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A Place for Mom

Senior Care Innovation Scholarship Finalist Emma Breault

Dana Larsen
By Dana LarsenAugust 17, 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 Emma Breault.

Congratulations to Emma Breault, Senior Care Innovation Scholarship Finalist! Read Emma’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.

Emma’s Essay

Major advances in the healthcare industry have made it possible for people to live longer and healthier lives than ever before. However, longer life often comes with unique challenges that are not being adequately addressed. The next step for healthcare needs to be improving care for seniors by making several key modifications to the current system. Throughout my nursing career I hope to contribute significantly towards these much-needed changes.

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There are four changes that need to happen over the next 37 years if the various needs of the elderly community are going to be met by 2050. There needs to be more resources for home and community-based care, increased support for caregivers, greater emphasis on an interdisciplinary and team approach to geriatric health care, and more research and development in the areas of drug therapy and diagnostics. Despite how important it is that these areas are fully addressed, there are very few geriatric care clinics, the number of geriatricians is steadily declining, resources for the elderly are also declining, and what remains is constantly under threat of extinction. Even though octogenarians are the fastest growing population in the United States, the resources to care for them are rapidly depleting. The innovations that are needed in the senior care industry are actually not very complex. Rather, they only need to become more of a priority.

Peer-reviewed studies and my own empirical conclusions have shown that patients recover from injury or illness faster when they are able to do so in the comfort of their own home. However, during my work on an adult oncology unit, I have seen firsthand how difficult it is to discharge patients to their home without proper care in place. Common obstacles are insufficient insurance coverage, a lack of nurses available to make home visits, and a lack of support for caregivers. Barring changes to insurance coverage, increased funding to build a more comprehensive home health care system would provide immense benefit. Additionally, the need for a team approach to home rehabilitation, especially for the elderly, is crucial. Adequate funding would allow the involvement of nurses, physical therapists, occupational therapists, and social workers. With the advent of an improved home health care system we will see shortened times to discharge and significantly shorter recovery times.

Another difficulty in elder care is the lack of support for caregivers. When an elder is sick with a chronic illness, the burden of care often falls to the spouse or children. Often the caregiver fills in the gap that exists in the home health care system. The caregivers, whether medically trained or not, provide medical, social, and emotional support around the clock. This puts a tremendous amount of stress on both the patient and the caregiver. Caregivers are an extremely important part of the recovery process, but the best system would involve a network of people sharing the burden. Community-based care such as the PACE (Program for All-Inclusive Care for the Elderly) program can help provide support to the caregiver by sharing in the care of the elder. PACE is a day center where Medicare and Medicaid-eligible individuals can go and receive both health and social support from the numerous nurses, social workers, nutritionists, physical and occupational therapists on staff. On weekends and at night, patients are able to go home to be with their families and sleep in their own beds. In addition to improved home care services, more chronically ill elders and their families would benefit from having access to community-based care programs such as PACE.

A team approach to geriatric care is also incredibly important, but often is not fully actualized in most situations. There is a need for many team players with varied specialties and subspecialties. However, the large number of practitioners caring for a senior can lead to dangerous miscommunication. I have seen this problem many times in the case of polypharmacy. Excellent communication between practitioners about drug use is critical, especially in the geriatric population. Since seniors tend to be on many different drugs at the same time, the risk for drug-drug interaction is high. An effective tool for preventing miscommunication is multidisciplinary clinics. With multidisciplinary clinics, patients can go to one location, see multiple physicians who truly work side by side, and have a central location for all medication prescriptions and pick-ups. Furthermore, patients have access to emotional support as well. Although multidisciplinary centers are ideal for improving communication, they are not feasible in all locations. Regardless, timely and accurate communication among practitioners is key to improving care for patients, especially for elders

Finally, the vast need for creating improved targeted therapies, especially for elderly populations, is overwhelming and requires intense immediate efforts. Most trials target the 18-65 population, and once the drug(s) have been proven safe and effective, they are tested in children. The vast majority of drugs are not tested in the elderly population, but are simply made available to them once FDA approved. However, older patients have slower metabolic rates and therefore metabolize drugs differently than their younger counterparts, making their therapeutic index potentially much smaller and putting them at greater risk for adverse reactions. To compound this issue, older patients typically are on multiple medications which could pose a heightened threat for complications with an investigational agent. To fix these potential problems, I strongly support the efforts to include post-market studies of various medications in the elderly population. Just as children’s bodies function differently than the 18-65 patient population, and we have post-market studies to test drugs in children, we should have equal efforts for safety testing in the elderly population. Through comprehensive testing, we can avoid potential adverse reactions and find specific therapeutic ranges for our older patients.

Many changes need to be made in order to ensure proper care is provided to our older patients. Providing more resources for home and community-based care, fostering better communication among the geriatric health care team, and increased drug research and development for patients over 65 are just some of the many ways in which we can improve the geriatric health care system. There are many other issues that need to be addressed in the fight for improved geriatric health care such as prevention, increased health education, improved access to health care, and encouragement of providers to choose a career in geriatric medicine. My personal goals towards this end are to champion the development of more multidisciplinary clinics, petition for increased resources for home and community-based care, and encourage post-market research in the elderly population. With the help of this scholarship I will be closer to obtaining these goals. I appreciate you reviewing my ideas and considering my application. Thank you.

View otherSenior Care Innovation Scholarship Finalists. Don’t hesitate to congratulate and vote for Emma in the comment form below if you think her essay is one of the most compelling of all the finalists. Keep in mind we are awarding 5 of the finalists with $1,000 which they can use toward their studies. 

Dana Larsen
Dana Larsen
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