RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Meet Me In The Woodshed A Tragedy in a Small Town: Recognizing and Preventing Suicide in the Elderly Project Date: 1/1/2007 Elder suicide is major issue in Oregon and the United States. Suicide rates among persons age 65 years and older are the highest compared to any other age groups. In 2003 in Oregon, the suicide rate per 100,000 in people aged 65 years or more was more than twice the rate in people aged 15 to 34 years old (27.14 versus 13.41). This project aimed to quantify the problem of elder suicide, identify risk factors both generally and specific to Oregon and Tillamook County, and propose prevention strategies for the community and physician. Data sources included research studies on elder suicide, census and CDC statistics, and interviews with community professionals involved with suicide prevention and treatment. Risk factors for elder suicide overall include chronic disease, social isolation, and the misconception that elder depression is a normal part of aging. Oregon has the 4th highest elder suicide rate in the county and some factors specific for the elder Oregon population include living in a rural setting, “rugged individualism”, and firearm ownership. Physicians can help prevent elder suicide by encouraging a warm and trusting relationship with patients so that they feel safe sharing depressive thoughts. Physicians have tremendous power of influence with their patients’ health care decisions and can strongly recommend counseling and treatment for patients at risk. In the upcoming year, the Oregon DHS plans several community meetings to develop prevention strategies specific to the local area. Finally, a refrigerator magnet with important contact numbers for outreach and counseling services was designed for elder patients to have at available at home. The hope is that in the future, elder patients considering suicide will contact his friend, doctor, or counselor to begin their path to recovery. Perspectives on end of life preparedness and POLST implementation by providers in Reedsport, Oregon. Project Date: 1/1/2007 End of life planning is an emotionally charged topic of discussion for medical personnel, patients, and families. Throughout the country, the use of heroic and expensive treatment for those with terminal conditions is the subject of debate by medical personnel as well as ethicists. End of life practices vary by hospital and certainly by demographics. This project seeks to explore the attitudes and practices of seven medical practitioners in a family health clinic in a coastal community in Oregon. The unique environment that is embodied in this town is similar to other small rural communities across the country. Reedsport has a critical access hospital that contains 22 acute care beds with accommodations for two ICU beds. It also has an extended care facility associated with the hospital. Its ER is staffed primarily by local family doctors. The family practice clinic serving this health district is located immediately adjacent to the hospital. This presents a unique opportunity to evaluate the practice and implementation of end of life measures in different medical settings by the same medical practitioners. Many if not all of the patients who are admitted to the local hospital by the ER physicians are also the patients of these same practitioners of community based medicine. Attitudes toward end of life issues were sampled by personal interview and completion of a small survey. Strategies are discussed for the increased implementation of POLST forms in the practices of these providers and in their community. Examining Barriers to Physician Referrals to Hospice Care in Josephine County Project Date: 2/13/2006 The goal of hospice care is to provide palliative care, symptom control, and emotional, spiritual, and social support for both patients and their families. Hospice services are meant to provide quality of life during the dying process. Lovejoy Hospice receives approximately 50% of referrals from area physicians and approximately 45% directly from families. These percentages either reflect a high public awareness of hospice services or that there are barriers for physicians when it comes to offering hospice as an option. Therefore, a survey was designed to help identify barriers in the physician community. The survey includes questions about physician and hospice interactions, the difficulties of discussing end-of-life care, the tools physicians would find helpful in an end-of-life discussion, and the awareness of the range of diseases and age groups that hospice can serve. The responses will be analyzed and, hopefully, barriers identified. With this data, strategies can be developed to aid physicians in overcoming barriers to offering patients hospice care as an end-of-life option. The desire to help physicians overcome barriers comes from the ultimate goal of ensuring that no patient goes without hospice care because the option was not presented to them. The Tragic Loss of Dr. Craig Roberts: Grieving Within the Medical Profession Project Date: 1/5/2004 A short time ago, Tillamook County lost a beloved member of their medical community, Dr. Craig Roberts, in a motor vehicle accident. This paper attempted to describe the medical professions’ experience with this tragedy and examine their grief response. A questionnaire was distributed to various members of the medical community who knew Dr. Roberts, including physicians, emergency department (ED) nurses, Emergency Medical Technicians (EMTs), and medical assistants. The questionnaire acted both as a means to gather information as well as a therapeutic intervention. The responses from the questionnaire were examined and a paper was written describing their grief response and how this compared to grieving reported in the literature. It was found that the grieving pattern and coping mechanisms of the medical community were very similar to previously reported studies. However, the incident was quite severe for those involved, due to the fact that they had to remain in a caregiver role and had little time for grieving. Children and Grief: Resources for Pediatricians in Coos County Project Date: 2/11/2002 Children grieve according to their developmental stage and individual personalities. There is no "right" way to grieve and each child will go through the process in their own way. Pediatricians can be a vital source of support and information for families dealing with the loss of a loved one. In Coos County pediatricians also have the additional resource of the Light House Center, a support program for grieving children, teens, and families. Working with the Family Services Manager, I developed an educational and fund-raising presentation as a service to the Light House Center and the pediatricians of Coos County. Back to subject search page or search by preceptor site