Aging in place: 'It starts with a question of: What would you like? What does life mean for you?'
Alisha Johnson is a Care in Aging Post-Doctoral Fellow at the Sinclair School of Nursing here in Columbia. She spoke about aging in place, and what that means for older adults and long-term care facilities.
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Alisha Johnson: So, I'm a nurse by training, and I chose nursing because I like to help people – the classic story, and I worked in a critical care hospital environment like most graduates of nursing schools do.
But when I got into graduate school and started to figure out what I wanted to study – what I wanted to make better in the world – I came into elder adult care and nursing homes, because it's a big area where so much improvement can be made.
The hospitals kind of have it figured out. They have good processes in place, they have good backup, but the long-term care area – nursing homes, elder care. There's a lot of work to be done in that area. So, I chose to focus on that as my PhD research.
My research is actually it's started in nursing home and nursing home care, but it's evolved as I've gotten into my postdoctoral research, working with a team here at Mizzou, and really looking at broader not just nursing home.
"So, it really is simply about saving people by finding out what they want and then we can prolong their life, and not just prolong their life – but prolong their fulfilled life. What do they want?"
But even before nursing home, you know, in the assisted living landscape. How can we keep people in a happy place longer and keep them stimulated?
So, how can we set up the environment where they have activities that are of interest to them? How can we set up where they have access to mobility? So, maybe there's transportation for them?
Maybe they can't drive? But it doesn't mean that they have to be stay in one place. Can we provide transportation for them?
How can we help them have game nights? How can we help them have social hours? Finding ways for them to stay in a community as opposed to isolated, and it really is that simple.
It starts with the question of what would you like? What does life mean for you? What kind of environment do you want to live in, so that we can identify what their wishes are?
Then that is a stepping stone for us to then build that environment, and to build a care plan, or to build a trajectory of how can we provide services to keep you in place, as you get older, as you might need more help with some of your activities of daily living, but you want to maintain that independence as much as you can.
So, it's really super simple, yet really hard. You just have to ask the questions, and then listen. We just have to build in the time and the space to ask questions and to learn who people are and connect with people.
And you know, systems in healthcare were set up to be efficient, cost effective, and it really can interfere with our ability to connect with people.
So, we have to be conscientious as healthcare providers to say, “No, we need to pause and ask what the person wants first, and then build our processes around that.”
As opposed to the other way around where we build our processes and expect these people to fit in it. That doesn't work and it's not in their best interest and can actually cause early death.
So, it really is simply about saving people by finding out what they want and then we can prolong their life, and not just prolong their life – but prolong their fulfilled life. What do they want?