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  • Locations:Eastern Region - White River junction, Vermont (Togus Maine): VISN 1-10Central Region - Iowa City, Iowa: VISN VISN 11-12, 15-17, 23Western Region, Salt Lake city, UT: VISN 18-22
  • Just over 25% of rural caregivers live in the same household as the care recipient; 60% live within a one-hour drive; 4% live between a one- and two-hour drive away; and 11% live more than a two-hour drive away.
  • When a member of a farm or ranch family need part-time or full-time care, that need is usually filled by a family member. How to provide care and simultaneously keep the farm operation running smoothly is a consideration that must be made when working with rural families.
  • Rural caregivers are statistically more likely (78%) to turn to prayer as a means of support than urban (71%) or suburban (70%) counterparts.
  • *Wound care, blood sugar readings, catheter care (Van Houtven, Oddone, & Weinberger, 2010)**What questions to ask the physician and what information to collect and provide at appointments.
  • We’ll be weaving in Marilyn’s personal and professional experiences in rural ND and MN and Bret’s professional experiences with HBPC in Utah…
  • IADLS take on a broader meaning in rural settings…
  • Home visit with caregiver example.
  • Rural-specific issues – examples of isolation, distance, and informal support: Marilyn’s mom My mom was the primary caregiver for my dad who did not have dementia but he had multiple physical and mental health issues for several years before his death at age 81 8 years ago. For them, caregiving meant she not only cared for him but for all their livestock – feeding cattle in the winter etc. When he collapsed one evening she tried CPR to no avail and called the community volunteer ambulance department – it took almost an hour for them to get to the farm . On the plus side, one of the volunteers called his brother who lived 10 miles from the farm and in 20 minutes he arrived to support my mom.
  • Growing evidence that quality of family relationships prior to onset of dementia predicts the quality of caregiving experience that follows (Podgorski & King, 2009). Relationship satisfaction before onset was negatively associated with caregiver burden (Steadman, Tremont, Davis, 2007). More specifically, caregivers with preexisting high satisfaction in family relationship demonstrated significantly less burden, less reactivity to memory and behavior problems, better problem-solving skills, and more effective communication. Poor quality of relationships between care receiver and caregiver predicted caregiver depression and anxiety (Mahoney et al 2005)
  • Growing evidence that quality of family relationships prior to onset of dementia predicts the quality of caregiving experience that follows (Podgorski & King, 2009). Relationship satisfaction before onset was negatively associated with caregiver burden (Steadman, Tremont, Davis, 2007). More specifically, caregivers with preexisting high satisfaction in family relationship demonstrated significantly less burden, less reactivity to memory and behavior problems, better problem-solving skills, and more effective communication. Poor quality of relationships between care receiver and caregiver predicted caregiver depression and anxiety (Mahoney et al 2005)
  • As an APS worker, I was called out to investigate a situation of an older woman who lived in the country who was caring for her husband with moderate stage AD. He was a wanderer so she would tie him to a chair when she went to the nearby village [about 10 miles away] so he wouldn’t wander and get lost in the fields and/or freeze to death in the winter.
  • Mention how my siblings and I talked my mom into getting a cell phone to carry with her as she went about her chores on the farm and trips to town. She did and we discovered she didn’t have a signal until she drove ½ mile from the place! At least it ensured she could call someone if she had trouble on the road…especially in the bitter ND winters. Also talk about how my 81 yr old mom and her 89 yr old sister who lives “in town” 45 miles away from the farm have developed their own “1st Call for Help” – they call one another after they get up and before they go to bed.
  • Part of The American Recovery and Reinvestment Act of 2009 (Recovery Act) Broadband Technology Opportunities Programexpand broadband services to rural and underserved areas and improve access to broadband by public safety agencies.Broadband Initiatives Program support the expansion of broadband service in rural areas through financing and grants to projects that provide access to high speed service and facilitate economic development in locations without sufficient access to such service
  • SCORE = Supporting Caregivers of Rural-Veterans ElectronicallyCaregiver interventions such as REACH typically address Safety concerns Behavioral issues Legal/financial issues Community resources Caregiver support and education
  • Its likely that the caregiving efforts in rural areas will involve more than a primary caregiver even if formal supports aren’t being used.These photos depict a few members of my mom’s network – friends, family, and animal companions Talk about my mom’s experience when she slipped on the ice and shattered her wrist the Sunday after Thanksgiving 2 ½ years ago watering the bulls out in the pasture and how the community rallied around her to allow her to stay at home.
  • Summer evening on the farm
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