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Senior Care Innovation Scholarship Finalist Elizabeth Nelms

Dana Larsen
By Dana LarsenSeptember 1, 2013

A Place for Mom is proud to announce the commencement of their annual $1,000 scholarship for advancement in the field of gerontology. This is a general scholarship which will award the selected applicants with a financial donation. We have narrowed-down the finalists, which includes Katherine Kitchen.

Congratulations to Elizabeth Nelms, Senior Care Innovation Scholarship Finalist! Read Elizabeth’s essay below and vote for her if you think she deserves to be one of the 5 recipients of the $1,000 scholarship awards.

Elizabeth’s Essay

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By 2030, approximately one out of every five residents in the U.S. will be 65 or older (Vincent & Velkoff, 2010). Additionally, the number of U.S. citizens ages 65 and up are projected to more than double from 40.2 million in 2010 to 88.5 million in 2050 (Vincent & Velkoff, 2010). The baby boomers will accelerate the country’s aging due to the fact that, by 2030, all baby boomers will have reached “old age” (Vincent & Velkoff, 2010). These are interesting projections, especially when applying this information to the statistics provided by the Administration on Aging concerning significant increases in the estimate of older adults affected by Alzheimer’s disease. Due to the significant increase in the older adult population over the next few decades, there seems to be so much effort, time, money, and research focused on cognitive impairments and how to manage the impairments rather than focusing on successful aging and cognitive health in older age.

Information presented by Lustig et al. (2009) concerning training to maintain or improve older adults’ cognitive performance seems to be quite interesting and promising as a means to advocate successful aging and healthy cognitive aging. Some of the trainings include: strategy training, multimodal approaches to training, cardiovascular training, and process training (Lustig et al., 2009). Each of these training methods have strengths and weaknesses, but they can be utilized and individualized in order to provide cognitive training for older adults in a way that best suits his or her needs and abilities. For instance, cardiovascular training might have less of a positive affect for older adults who have physical limitations while a multimodal approach that also incorporates cognitively and socially engaging components (e.g. stimulating games like logic puzzles and intellectual board games or creative drawings) might have the biggest benefit.

I believe that an increased emphasis on cognitively, physically, and socially stimulating activities is necessary, and increasingly vital, for older adults of all ages whether they have cognitive or physical impairments or not. Societal views certainly seem to lean towards overwhelmingly negative aspects of the relationship between increased age and cognition. It is important that we learn about late life learning based on neural plasticity and how cognitive training can decrease morbidity and increase an older adults’ quality of life. It is equally important that we share that information with others not in the field of gerontology so as to help reshape society’s views of aging. As we focus on the future of cognition and aging, we might consider innovations in the form of individualized and empowering activities as a way to increase cognitive functioning in those who are cognitively impaired as well as decreasing cognitive decline in those without symptoms of dementia.

In saying that, I would like to focus on innovative programs I feel should be implemented in order to increase the quality of life in residential-dwelling older adults who have Alzheimer’s disease and other related dementias. In regards to cardiovascular training and physical activity, Thurm et al. (2011) found that that not only is physical exercise good for the cognitive functioning in healthy and ambulatory older adults with dementia, but it is also beneficial for those with dementia who are extremely physically frail. The Thurm et al. (2011) study was able to expand the positive effects of physical activity (namely aerobic exercise) to those who are extremely physically frail and have dementia. There was a stabilization in cognitive functioning for those participants who received the multimodal physical activity while the participants in the control group showed significant cognitive decline. I believe that, many times, physically frail individuals with dementia are not given the opportunity to exercise in any capacity because they are deemed incapable of such physical exertion. I think that these findings show that allowing and enabling exercise in this population can help them to retain their cognitive ability for a longer amount of time, which can be extremely beneficial to themphysically and mentally, as well as increase their quality of life.

