Gerontology Program Minnesota State University, Mankato Spring 2004
Center on Aging
“Aging in Place” is a phrase that is frequently used in gerontology. Today many elders are choosing to reside in their homes as they age even when their health does not allow them to live independently. How are the needs of elders being met? Society is becoming more aware of and better educated about the needs and desires of elders. Programs and services have been and continue to be developed to assist elders in their homes more effectively. However, these services are not always available to all elders. Elders living in rural areas are at a disadvantage compared to urban elders.
According to the 2000 census 12.1% of the population in the state of Minnesota is sixty-five years of age or older. In the United States 21% of the population lives in a rural setting. A rural setting is defined as 2,500 people or less. Elders living in a rural setting have difficulty receiving services. Eighty-two percent of rural elders report themselves to be far from a set of core services contrasted to only 10% of urban elders.
Some of the services that have been developed for the elderly are services such as: home health care, respite care, adult day centers, Meals on Wheels, hospice, and support groups. These services have been developed to help elders person live, healthier lives within their homes. Services are growing and expanding. In 1998, 7.6 million individuals received formal home care services.
Services that are available to elders and caregivers in an urban setting are often not available to those in a rural environment. Often the community is strained for home service programs because there are not enough resources available in the community. For example, in a rural setting home health care agencies might not have enough staff to care for all the needs in the area. At times there are people who need twenty-four hour care seven days a week and rural communities might not have enough staff to cover all of these shifts, leaving the responsibility to the elder’s family. The elder’s family may be spread out and unable to help. Family farms are disappearing and small towns are dying. More people are moving away from the community in which they were raised leaving aging in place for an elder even more difficult.
An elder might live beyond the geographic boundary line for Meals on Wheels delivery, therefore, services cannot be extended to them. Rural areas might not even have respite care or hospice programs for elders and their families. Transportation can also be an issue in a rural setting. In metro areas there is often some sort of transportation system in place, whether it is a bus route, taxi cab, or subway system. These services are not available to someone who lives 50 miles from the nearest city. In rural areas there is a higher percentage of elders who are dependent on private vehicles. Once again, this leaves the rural elder at a disadvantage. If elders are unable to drive they become prisoners in their homes. They have no way to travel independently and they are dependent on family members or friends.
Due to the fact that a rural environment has fewer resources available elders are at a disadvantage when aging in place. Many people want to remain in their homes throughout their entire lives including old age, but without adequate programs and services available healthy aging in a rural community is difficult and not always manageable. Many elders are forced to move into an urban setting or they are neglected. Services for rural communities have not reached an acceptable level yet. However, awareness can be raised through education and advocacy.
MSU Professors Conduct Research in Fergus Falls
Increasing numbers of assisted living and nursing home providers are building onto or remodeling their facilities to provide special living space for elders with dementia. With growing numbers of elders with dementia, it is important that providers create care models that address the special needs of this population. Pioneer Retirement Community and the Pioneer Foundation believes they have a model of care that benefits the residents, staff, family, and community of Fergus Falls.
At the request of Pioneer Retirement Community’s CEO, John Richards, and Director of Development of the Pioneer Foundation, Dewey Tommerdahl, Dr. Kathryn Elliott, Director of the Gerontology Program at Minnesota State University, and Dr. Leah Rogne, member of the Gerontology Program faculty at Minnesota State University, and the Sociology Department, have conducted research that examines the effectiveness of that facility’s social care model for dementia.
By conducting a series of open-ended interviews with residents, staff, family, and key members of the community, who serve as board members, Drs. Elliott and Rogne are studying dimensions of care such as quality of life, staff-resident interaction, community and family support, administrative philosophy and policies, the physical environment, and client satisfaction. Questions asked of staff, residents and family were also designed with the goal of determining the roles and connections the facility has to the community of Fergus Falls. Examples of questions asked were:
Questions posed to Staff: Tell about your relationships with residents’ physicians. Are they trained in gerontology? Are there ever conflicts over resident care and quality of life issues? How do you balance resident autonomy with safety?
Questions posed to Residents: What do the staff here do for you? What kinds of choices do you get? What makes this a good place to live?
Questions posed to Family: Talk about the staff. How do they relate to your relative? Has your relative maintained activities and relationships with people in the community in addition to family? Are you informed adequately about your relative’s condition?
Additional information was collected from observations of staff routines, staff-resident interactions, and family interactions with residents and staff.
The collection and analysis of this information will supply a documented resource of the implementation of high quality dementia care by Pioneer Foundation, owner of Pioneer Retirement Community, as well as providing other communities and facilities with a valuable resource. It is hoped that the eventual outcome of this research will be an exportable model for the social care of elders with Alzheimer’s disease and other forms of dementia.
Rose M. Hull Scholarship
The 2004-2005 Rose M. Hull recipient is Shelly Sohre. Shelly will be finishing up her first year in the Gerontology Program and has also been a graduate assistant this year. Shelly received her undergraduate degree in social work from MSU and is very familiar with the Mankato area since she grew up in Good Thunder. Shelly has always had an interest in working with the elders. Growing up next door to her grandparents and spending a lot of time with them increased her desire to work with this population. Shelly feels that her grandparents have been inspirational in guiding her towards this direction in her life. Shelly has always admired elders and it is a dream of hers to make a career working directly with them. Although Shelly is not quite sure what her professional plans are at this time, she has been able to get hands on experience this semester through her internship at a hospice program in Fairmont. Outside of school, Shelly enjoys reading, watching movies, exercising, traveling and being outdoors.
