Activity ID



April 13, 2021

Format Type


CME Credit



CME Provider

Oregon Health & Science University School of Medicine


Older adults in rural Oregon have few geriatric health care resources leading to significant access inequality and health disparities; such circumstances will continue if current geographic and demographic trends continue. Oregon is a state with complex and diverse geographical, sociocultural, economic, and demographic components. Oregon’s total population in 2017 was 4,142,776 with 17.1% of those aged 65 and older. That number is rising, with a 3% increase in citizens aged 65+ over a 3-year period. As of 2017, 34.9% of Oregon’s total population lived in rural and frontier communities. Approximately 28.3% of Oregon’s older adults resided in areas considered to be rural or frontier settings. Twenty-three of Oregon’s 36 counties are classified as either rural or frontier by HRSA. Nineteen of those 23 counties have older adult populations comprising >20% of their total population; in 13 rural counties, adults 65+ comprise >25% of the population.

Despite these population trends, rural geriatric care has lagged behind the need. As of 2016, 24 Oregon counties had no geriatric specialists. Of the 51 board certified physicians who specialize in geriatrics in Oregon (42 in geriatrics, 9 in geriatric psychiatry), most practice in the Portland Metropolitan Area with the remainder scattered throughout the urban centers of the Willamette Valley and Southern Oregon Valley. Only 3.1% of nurse practitioners, 0.4% of physician assistants, and 2.1% of pharmacists specialize in geriatrics with no published data on how many of those professionals practice in rural settings. Strikingly, rural and frontier Oregon counties have higher rates of Alzheimer’s disease related deaths than urban centers (36.3% and 32.4% vs 31.4%, respectively); and providers interviewed as part of the Oregon Office of Rural Health’s 2017 listening tour identified concerns over increasing geriatric behavioral health patients and respective lack of services available. Institutionally-conducted needs assessments through the Oregon Echo Network of rural providers have, for the past 2 years, identified geriatrics and dementia in the top 10 topics about which they wish to receive education. The Geriatric Behavioral Health ECHO provides a critical opportunity for me to develop the professional skills needed to transform rural Oregon practices into age-friendly health systems

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NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

Educational Objectives

By the end of this 12 session ECHO course, participants will be able to: • Describe common presentation signs and symptoms of depression and anxiety in older adults • Describe pharmacological and non-pharmacological treatment options for depression and anxiety in older adults • Demonstrate holistic strategies for managing challenging dementia related behaviors • Identify age related sleep changes and insomnia in older adults and provide initial pharmacological and non-pharmacological treatment options • Develop skills related to pain management in older adults, including de-escalating opiate pain regimens • Identify risk factors and initial risk mitigation strategies for older adults who frequently fall • Develop a framework for advance care planning in older adults who have dementia and behavioral health diagnoses


Interpersonal & Communication Skills, Medical Knowledge, Patient Care & Procedural Skills

CME Credit Type

AMA PRA Category 1 Credit

Practice Setting

Inpatient, Outpatient, Rural, Urban, VA/Military

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