Celebrating Geriatric / Gerontology Scholarship at USM
USM is proud to bring Careers in Aging Week, April 7 to 11, celebrated by dozens of institutions across the country, to the Southern Maine community. Join us at USM Abromson’s Center in the later afternoon on Tuesday, April 8.
USM scholars will share their recent work during this highly interactive event.
- Long Term Services and Supports Research Seminar - Elise Bolda
- Recent research projects with the OLLI National Resource Center – Mike Brady
- Dual Eligibles in Maine - Stuart Bratesman
- Outpatient Programs for People with Dementia – Lisa Clark
- Supported Decision Making as Alternative to Guardianship - Nina Kohn
- The Savvy Caregiver Program: Outcomes and Opportunities for Dementia Family Caregivers - Linda Samia
- Occupational Therapy Intervention – Charles Smith
Followed by Roundtable Discussions
- Audience Introductions
- Round Table Discussion: Enjoy light refreshments and share in the discussion
Chair, Graduate Program in Public Health (MPH)
Associate Research Professor
Long-Term Services and Supports Policy Research Seminar
Persons in need of services and supports over the long term, and their loved ones, often encounter a fragmented array of public and private sector services, supported by restrictive financing and confusing policies. This presentation applies a public health perspective to the differing goals and varying needs of adults with need for assistance from others, and policies and strategies to address these needs. Topics addressed include the demographics of aging and disability, health services research on utilization and expenditures for long term services and supports, options and issues in independent living, home/community-based supports, and group living options, federal, state and local program and policy trends, and evidence on emerging best practices from community development to slow medicine.
Professor of Adult Education and Coordinator of the Adult & Higher Education Program
The Quest for Community in Osher Lifelong Learning Institutes
An open-ended online survey designed to explore issues related to learning communities was administered to directors of Osher Lifelong Learning Institute Programs across the United States. Sixty-five (65) directors responded to this survey. Findings included a description of learning community which is constituted by learners having common goals, a sense of ownership, sustained relationships, holistic engagement, and meaningful peer interactions. Any successful strategy to build community rests on the foundation of committed volunteers and a responsive host institution. In addition to these, directors nurture their learning communities through a variety of strategies that include special interest groups, educational travel, sponsoring socially-focused activities, and consistent communication. This study also explored implications for international lifelong learning programs and the future of learning communities in the face of increased online and other distance education modalities.
M.S., O.T.R./L., C.L.T.
Clinical Faculty for Occupational Therapy
Outpatient Programs for People with Dementia
Dementia is a growing problem in the United States and internationally. Billions of dollars are spent worldwide caring for people with dementia. The World Alzheimer’s report and the Obama administration are focusing efforts around this debilitating issue. Often, the prevalent opinion around a dementia diagnoses is that of a death sentence for any continuance of a meaningful existence. Many people continue to claim that nothing can be done for the person with dementia. However, increasingly, research finds that staying active and engaged in life’s occupations maintains health for people with memory impairment. Improving the functional lives of people with dementia, and their caregivers is a key role for occupational therapy practitioners. Occupational therapy practitioners understand the relationship of participating in life, to health. People with dementia can remain involved in activities when they are adapted and adjusted for the level of performance the person is capable of. Caregiver education is key, to minimize the “easier to do it myself” temptation.
An example of an outpatient wellness program based on the Occupational Therapy philosophy is presented – the “Living Well with Dementia” program. This is an innovative outpatient wellness program started in Portland, Maine, coordinated by an occupational therapist. This outpatient program for people with mild to moderate dementia will be discussed, including active, short course rehabilitation and wellness groups which provide cognitive stimulation, leisure enhancement, physical exercise and support for people with dementia.
Policy Analyst, Cutler Institute
Visiting Professor of Law
Historically, the state has responded to the decision-making challenges facing persons with cognitive disabilities by authorizing others to make decisions for them. In response to concerns that this approach unduly undermines the rights and autonomy of persons with disabilities, the disability rights community has begun to promote “supported decision-making” as an alternative paradigm for addressing cognitive disability. Supported decision-making is an approach under which the person with a disability retains decision-making authority, but is provided with help in doing so. This presentation will describe the approach and its potential benefits, including its potential to reduce reliance on the guardianship system. It will also identify concerns about the approach and gaps in knowledge as to how it is operationalized and as to its outcomes. It will conclude by suggesting avenues for further research.
Linda Samia, PhD, RN, CNL
Assistant Professor, School of Nursing
The Savvy Caregiver Program: Outcomes and Opportunities for Dementia Family Caregivers
The Maine Savvy Caregiver Project (MSCP) is a statewide multiagency project designed to train non-paid family caregivers to care for persons with dementia in the home. There are two programs available for caregivers: the original evidence-based 6-week Savvy Caregiver Program (SCP) and a newer evidence-informed 4-week advanced program: the SCP-II. SCP is intended to improve caregiver knowledge, skill, and attitude. SCP-II prepares the caregiver to make difficult decisions, manage increased dependency, prepare for end-of-life, and take better care of self.
The MSCP is currently grant funded by the U. S. Administration for Community Living under an award to Maine’s Office of Aging and Disability Services. The project involves a partnership between Maine's Office of Aging and Disability Services, Maine's five Agencies on Aging, various community hospitals, and the USM School of Nursing.
Since February 2009, 1,634 caregivers have been trained: 1,450 in SCP and 184 in SCP-II. The SCP has been delivered in each of Maine's 16 counties with certified facilitators delivering 197 SCP and 30 SCP-II trainings. Outcomes are overwhelmingly positive. Caregivers are more confident and skillful in their roles, they are less depressed, and have fewer negative reactions to their person’s behavior. Caregivers are asking for help and finding more joy in their relationships.
Next steps for the MSCP include plans for sustainability and further adaptation with technology to reach more rural caregivers. The program is now embedded in each of the state’s five Agencies on Aging and will be sustained in the Family Caregiver Support Program funded under The Older American Act Title IIIE funding. Agencies are also seeking additional grant funding and they are working with multiple partners such as hospitals, adult education programs, adult day centers and community care teams to deliver the program. With technology the goal is to reach caregivers with fewer face-to-face sessions while still delivering core elements of the program and providing opportunities for practice and group learning.
School of Social Work
Occupational Therapy Intervention
Given the fact that the United States faces an increasing population of community dwelling older adults with moderate to severe functional disabilities, and the relative decline in available resources (e.g., informal caregivers, public funds for social services) the researchers conducted a study to examine the efficacy and cost-effectiveness of a novel occupational therapy intervention designed to give older adults, and their caregivers, the tools and skills to care for themselves. A randomized control trial was conducted to examine the relative differences in outcomes among community dwelling older adults with disabilities of two interventions: 1) conventional personal care and case management services vs. 2) conventional services plus an occupational therapy assessment and intervention. A total of 60 clients were assessed at baseline and 3 month follow up. Results indicated that participants that received the occupational therapy intervention in additional to conventional services had improvements in home safety (p < .0005) and reduction in fear of falling (p<.05). The study also found that the occupational therapy intervention led to a 39% reduction in recommended hours of personal care services, which if implemented, would result in significant cost savings for clients and/or public agencies.
Findings published in The Gerontologist: Sheffield, Smith, & Becker (2013). Evaluation of an agency-based occupational therapy intervention to facilitate aging in place, The Gerontologist, doi: 10.1093/geront/gns145