AltschullMaking the decision to move out of one's home and into a retirement community can be daunting. Well older adults, by definition, are primarily able to care for themselves. But with aging comes increased vulnerability - possible falls or injuries, medication errors, and transitions to lifestyle changes. About 75 percent of those 80 and older report at least one disability, according to government figures, and one-half report two or more.
Finding the right balance between personal autonomy and a supportive environment can be difficult. From older "baby boomers" who came of age resisting convention, to survivors of the Great Depression for whom adversity is a challenge, remaining independent is a major goal. Through a unique partnership between the School of Nursing and the ERA Care organization of retirement communities, many older adults are finding that there are advantages to living in a community setting, particularly when the top-ranked UW School of Nursing is a collaborator in the development and management of all health care programs.
One such individual is Herb Altschull, a retired professor from Johns Hopkins University who resides at University House, one of six ERACare communities in the greater Seattle area. When he became confined to a wheelchair at age 76, Altschull decided it was too difficult to continue his part-time teaching schedule and began looking for a place to live that would meet his future and present needs. "I took a month off and cased all the independent living places I could find. This was by far the best."
Why? As a former journalist and an instructor of public policy and the media, Altschull enjoys living in a community rich with ideas. "There are retired professors here from forestry, aeronautical engineering, all kinds of stimulating fields. Every Saturday morning we have a current events discussion, and every Monday morning we have a coffee hour where people make presentations about some topic of interest. I've given a couple of these myself. It's very interesting."
Altschull, who earned his Ph.D.at the UW, uses his computer daily for research and writing, and he has helped other residents become more computer-savvy. "I'm a real proselytizer about going online when you need to get information about something," he says.
It is this kind of fit between personal competence and the surrounding environment that is the goal of health care for older adults, says Dr. Basia Belza, professor of biobehavioral nursing and health systems. ""Providing optimal care to older adults includes creating a fit between personal competence and the environment. As individuals age, we need to create environments to accomodate varied levels of social, physical, and psychological competence. A restorative model of health care focuses on maintaining and improving competence, rather than just the management of disease."
idaBroadviewAt Ida Culver House Broadview, another ERA Care community, resident Stella Binder considered moving into an independent living apartment several years ago when she was having some problems getting in and out of bed, but then decided she wasn't ready. When her husband developed dementia and began needing physical assistance as well, however, she decided it was time.
Binder takes advantage of the weekday Wellness Clinic at Ida Culver, where nursing students practice health promotion and acute care skills under the supervision of Patricia Gordon, MN, a lecturer in psychosocial and community health who works with nursing students in the clinical setting. Students also learn case management and organize a health fair each year. Ida Culver Broadview has three levels of care: independent living, assisted living, and skilled nursing care.
Community Health Director Judy Shannon 94', is enthusiastic about the "rich environment" at Ida Culver House. Her job is to organize programs that fit as many interests as possible, and she notes that this can be a formidable challenge.
"Many of our residents are still active and healthy and want to attend the symphony, opera, or other cultural events, or perhaps take a Tai Chi class." She notes that many others still travel, and that one recently left to work for Elderhostel in India.
AllenGardenTownSquareShannon earned her BSN from the UW in 1994, after working 20 years as a librarian. She has great admiration for community residents and knows them by name. "We have four residents over 100, and probably 12 more over 90. And a whole range of residents in their 60's, 70's and 80's." Many "younger elderly" live in cottages on the perimeter of the Ida Culver complex. "They want security and are tired of the housework," she explains. Some moved from a house to a condo before making the transition to independent living.
Shannon works with residents on program planning, including physical fitness activities, cultural offerings, lectures, outings, crafts, social events, and mental or social health programs, such as a recent lecture on life transitions. Activity programs vary according to cognitive and physical status of the residents.
For others considering future living accomodations, physical fitness is a priority. Across Lake Washington at ERA Care's Gardens at Town Square community, for example, a new Senior Pro Fitness program offers individualized fitness plans in a specially designed equipment room. Recreation coordinator Kerri Spruston takes a detailed health history of each Senior Pro Fitness member to decide what combination of balance, strength, agility and endurance training is best. She is happy to demonstrate a new balance monitor that requires users to match changes in balance to a visual grid on a computer screen. "It's much harder than it looks," she explains.
One of the most enthusiastic Senior Pro Fitness members that Spruston works with is 89 year-old Eugenia Allen, who has lived in the Gardens for two years. Allen exercises every day and meets with Spruston three days a week. "My physcian says I'm more flexible than any patient he has at this age," she happily reports. Energetic and outgoing, Allen says she loves exercise and has always been active. Originally from Miami, she made the decision to join the Gardens community after moving to Seattle to be closer to her daughter and grandchildren. "I love this place," she freely offers. "I know some people think they're not going to like a place like this, but I like it better every day."
The School has had a collaborative relationship with ERA Care since 1990, assisting in the development and management of all health care programs in its six communities. Undergraduate and graduate students and faculty participate in clinical and research opportunities in the ERA Care communities, contributing to improvements in both health and safety procedures.
CREDITS: University House resident Herb Altschull continues to write and do online research in his retirement.
Ida Culver House Broadview resident Stella Binder, left, talks with UW Bothell nursing student Joan Johns in the Wellness Clinic.
Eugenia "Genie" Allen, a resident of Gardens at Town Square, demonstrates her treadmill workout at the grand opening of the Senior Pro Fritness exercise facility.