Growing Infrastructure for Holistic Linkages to Occupational Therapy - PowerPoint PPT Presentation

Agenda  UNE Center for Excellence in Aging & Health (Tom)  Applied Research in Aging (Regi)  Promotion of Healthful Aging (Tom) Growing Infrastructure for Holistic  Linkages to Occupational Therapy (Regi) Health Research with Aging Mainers  Q&A TOM MEUSER, PHD, DIRECTOR, UNE CEAH REGI ROBNETT, PHD, OTR/L, ASSOCIATE DIRECTOR 11/9/19 A Focus on Maine Maine's Demographic Context The average age of Maine’s population is the highest in the nation due to a growing baby boom population and a relatively static younger population. ~21% of Maine Citizens are Aged 65+ ~61% Live in Rural Areas ~30% Live Alone ~29% Low Income / 8% Below Federal Poverty Level ~20% of Maine Seniors are Veterans

UNE Context – A Health Sciences University Plus Osteopathic Philosophy of Health (Paulus, 2013) 1. Humans function holistically in a dynamic state of connected 1831 oneness . Building upon the traditions of St. 2. The body and psyche have the ability to self ‐ heal , or to adapt, in Francis College and Westbrook the presence of disease, or injury. College, the University of New England 3. Structure (anatomy) and function (physiology) are has grown and evolved for more than interconnected and inseparable in disease and health. a century. Now encompassing three 4. When the musculoskeletal system fails to perform normally, the campuses, over 40 undergraduate entire organism may suffer a localized or generalized disorder. majors, six Centers of Excellence in 5. Osteopathy is a health care system based upon finding and Research, a College of Osteopathic treating the causes of a disease or injury rather than only Medicine, a College of Pharmacy, and attempting to address symptoms. Northern New England's only College 6. The foundation stone of the Osteopathic system of health care of Dental Medicine, our institution is is based upon trusting the unnamed forces of healing , which are Andrew T. Still, MD, DO, poised for progress. concordant with Nature. Founder of Osteopathic Medicine Adv Advancing ncing in inclu clusiv ive, narr narrativ ive ‐ in inform rmed and and out outcom ome ‐ orien oriented ed re research on on heal health thful ful aging. aging. The CEAH will fund or, otherwise, Partnerships are critical for successful research on support 12 new human aging human aging. The CEAH has opened a new research A longitudinal study and studies starting this summer. The and teaching space in the Motherhouse at Baxter thematic framework (above) will research registry to Woods, the old St. Joseph’s Convent, near the Portland guide our first call for pilot drive student and Campus. Key local and regional partners are extending proposals in December, 2019, for faculty research on our reach to explore research opportunities near the 2020 ‐ 21 Academic Year. healthful aging. campus, in the rural north and beyond.

Satellite Office What is the Legacy Scholars Program?  A century old convent repurposed as a 55+ independent living community opened in October, 2018  88 Units: 22 Market Rate, 66 Affordable  ~100 Residents, Ages 55 ‐ 93  Physical plant presents challenges for healthful aging 10/16/19 – Peter Baker from the  Many residents face economic, social Alzheimer’s Association presents on the 10 Warning Signs to 90+ Legacy and health ‐ related challenges Scholars at the Ferry Beach Retreat and Conference Center, Saco, ME. Other Registries in Maine Making the LSP Representative of Maine's Population Our early recruitment efforts involved UNE alumni, local contacts and friends, and persons The Maine Initiative for Neurologic Aging & The goal of the Maine Older Adult Research reached through community presentations. Health (MAINAH) is a statewide research Registry is to create a way to quickly recruit study and registry in healthy brain aging, adults 50+ for research projects through the memory loss, Alzheimer’s Disease (AD), and In recent months, the LSP was featured in University of Maine and partner organizations. related disorders. statewide and regional conferences (e.g., The registry makes it easy for older adults to The registry will help keep you informed of the Wisdom Summit, TriState learning Collaborative connect with and support research. The types latest research and services in Maine related on Aging Conference) and in statewide email of research projects vary and can include to brain and cognitive health. Enrollment will blasts. also give you an opportunity to participate in research on topics like caregiving, Alzheimer’s brain aging related research. All expenses are and dementia studies, studies on emotional Reaching rural elders is a priority. covered by research grants and nothing is well ‐ being, volunteering, and testing new charged to you or your insurance. Early Efforts products and services for older adults.

