College of Public Affairs and Community Service Department of Gerontology
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Putting a human face on the study of aging

Nobody wants to get old. Nobody wants to give up control of their life or their health care to a person who changes every eight to 12 hours.

Nobody wants to die—and few of us have the fortitude required to stay beside and care for someone who is dying.

The subjects of aging and of those who give care to an increasingly aging population—along with the important questions and concerns these topics raise—form the foundation of several notable research studies (see sidebar below) conducted and published recently by the faculty of the Department of Gerontology at UNO's College of Public Affairs and Community Service. (Pictured: Gerontology faculty, from left, Professors Chuck Powell, Kyle Kercher, Lyn Holley, James Thorson and Karl Kosloski. Photo by Tim Fitzgerald).

Though research can be a study of cold numbers, pie charts and graphs, for the faculty, staff and students of the Gerontology Department, research takes on the added dimension of a human face. The face of a loved one, a friend, or a study subject who two weeks ago was a stranger but now is called by name.

It is research that impacts all of us.

That includes the "Care Giving and Nebraska's Elders" study commissioned by the Nebraska Office on Aging. The study examined the responses of 1,000 persons, split evenly into two age groups: those 50 to 65 and those older than 65. Those surveyed were asked about their health, living status, functional ability, whether they have received care and from whom, whether they currently are providing care to a frail older person, and whether they ever have provided care to a frail elder.

Filling in the gaps

Gerontology Chair Dr. James A. Thorson says the study revealed considerable useful data: "We found that most care giving, 42 percent, was done by a spouse. And we found many instances of people in their 70s taking care of people in their 90s."

The study indicated that family members deliver approximately 85 percent of the services provided to the elderly. "This is a valuable study because state officials need to know where the gaps are in current programs and what is needed to fill them in," Thorson says.

Respondents were asked what services they desired and what were lacking in current programs. "Nobody said they needed more senior centers. Nobody said they needed more bingo games," says Thorson. "What they need is someone who will give Grandma a bath, change her dressing and make sure she has a hot meal."

The responses illustrate that the problems, issues and concerns faced by the elderly are no different in Scottsbluff than in Omaha, Thorson adds. "They are all asking the same things. They want adequate home services and skilled in-home nursing. Basically, they want family members to be allowed to do their job but to help them out when they need it."

In other research, a profile of home-care workers based on the 2000 census, researchers identified the characteristics of the long-term-care workforce in areas ranging from demographics to income and wages. This research, says Dr. Karl Kosloski, can be extremely useful in helping find and hire direct-care and home-care workers. "It gave us a dramatically different picture than the one we were used to," he says. "This data will allow those who need to recruit and retain the long-term-care workforce very specifically targeted areas upon which to concentrate."

The healing power of art

In a demonstration project at the House of Hope long-term-care facility for dementia patients, artists gave residents the opportunity to participate in five different art activities: music, dance, painting, collage and sculpture. A research team of faculty and doctoral students observed the residents and rated their levels of participation according to three criteria: their engagement in the activity, their apparent interest and their expressed affect.

"Overall, music, dance and painting elicited higher levels of interest, engagement, and pleasure than did collage and sculpture," Kosloski says. "All of the art activities, however, elicited levels of interest, engagement and pleasure at least comparable to some of the usual and customary activities ongoing at the facility.

"The findings suggest that all of the art activities can appropriately be incorporated into the ongoing stream of activities designed to enhance the quality of life for patients with Alzheimer's disease."   

As the population ages, issues of care and of "death with dignity" are a growing concern, Thorson says. "People don't know how to help when someone's dying," he says. "Too often, we're scared of it so we stay away and then the person dies alone, which is a pity."

Society, however, is beginning to deal with these issues in a more honest, matter-of-fact way. "We're starting to see health care professionals entering into a dialogue when it comes to important care issues such as how to control pain, keeping a person as comfortable as possible, adhering to their living wills and allowing them to remain in control of their life and their death," Thorson says. "The question of withholding treatment at the patient's request and whether or not that is euthanasia is a big topic of discussion today."

These discussions have sparked interest on the UNO campus. "We started a 'death and dying' course in 1972 with seven students," Thorson says. "Now we have to cap it off at 110 because that's the number of seats in the room."

For Thorson, the research became personal when in 1997 he helped care for his 84-year-old mother, who was dying. He wrote about his experiences in "Innovations in End-of-Life Care," an international journal and online forum.

"As the weeks went by," he wrote, "the docs were open to my suggestions that the heart and blood pressure meds my mother was on were in fact an echo of a previous time when we were hoping to extend her life. They agreed to withdraw everything now that our intention was simply to keep her comfortable. Our goal had changed, and it seemed necessary to articulate that fact. Had I not brought it up, I'm sure everyone would have continued to pretend that she would get better."

Keeping her comfortable meant limiting her visitors, yet making certain she had company. Thorson would leave the university to have lunch with her then return in the evening. "One of the things she enjoyed most was being read to. I recall that the last book was a thick biography of the Windsors. Near the end, she asked me what page I was on, and when I told her it was 86, she said, 'Read faster.'"

Old age. Diminished capacity. Limited independence. Sickness. Death. They can't be eliminated. But because of research being conducted by UNO's Department of Gerontology, they can be better understood, better addressed, and less feared.

And keeping a human face on the data provides uniquely relevant answers to the questions that government officials, care givers and families are asking every day.

 

Care-giving studies

Studies recently published by the faculty of UNO's Department of Gerontology include the following:

• "Care Giving and Nebraska's Elders," a report on a survey conducted by Drs. James A. Thorson and Chuck Powell of the Department of Gerontology at UNO.

• "A Profile of Home Care Workers From the 2000 Census: How it Changes What We Know," by Drs. Lyn Holley and Karl Kosloski of the Department of Gerontology at UNO, Jerome Deichert of UNO's Center for Public Affairs Research, and Dr. Rhonda J.V. Montgomery of the University of Wisconsin-Milwaukee.

• An examination of Creative Art Therapies conducted with Alzheimer's patients at the House of Hope in Omaha.

• An in-depth analysis of the relationship between depression and physical health conducted by Dr. Kyle Kercher of the Department of Gerontology at UNO.