The Eden Alternative
As we recognize that the baby boomers are quickly aging and soon our society will see incredible changes, it seems that the baby boomers will not be a passive cohort, but a generation that will get things done. They will most likely demand care and services at a whole different level than we see today, and this will probably also be true in the long term care setting. Will the baby boomers be satisfied with nursing homes? Or will they demand more care in homes that allow them to age in place, assisted living facilities or other alternatives? It seems predictable that they will demand change and will demand more alternative forms of care than what their parents desired or received.
Dr. Bill Thomas, founder of The Eden Alternative feels the same way. “The baby boomer generation is coming. And the irresistible force of the baby boomers is about to collide with the unmovable object of the nursing home. And there’s going to be explosive change that comes from this collision. The boomers will not leave one stone upon another. They will completely wipe out the nursing home we remember from the 20th century” (www.edenalt.com). This inspires one to ponder and ask questions about the future of long term care as we see it now. The Eden Alternative is one specific area of alternative care that should be examined further with regard to how it came about and what it provides.
The Eden Alternative was established when Dr. Thomas, who was a physician at a nursing home, was no longer satisfied with the medical model for nursing home care. Although he loved the people, he hated the environment and desired change. Committed to creating social and physical environments that are dedicated to eliminating loneliness, helplessness and boredom, The Eden Alternative strives to do just that. The Eden Alternatives mission is to improve the well-being of elders and those who care for them by transforming the communities in which they live and work. The core concept is to create environments that are habitats for human beings and not institutions or facilities for elders who are frail. Because Thomas believes that therapies and pills fails, bringing in animals, plants and other people into facilities is also an important and a key component to creating a positive environment.
The Eden Alternative has been very successful in many nursing homes creating change and an environment in which elders desire to live. Researchers have found numerous benefits for residents associated with implementing The Eden Alternative. Physical functions of walking, bending and reaching and the cognitive functions of watching plants grow or counting seeds are beneficial. Companionship, affection, entertainment, socialization and physical activity were also increased due to animals and children coming to the nursing homes.
It is no secret that long term care is changing and will continue to see change as the baby boomers age. Looking at alternatives to nursing home care is becoming more and more important and as we work in this field, it is important for us to be aware of what is out there to initiate change. For more information on The Eden Alternative see www.edenalt.com.
Mayo Clinics is pleased to announce its 2004 Mayo Spiritual Care Research Conference. Spirituality Measured: Capturing the Elusive Effect will be held November 4 and 5, 2004 at Mayo Clinic in Rochester, Minnesota. There will be few conference forums in North America designed specifically for the discussion of spiritual research. This healthcare conference is designed to disseminate research findings and practice application in religion and spirituality. Conference attendees will have the opportunity to interact with people from across the continent who have come together to discuss the contribution of spirituality to health. Dialogue will be multidisciplinary and will examine what we know and do not know about evaluating the elusive effect of spiritual care.
Presentations are being sought related to the conference goals:
* Promote multidisciplinary conduct of spiritual research.
* Disseminate research findings about the contribution of spirituality to health.
* Promote multidisciplinary dialogue around this research.
* Encourage application of spiritual research into clinical practice.
For more information, contact Mayo Continuing Education Nursing Education toll free at 800-545-0357 or 507-266-1007, fax 507-266-6910, or e-mail email@example.com. Visit our website at www.mayoclinic.org/nurisng-rst/nursingcne.html.
Planning, Funding, and Sustaining a Hospital-Based Palliative Care Program: Tools and Strategies for Success. May 6-8, 2004 at the Millennium Hotel Minneapolis.
An engaging, highly practical, and comprehensive overview of all operational/financial aspects of starting and sustaining a successful palliative care program. Participants will learn how to plan, organize, fund, manage, and operate a program that: delivers the highest quality care of serious illness; is highly cost efficient; generates widespread administration, clinician, and patient support; increases patient and staff satisfaction; meets accreditation standards.
Health managers who need help in winning support for establishing, and operating palliative care programs. Attendees may be physicians, nurses, administrators, and others responsible for planning and implementing hospital and health system-based palliative care programs. Institutional teams are encouraged to attend.
Contact information: Palliative Care Seminar, Center to Advance Palliative Care, 1255 Fifth Avenue, Suite C-2, New York, NY 10029. Lisa Morgan, Phone: 212-201-2680, Fax: 212-426-1369, E-mail: firstname.lastname@example.org.
Gerontology Program Fall Courses 2004
Class Time Professor Course
Biology of Aging/Chronic Disease Offered next spring Bentley BIOL 4/517
Aging: Interdisciplinary Perspectives MWF 11-11:50 Elliott GERO 200
Topics in Gerontology: T 6-8:45 Elliott GERO 601
Aging, Diversity, and Elder Services
Sociology of Aging MWF 2-2:50 Rogne SOC 4/504
Individual Study ARR Elliott GERO 677
Death Education MWF 11-11:50 Barr HLTH 4/541
Sociology of Death W 5-7:45 Rogne SOC 4/505
Nursing Home Administration
Managerial Accounting Various Sections Staff ACCT 210
Aging: Interdisciplinary Perspectives MWF 11-11:50 Elliott GERO 200
Health Administration ARR. Romas HLTH 659
Introduction to MIS Various Sections Staff MGMT 210
Principles of Management Various Sections Staff MGMT 330
Human Resource Management Various Sections Staff MGMT 4/540
Gerontological Nursing Various Sections Smith NURS 340
Seminar: Human Resource Management TH 6-8:45 Staff POL 662
Sociology of Aging MWF 2-2:50 Rogne SOC 4/504
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