Case Study: Arkansas Aging Initiative
A Statewide Program Uses Interprofessional Teams to Improve Access to Care for Older Arkansans
Bonnie Sturgeon was an independent 80-year-old in 2005 when shortness of breath began to slow her down. She had been living on her own for decades, driving herself to church and singing in the choir. She went to the Christus St. Michael Health System in Texarkana, Texas, her home town, for a diagnostic workup. There she met Amyleigh Overton-McCoy, PhD, GNP-BC, RN, a geriatrics nurse practitioner with the Arkansas Aging Initiative (AAI).
“When I first went to see Amyleigh, I was there an hour or more,” Ms. Sturgeon said. “She asked me every question she could think of, and I wondered how many questions could be asked?” But the intensive interviewing and testing revealed that she had three blocked arteries and had experienced a heart attack. Ms. Sturgeon was scheduled for a triple coronary artery bypass grafting procedure. Five years later, she credits Ms. Overton-McCoy with saving her life. “I’ve not ever been in her office that she hasn’t gone over the past visit, what progress I made, and if I’ve had any new problems, even the smallest thing.”
Patient centeredness, meticulous diagnostics, and wise counsel represent the kind of nursing that might provide a textbook definition of holistic care. This is the kind of care older Arkansans have been receiving since state voters passed the Tobacco Settlement Proceeds Act of 2000, which ordered that state monies from the Tobacco Master Settlement Agreement go toward health care initiatives, including the AAI.
Affiliated with the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, the AAI has two direct service components. First, a team consisting of a geriatrician, an advanced practice registered nurse (APRN), and a social worker provides care at each of eight satellite centers on aging owned and managed by local hospitals (and financially self-supporting through Medicare). The team follows its patients across settings—hospital, clinic, home, and nursing home—as needed. Second, an education component supported by the tobacco settlement funds targets health professionals and students, older adults and their families, and the community at large.