LSP Annual Survey Emphasis Areas LSP’s Integrated Approach to Human Subjects Research The LSP Annual Survey is not hypothesis driven, nor is it a deep dive into any one area (except for a handful of clinical measures). The goal is to paint a broad picture across the emphasis areas. Planned expansions will examine medication usage, experiences LSP with pain, oral health, etc. Profiles created from these data support hypothesis generation and the targeting of specific sub ‐ groups for new IRB approved studies. As longitudinal data extend over 3+ years, possibilities open up for additional research utilizing these data and in combination of studies recruiting from this cohort. Data Snapshot (8/22/19, n = 338) Positive Screens on the Self Report AD8  74% Female  Mean Age = 72 (SD 6.8)  91% Reside in Maine  Mean Years Education = 17.4 (SD 2.8)  25% Born in Maine, 35% in NE (not ME)  18% Report Present Caregiving Duties  98% Caucasian  42% Report Present Forgetfulness  65% Married/Partnered  30% Report Present Sleep Disturbance  71% Retired  16% Report Hx of Head Injury  23% Rural (“away from a city”)  15% Report Hx of Diabetes  70% Single Family House  44% Report Hx of Hypertension  33% Live Alone  56% Report Hx of Arthritis  88% Drive Most Days 19% of respondents screen positive for possible dementia on the AD8. This tool has reasonable sensitivity and specificity in community samples when used as a self ‐ report measure. Investigating this finding is a priority.

Applied Research • How does this fit with OT? Applied Research • A means of growth through the development of new approaches • Furthers our understanding of humans Regi is up... as occupational beings • Enhances our credibility • Promotes evidence ‐ based practice • Can provide the context for interprofessional collaborations

Types of Research Narrative Informed Research QUANTITATIVE QUALITATIVE We believe that all research can be informed and enriched through the inclusion of perspectives of • Lots of • Explorative real people. numbers/statistics • The lived experience • Hypothesis driven Meet Mille (97) and Bud (99) married for 78 • Phenomenological years and still living independently in their own • Can gather support for two ‐ bedroom home in a suburb of St. Louis, • May not have a priori specific interventions or Missouri, in 2007. assumptions assessment methods Notice how they communicate and their perspectives on successful aging. NEITHER PROVE ANYTHING Studies @ UNE Applied  A study in PT on knee pain and function Research  A clinical trial in DM focused on prevention of cavities below crowns  A study in Psych focused on older adults’ use of e ‐ reader What are our interests at UNE? technology  A study in Psych focused on emotional regulation and close relationships—impact on health (via daily diaries) We are organizing our research on healthful aging based on larger themes (above). Our goal is to bring professionals together across disciplinary lines to address questions and issues that impact the daily lives of Maine’s elders.

• A study in MPH looking at understandings of ageism as a threat to public health • A study in DM looking at older patient perspectives on informed consent in dental care • A study in SW to validate a board game for intergenerational family communication • A study in OT & COM on perceptions of technology as solutions for cognitive challenges among people with early stage AD and their caregivers • And more in process… Student projects (OT) Studies Now Recruiting Functional assessment in the home End of life wishes of significant other/self (older adults, LSP) (SOS) dyads Follow up from the AD8 study (self ‐ reported Using GoWish cards changes in cognition commensurate with early Seek to establish percentage of agreement in most stage AD) important wishes between SOS pair members One ‐ hour, to include cognition, balance, (quantitative) physical performance, and visual perception To explore enhancing GoWish cards by How do performance ‐ based measures relate incorporating occupation ‐ based questions to self ‐ report especially in early stage (qualitative exploration) dementia? Group just had phone discussion with Michael Pizzi This is a pre ‐ pilot study—hoping to gather data How might this knowledge promote more for eventual grant funding thoughtful end of life care?

Healthful Aging Lifespan vs. Healthspan BREAK “Healthspan” How long do you want to live?