaired. The degree to which the influences of a
rural environment add additional hardships in identifying and
accessing needed post-discharged support services is not known.
Clinical nurse specialist have demonstrated the ability to effectively
meet the specific post-discharged support services is not know.
Clinical nurse specialist have demonstrated the ability to effectively
meet the specific post-discharge health care needs of high-risk
hospital patients. In this experimental study, the CNS will be used
to provide post-discharge care for frail, rural-dwelling elderly
patients, along with their families and concerned others. An
equivalent control group will not receive this specialist care.
Utilization of health care resources, the patient s cognitive and
functional status, and family or concerned other s general health
and caregiving stress will be compared between the treatment and
control groups at four different points in time. Results of
longitudinal data collection are expected to show that the CNS
intervention significantly improved the quality of care for frail,
rural elders and their families.
Effective start/end date8/1/977/31/00


  • National Institute of Nursing Research


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