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SOUTHERN MAINE LONG TERM MINUTES
Introductions:
UPDATES: Ann O’Sullivan, Caregiver Coordinator, SMAA – Red Cross
funding through National Case Management Week is October 8 through Friends/Family/Senior Companion Program, Foster Grandparent Program was awarded a Federal grant for the Senior Companion Program and was one of seven in the nation. The Senior Companion Program received the
highest grant. Flyers are available.
Susan Rosenbaum, Hospice of Southern Maine, talked about the Hospice Volunteer program, which was created a year ago. This program is for hospice patients who have a year or under to live. There are trained volunteers who can go into the home and help with patients and also another person the patient can talk to besides medical and family about changes that maybe occurring now or will occur in the future. PRESENTATION: Debbie introduced Dr. Marilyn R Gugliucci,
Director of Geriatric Education and Research at This is a new job for Marilyn who has a doctorate in
Gerontology Post Doc Research Fellowship at UNE - The average age of a Medical student used to be in their
30’s but now they are in their mid 20’s up to 30. Most of the students are out of their
Bachelor’s Degree. The purpose of this
program is for the student to learn how to communicate with institutionalized
elders and the project goal was to conduct ethnographic research to determine
what the life of an older adult living in a nursing home is like. The student who wanted to do this is of
Lebanese decent and came here in her teen years with her family and whose
home in A good example is of a researcher who had gone into a
community in Dr. Gugliucci made contact with
Steve Marston up in Skowhegan, who is a friend and had worked together on the
Rural Geriatric Conference which was in June this year and he contacted Sandy
River Health Group. The site of this
research project was at When data is done it is in the form of quotes and categorized according to themes. There are 4 states of experiences as follows: · Arriving at the nursing home · First days at the nursing home · Daily life at the nursing home · Leaving the nursing home Dr Gugliucci described Rana’s first pre-admission visit, followed by the first few days of her stay at the nursing facility. It started as the student being very nervous and sick to her stomach and dreaded every minute and felt it was going to be like a prison atmosphere at the nursing facility. When Rana actually moved to the nursing home she felt trapped at the thought of being there for two weeks and hated that feeling. There was a twang of jealousy when the nursing staff changed shifts that they could leave and Rana could not. The first meal was an experience – a salad and soup was ordered and the nurse joked and asked the student if she would like a clothing protector. Rana just laughed it off, then midway through the meal realized she had a huge chunk of tomato on her shirt and wished she had a clothing protector. The biggest thing is going to be getting used to being dependent on someone else. As the days went on Rana, besides feeling homesick, felt very alone and missed the old life and it felt very far away. Rana mentioned this to the ladies at the nursing home and they asked her to think about how they feel and it was hard to fathom. On Day 9 Rana realized that
there is not a lot of privacy. The On leaving Rana said it was very hard and sad to leave and say goodbye to everyone as she was feeling like she had been with family. As stressful, depressing and exhausting the two weeks were Rana learned more in those 2 weeks than she ever learned, she found the knowledge more useful and she is so thankful for all the wonderful people she met, especially the residents who taught her so much. Rana now wants to be a geriatrician which is something she had never considered before. The next student, Molly Trauten,
came from The immersion idea was Dr. Gugliucci’s
brainchild. It was started in 2005
when a medical student approached her for advice on “how to speak to
institutionalized elders.” In other
words “You Mean People” The student was asked if they would be willing to
live in a nursing home for two weeks.
The experience so touched the student, who had never spent time around
older people before that she wanted to be a geriatrician. Molly Trauten
wanted the same experience but not just for two weeks. Dr. Gugliucci,
who has access to 25 nursing homes through the medical school, found places
in Maine willing to take Molly without charge. Molly stayed at St. Andre’s for longer she
started changing the culture and watched the residents become more
independent. The residents were asked
to turn off lights and were given little tasks to do. It was interesting and why it is so
important that the time spent in these facilities is two weeks. One of the things happening at Seal Rock
Nursing Home is a training for the The learning opportunities offere
medical students and health professional students a chance to learn from
experience. The student gets a fuller
understanding because they are experiencing it hands on. The staff administration and residents
benefit from the student being there also.
