UMass/MassAHEC’s Rural Health Scholars Pathway: Fostering an Interest in Rural Elder Care

Statistically, rural communities have more elders and are grappling with fewer resources to support these elders. The opportunity for medical students to learn from experts in the community will have a life-long impact. Maegan Pollard, UMass Medical School Class of 2019 returned to Martha’s Vineyard this summer, learning from Nancy Lang RN, MS, MPH, DNP, BC and Leslie Clapp, Executive Director, at the Martha’s Vineyard Center for Living. Maegan is a student in the UMass Medical School’s Rural Health Scholars Pathway, supported by MassAHEC; last fall, along with 7 other students, she was placed on the island for the school’s required two-week population health clerkship.

From Maegan: After my experience as a Rural Health Scholar for the Dukes County Health Council gathering quantitative and qualitative data on Substance Use Disorder prevalence on Martha's Vineyard, I couldn't wait to go back to the picturesque island we had come to know and love. Having a personal interest in geriatrics, palliative care, and rural medicine, I was thrilled to be approached by Nancy Langman and Leslie Clapp of the Martha's Vineyard Center for Living to research dementia prevalence island-wide. For three weeks between May, June, and July, 2017 I was asked to participate in what has come to be a thrilling yet extensive project- to assess and map the resources available to islanders regarding care for their loved one with dementia. I conducted interviews with various island stakeholders who interacted with citizens with dementia on a daily basis: public health officials, family members, day program providers, charge nurses, CNAs and PCAs, physicians and NPs, social workers and more. I transcribed and coded these interviews for themes of the current barriers to care, and am developing a concept map to track the dementia patient's journey through the existing continuum of care. Through these methods I have gotten an intimate look at some of the most vulnerable patients and care providers on the island as they grapple with the pain and indignities of memory loss. I presented my findings at the Martha's Vineyard Hospital Grand Rounds, sharing in animated discussion with care providers of all disciplines--geriatrics, pediatrics, social work, nursing, etc.

I am so grateful for the opportunity to delve into the rich, rural community of Martha's Vineyard, with all of its character, strengths, and challenges. I have witnessed the difficulties of surmounting the red tape of small town politics, but also the passion and ingenuity of community members who have given countless hours to making their community more dementia-friendly. I have seen how different organizations crop up to try and tackle these unwieldy public health concerns, attempting to ration public funds while tirelessly lobbying for the great fiscal need. I have been touched by the unparalleled generosity and hospitality I have experienced as an off-islander exploring a new town (or should I say 6 new towns), as folks have filled my arms with food and hugs. Over the short time I have spent in Martha's Vineyard examining a public health crisis that will undoubtedly affect the rest of the nation in due time, I am simultaneously apprehensive and humbled by the work that we have left to do--but undoubtedly amazed by the remarkable grass-roots effort that has already been done. Rural health is a vibrant field, and the Martha's Vineyard dementia efforts are the pinnacle example of how to provide quality care to an invisible population with minimal resources.

From Nancy and Leslie: Nancy: Martha’s Vineyard is facing a Silver Tsunami with our rapidly growing aging population. The Martha’s Vineyard Center for Living, under a grant from Martha’s Vineyard Hospital, is working in collaboration with the Rural Scholars Pathway program at the University of Massachusetts Medical School. The assigned scholar, Maegan Pollard, is a rising third year medical student. She is spending time on the Vineyard this summer working with us to meet with stakeholders and research data in order to predict age-adjusted incidence and prevalence of dementia. A better understanding of the future needs will allow us to plan services and programs to continue to assure support for people with dementia and those who care for them. We are off to a great start following Maegan’s visit last month when she spent her time meeting with stakeholders, observing programs and leading focus groups.
Leslie: It has been a pleasure to work with Maegan. She has brought a level of enthusiasm and attention to detail have been wonderful assets to our project. She presented at MV Hospital grand rounds and did a phenomenal job. Looking forward to more and I know the end report and data analysis will be more than we could have hoped for.

Content from NERHRT member MassAHEC

UMass/MassAHEC’s Rural Health Scholars Pathway: Developing a Future Rural Health Provider

How do we foster medical students’ interest in rural health care? By providing them opportunities to learn about rural practice and to learn from those committed to caring for rural populations. Ciarra Nickerson, UMass Medical School Class of 2020, and a student in the school’s Rural Health Scholars Pathway is at the Outer Cape Health Services (OCHS) this summer with support from MassAHEC. This is how she and Andy Lowe, Director of Program Management Resources for Outer Cape have summarized her summer so far!

From Ciarra: My time at Outer Cape Heath Services has allowed me to better appreciate and experience, the challenges faced by rural health centers. I have been able to learn about many ways in which OCHS works to improve access to care to the people of its service area, and I have been very impressed by the programs they have developed to meet the unique needs of this rural, isolated population. One such program is the Community Resource Navigators; I was able to shadow the navigators in Provincetown, the Cape’s most isolated town. While there, I sat in on a meeting run by the Provincetown Police Department. This meeting included representatives from different local programs and I was struck by the importance of them all coming together to work toward their common goal of minimizing barriers to health and wellness, thus promoting the physical, mental, and behavioral health of all community members.

From Andy: Outer Cape Health Services is a community health center with three locations serving rural, isolated Lower and Outer Cape Cod, Massachusetts. Operating in a medically underserved area, OCHS has a commitment to strengthening the professional healthcare workforce, particularly in rural and isolated areas. As part of that commitment, OCHS is proud to host medical, graduate nursing, and other healthcare professions students with learning engagements that will help further their practical education. One example is Ciarra, who is spending eight weeks at OCHS between her first and second medical school years. During the experience, Ciarra is being introduced to a broad array of activities at OCHS, including shadowing our Community Navigators; learning about our Medication Assisted Treatment program; gaining clinical experience; as well as being exposed to the OCHS call center, credentialing, research initiatives, healthcare analytics, marketing, communications, and other aspects of clinical and supporting operations in a community health center. This real-world experience will complement Ciarra’s classroom learning and help prepare her to become a well-rounded healthcare provider, and—we hope--to choose to practice in a rural environment.

Content from NERHRT member MassAHEC