RCHC Community Project Abstracts

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Chronic Pain Management Treatment Options
Date of project: 4/27/2009

Chronic pain management accounts for a significant number of visits to primary care providers. Effective management of these patients is challenging because of the complexity of chronic pain, the variable efficacy of available treatments, the limited resources of patients, as well as the abuse and diversion liabilities of controlled substances. Chronic pain often incorporates physical, psychological, social and cultural elements. Moreover, these patients can present with multiple co-morbidities and are high frequency health care consumers, both of which contribute to provider fatigue. The present study describes a small sample of chronic pain patients, illustrates current and past pain management strategies and reports current opinions from multiple staff members on the current state of pain management at the Legacy Clinic in St. Helens, Oregon. It concludes by proposing one management option that may improve treatment efficacy and address economic concerns inherent in this common medical problem.

Resources Available for Patients with Dementia in Columbia County, Oregon
Date of project: 3/17/2008

Dementia represents a major health issue for geriatric patients in the United States. This study serves primarily as a community profile and assessment of the resources available to patients with dementia, specifically Alzheimer's disease and their families in Columbia County, Oregon. The study evolved during preliminary conversations with the staff of the primary care internal medicine clinic in St. Helens, Oregon. They identified the availability of resources for dementia as a consistent challenge in offering guidance to their patients. A survey of local resources was conducted which included site visits to nursing homes and senior centers, contacts with social workers, and internet searches for resources. The local resources were compared with those described in the medical literature and the National Alzheimer's Association. Questions to evaluate the effectiveness of the local resources were prepared for patients with dementia and their caregivers. A simple handout was prepared to identify key resources in the community and at large.

“WI I ” TA S T I C : T H E I N T ROD U C T ION OF A NOV E L V I D EO G A M E CON SOL E I N TO A N U R S I N G HOM E
Date of project: 12/31/2007

For nursing homes, the maintenance of physical activity is often an important, if not primary goal of day to day activities. It is commonly believed that lack of physical exercise will lead to exacerbation of co-morbid conditions and general overall decline. In many commercial nursing homes, this is primarily accomplished through group exercise as well as formal physical and occupational therapy.; each of these approaches has their limitations. The purpose of this project was to provide a qualitative analysis of the introduction of a novel video game console concept developed by Nintendo called the “Wii.” This console is unique in that it is one of the first to be introduced into the mass market that implements the use of physical interactive technology into game play. This task was accomplished through two general introductory sessions and two case study sessions with nursing home patients. Qualitative observations and analysis are reported with recommendations for follow studies that could be performed using a quantitative approach.

Fall Prevention Services For Geriatric Patients In St. Helens, OR
Date of project: 10/15/2007

Geriatric morbidity and mortality increases after fall injuries.1 Many of these falls may be avoided with fall-prevention strategies that involve improving geriatric strength and mobility. The goal of this study was to identify local fall-prevention resources and services for geriatric patients--specifically, programs that could provide mobility-assistance-device (i.e. canes, walkers) training, home fall-prevention safety consultations and home mobility improvements/installations. Geriatrics patients from the St. Helens, OR community and their medical and social services providers were interviewed. Although rehabilitation services in St. Helens for geriatric patients who have already experienced a fall injury are easy to identify and access, services to prevent healthy, active seniors avoid falls are not.

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