Another seemingly vital innovation, in regards to artistic and creative expression -and as a multimodal training approach, is an overhaul of art programs in residential facilities. Art programs can provide older adults with many opportunities to exercise creativity which, according to Lindauer (2003), can be expressive, spontaneous, as well as innovative and original. These art programs should be designed to promote social activity, emotional expression, and a boost in cognitive functioning, among other aspects that are beneficial for older adults. Such positive benefits and gains can be achieved by incorporating art activities that are novel, stimulating, and multi-modal (Noice & Noice, 2008). Participation in writing groups and creative writing promotes mental exercise, which increases the brain’s development in the second half of life (Cohen, 2005). This particular activity might be quite difficult for those with dementia, but there are specific tweaks to creative writing that can ensure that even those with cognitive impairments can reap the benefits from writing and storytelling. Encouraging communication in those with dementia helps them be more alert and have a higher quality of life, as well as slow the process of internalization (Braslavsky, 2001). For instance, one activity to promote storytelling, creative writing, and communication in those with dementia is called “Time Slips,” created by Anna Basting. The technique proposes that a 5-8 member group of participants who have dementia – sitting in a circle- should be given a clearly posed (in order to ensure the storytellers do not become stuck trying to recall fictional information) provocative photo, like a picture of the Marlboro Man or the flag raising at Iwo Jima, and asked open-ended questions about it in order to elicit participant creativity (Braslavsky, 2001). All responses should be written down and repeated to the participants, which is important because of the empowerment and self-trust having one’s words quoted can spur (Braslavsky, 2001). Benefits from this activity also apply to staff and family who interact with the individual (Braslavsky, 2001). An increase in communication helps staff to connect with the person with dementia, which makes providing care easier (Braslavsky, 2001). Also, this activity helps to magnify the participant’s individuality and creativity, which encourages family members to see the participant as a person (Braslavsky, 2001).

Participation in visual art programs has been found to, amongst the many other aforementioned benefits of artistic and creative expression, distract older adult participants from their physical ailments, stimulate cognitive functioning, increase quality of life, as well as provide opportunities for emotional expression (Arts and Aging, n.d.). Both experienced and novice artists can produce visual arts, an activity either type of artist can find enjoyable and rewarding (Seifert, 2007). Fornazzari (2005) found that an optimistic view of a person with dementia’s creative abilities encourages a positive focus on the person’s remaining functions. This will assist in allowing the individual with dementia to express him or herself in a creative manner, which can be especially beneficial for former artists who have developed dementia (Fornazzari, 2005). Art programs that incorporate visual art activities for individuals with dementia, especially in a residential setting, can provide excellent opportunities for these participants to express themselves artistically and creatively, promote memory stimulation, and increase social interaction and communication (Jones-Field, 2012). These same visual art activities can also be used by a residential facility to encourage family participation. Another visual arts activity for those with dementia can help encourage the participants to draw or paint by providing them with a piece of paper that includes pre-drawn designs and encouraging them to construct their artwork in any way they choose (Jones-Field, 2012). Musical interventions have been found to increase cognitive performance, as well (Noice & Noice, 2008). In particular, singing -as a performing arts program- may be particularly beneficial to older adults who have physical disabilities (Noice & Noice, 2008). There is a universal appeal for music, which should keep older adults engaged and motivated to continue participating in such a pleasurable activity (Noice & Noice, 2008). Music, especially in the forms of choir, music appreciation, and music therapy, has also been found to contribute to the maintenance of older adults’ quality of life (Sole, Mercadal-Brotons, Gallego, & Riera, 2010). Music therapy can be designed for an individual’s needs in order to stimulate the management of stress and pain, increase memory, encourage communication, amongst other important goals (American Music Therapy Association, Inc., n.d.). Visual and musical art interventions can be combined for older adults with dementia in certain Montessori artistic activities, like the “Over the Rainbow” activity designed by Susan Dyer. In this activity, the song “Somewhere Over the Rainbow” is played while participants are encouraged to draw or paint a rainbow.

Certain forms of these activities already exist, but I believe that a program that advocates and stimulates artistic, creative, physical, mental, and cognitive training activities is a necessary incorporation for all residential facilities that provide care to persons with dementia. Because of this, it is my goal to create a program comprised of the previously mentioned activities in order to ensure that those with dementia who live in residential care facilities are given optimal opportunities to be socially active and receive cognitively and physically stimulating interaction. Even though I believe that a focus on successful aging and cognitive health is essential, it is my focus and goal to ensure that those who currently have, or who will develop, some form of dementia -and who will require the care of a residential facility- have access to a comprehensive program that will encourage a higher quality of life, a reduction or slowing of the progression of dementia, and a deceleration in the act of “turning inward,” amongst other benefits. It is the creation of this person-centered and individualized program, incorporating, but not limited to, the activities detailed in this essay, that should serve as one of the many innovations necessary in the senior care industry in order to properly care for the steadily expanding aging population affected by dementia.

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Dana Larsen
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Dana Larsen
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