Every facility the students were said it was the greatest thing. It just had them turn their thinking. When they started the facility felt maybe
they should be treating the student differently, for instance at One of Rana’s experiences was playing scrabble with one of the residents every day, and then the resident had a massive stroke and died before Rana left. One minute the woman was there and the next she was not. That was a shock for Rana. They went through the change of getting different roommates and how unsettling it was. You would have thought they were 85 years old they way they reacted. One other word is that Dr. Gugliucci is a Gerontologist – beware of Gerontologists who dye their hair. If anyone hasn’t seen the movie “Dad” with Jack Lemmon you should try to watch it – very poignant about the changes that go on with the father and also how the son reacts to these changes. Susan Rovillard had asked if it is possible for students to come to home visits of clients? Question: How did the students feel after leaving, knowing they are going back to their regular lives with the residents staying in the facility. When you read through the students’ notes, they were so entrenched in the here and now, feeling dependent and feeling they were never going to get out. What is interesting, the residents didn’t think anything of it and embraced the students being there saying, never mentioning how young the students were and why they were there. In one case when Molly got to St. Andre’s, they took this very seriously and said we don’t impact the staff and St. Andre’s gave Molly a walker, gave her a diagnosis of COPB and congestive heart failure; gave her a nasal cannula. The visitors coming into the nursing home felt very sorry for her but the residents did not think anything of it. What was interesting was Molly could not leave her room unless she called someone for an assist and she wouldn’t call anyone because she didn’t want to put the staff out. This happens with older adults but by the end of the week Molly’s not making it and got so depressed – who wouldn’t – you are stuck in a room and you cannot move. At the end of the week the assist was taken off and Molly was able to move around again and talk with other residents. There is no allowance for adaptation – moved from your home, moved into a nursing home and adapt to the situation, if not you will be put on medication. What about letting a person grieve their home and grieve their change in lifestyle. Don’t go to medication right away and let person adjust to new surroundings. Question: After the students left were the residents aware why they were there? Yes, after a while the residents realized why the students were there and were going through the experience. They were able to say goodbye to the people they had become close to in the nursing facility. Question: Were there recommendations made to the nursing facility? Yes – with Rana it was a situation where she went in to see what the experience would be like but with Molly we met with every nursing home administrator and said what do you want to get out of this project. All of them got copies of the quotes of the experience. Some of them were looking at the depression part, some were looking at adaptation. The project that we were really interested in but did not happen at Southridge was they wanted to study transitions. They have an acute care floor where residents go from independent living to this rehab floor and has a stigma that once on this floor you don’t go back and so Molly was going to be in the assisted living part and then be transferred into a HIP Mobilizer for a week and go onto that rehab floor and talk to the residents and then transition out again. It depended on the Nursing Home Administrator as to what they wanted and what the student would focus on. What we were very careful of was not putting too much burden on the staff. Also never putting a resident in a situation where they would be talking about who they liked or didn’t like and how they felt about the nursing home. Every nursing home was incredibly accommodating and because they were not getting any money for this project they were truly invested in wanting to inprove their care. Question: It is a small piece but why can’t the staff eat with the residents? Seal Rock tried to get plates off trays and brought in warming trays to make it feel more like a home eating setting but it became too hard because of the volume. Interestingly enough Molly preferred the older, traditional nursing home, cinder block walls because of the community. The newer nursing facilities were too quiet, spread out and really separated people so she could not get connected. Don’t let the way a facility looks tell you the whole story. Debbie mentioned that while it sounds great to have staff eat with residents, they also need to get away for a break. Another thing Rana and Molly became aware of is the lack of touch which was very hard. There was an article in the Boston Globe that said you need four hugs a day to survive, eight to thrive. Debbie suggested that maybe the students could go into other kinds of housing not just nursing homes. Discussion. 2006 The results of the forums led to the creation of approximately eight that were discussed by delegates who were selected through those forums for the most part to serve as representatives of their peers at the Blaine House Conference on Aging. There were approximately 200 people at the conference. It was very heartwarming at the end of the conference when the pink cards went up and people were voting on resolutions. There was a lot of help from the Muskie Institute, from a number of other organizations leading up to the conference they received an overview paper on particular topics they had interest in. Delegates were asked to select an area to contribute to at the Blaine House Conference. The Delegates were split up into small groups in the morning around those topic areas and then in the afternoon brought everyone together to vote on the recommendations of the small group sessions in the morning. Eight topics that were selected for discussion. Two of them were related to Caregivers of Long Term Care Services for Families. The other was Caregivers of Long-Term Care Services Paid. The distinction was tried formal and formal caregivers. There was recommendations made around Community Involvement and Volunteerism; Elder Abuse, Employment, Transportation, Housing with Services and Health Aging. The following are the resolutions which were framed in the form of action resolutions that meant that we were trying to word them in a way that we were directing people to do something. Because of time constraints each of the workshops in the morning were limited to three resolutions. Some groups were very specific and some were very broad because they wanted to try to bring everything in and not lose it all. The proceedings themselves will reflect all the discussion in the groups but these resolutions may not reflect as detailed as reflected. Attached are the Action Resolutions of the Blaine House Conference on Aging and made part of these minutes. Debbie thanked Larry for his presentation. The next meeting will be Wednesday, Meeting adjourned Respectfully submitted
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