Lee-Ling Chen is one of the de Tornyay Center for Healthy Aging’s 2023-2024 Healthy Aging Doctoral Scholars, and a UW School of Nursing Adult Gerontology Primary Care Nurse Practitioner Doctor of Nursing Practice student. Her project is on “Fall Prevention and Management for Older Adults in Assisted Living Service Programs within Retirement Communities”. Her faculty mentor is Jonathan Auld, PhD, MAT, RN.

Why did you choose nursing?

My interest in nursing dates back to when I was about 10 years old. My grandmother was hospitalized with a post-hip replacement infection. One of my aunts insisted on giving her more nutritional support in hopes of keeping her alive. However, her body was declining and unable to absorb the nutrition and fluids. I felt that there was no purpose in prolonging her suffering. Eventually, she passed away after a few days. This experience profoundly impacted me and shaped my future aspirations. I realized the importance of providing the best care to patients based on their wishes and desires. Letting the loved one go is uneasy, but nursing guides us in listening and providing support for patients and their families.

Nursing is a rewarding career because it allows me to help people and make a positive difference in their lives. Additionally, the knowledge I gain can also be used to care for my own family. That’s why I chose nursing.

What made you interested in this topic for your DNP project?

For my DNP project, I am focusing on fall prevention and management in a retirement community, specifically targeting older adults who receive assisted living services. My interest in this topic is deeply personal. My dad has Parkinson’s disease and now also has dementia, which significantly affects his daily activities and balance. He has fallen multiple times, resulting in various injuries and fractures.

Through this project, I hope to develop strategies that will help older adults in assisted living programs prevent falls. Observing my father’s struggles made me realize that there are ways we can improve fall prevention and support the residents in these facilities. That’s why I chose to work on this topic.

Why is this research project important to do?

Fall prevention is a significant topic that has been discussed for a long time, but there is not much research focusing on older adults in assisted living services. Furthermore, the senior retirement community that I worked with was seeking recommendations on updating their fall prevention and management policies, which have remained unchanged since 2013. Effective fall prevention measures have markedly decreased falls, leading to cost savings and reduced mortality and morbidity.

For this project, I utilized the Ottawa Model as the framework, focusing on the Assessment phase, which includes innovation, potential adopters, and the practice environment. This approach helped identify barriers and informed project planning, aiming to bridge the gap between current practices and evidence-based recommendations. The findings from my project included comparing recent guidelines with Era Living’s policy and conducting an assessment of staff and residents via interviews. These interviews focused on awareness, attitudes, knowledge, and experiences related to fall prevention and management.

Has there been anything that surprised you while working on the project so far?

I was surprised that I didn’t find much evidence specifically focusing on fall prevention in assisted living. There’s limited information available on this area, possibly because I restricted my research to recent years. To address this, I used similar research on fall prevention and gathered related evidence that could be applied to residents in assisted living.

Another surprising finding was the reliance on community health nurses in retirement communities to identify individual risk factors and the confinement of fall risk assessment. According to the AHRQ’s Safety Program for Nursing Homes, an effective policy should incorporate interdisciplinary input on resident fall risk. This highlighted the importance of interdisciplinary input in creating comprehensive and effective fall prevention strategies. It made me realize how crucial it is to involve various healthcare professionals, residents, and families in assessing and managing fall risks to improve older adults’ overall safety and well-being.

What interests you about healthy aging and gerontology?

What fascinates me about gerontology is how our bodies change as we age. The presentation of symptoms in older adults can be atypical compared to younger individuals, which requires a specialized understanding of their unique needs. Older adults are a vulnerable population, and my interest in gerontology arises from my desire to help them navigate available resources and avoid unnecessary medications through deprescribing.

By focusing on healthy aging, I aim to improve the quality of life for older adults and support them in maintaining their independence and well-being. Everyone will get old. We’re aging every day, but the key is how to age healthily.

Did you have any past experience working with older adults in your career before you came to the DNP program?

I worked in the orthopedics unit and primary care settings before I came to the DNP program. At the hospital, I cared for many older adults who needed knee and hip replacements, as well as those with fractures and amputations. I loved interacting with them and learning about their lives, which provided me with invaluable insights into the challenges they face.

In my career, I also learned a lot from older nurses in the primary care setting. They have shared invaluable life lessons and knowledge with me, enriching my professional growth and understanding of geriatric care. Their mentorship has been instrumental in shaping my approach to nursing.

Additionally, I have always been the one taking care of my grandparents and now my parents because I have a nursing background. I truly appreciate the time spent with them and being able to utilize my nursing skills in caring for them.

Shao-Yun Chien is a UW School of Nursing PhD in Nursing Science candidate and one of the de Tornyay Center for Healthy Aging’s 2023-2024 Healthy Aging Scholars. Her dissertation is on “Developing a Culturally Sensitive Web-based Discussion Platform to Reduce Social Isolation and Loneliness Among Older Chinese Immigrants.” Her faculty mentor is Oleg Zaslavsky.

Why did you choose nursing?

I grew up in a family where many members were part of the healthcare industry, and they were always eager to help others. I remember my father often rushing to the hospital in the middle of the night to take care of patients.

In addition, I have always been close to my grandparents, and enjoy conversing with seniors because they have so many stories and rich life experience to share. In high school, my grandfather fell ill and was hospitalized. I felt helpless and unsure about what I could do to ease his pain and improve his condition. This motivated me to acquire knowledge and skills in nursing, to not only help him alleviate pain, but to also maintain a better quality of life.

Overall, I think healthcare is crucial for everyone from birth to the end of life. Learning nursing can help others as well as oneself. So I chose nursing.

What interested you about healthy aging in particular?

Healthy aging fascinates me because it’s a multi-faceted challenge that combines the physical, mental, and social. As the global population ages, understanding how to maintain and improve the quality of life for older adults is becoming increasingly important. I’m particularly interested in how we can use innovative interventions like technology to support the mental and physical health of the elderly to ensure they lead fulfilling and independent lives.

After I graduated from university, I worked as a nurse at a medical center in Taiwan, and approximately 80% of patients in my ward were older adults. It’s common to see patients distressed when their condition doesn’t improve as they expected after acute care and treatment. The medical personnel are usually focused on treating physical symptoms and often overlook the psychological aspects.

I wanted to enhance my understanding of mental health and psychiatric nursing in order to solve this issue. So I went on to study at the UCSF psychiatric mental health nurse practitioner program, concentrating on the psychological well-being of older adults.

You mentioned that you’re interested in technological interventions for older adults. What interests you about the technology interventions?

Because there is an important issue that’s called a digital divide. So many older adults struggle with using technology due to fear or aging, like visual impairments or hearing impairments, or other illnesses like depression or dementia. They’re not able to use technology products like younger generations. So they’re missing out on the convenience brought by technological advancement. I think it’s important to bridge this gap to increase the usability of technology for this population.

What is your project as a de Tornyay Center healthy aging scholar?

My project is called “Developing a culturally sensitive web based discussion platform to reduce social isolation and loneliness among older Chinese immigrants.”

I am leading this research with a focus on designing an online community that is culturally appropriate to the needs of older Chinese immigrants. The platform aims to mitigate and to reduce the feelings of loneliness and social isolation that are prevalent in this demographic.

The intervention is modeled on a virtual online community for the elderly, which was abbreviated VOCALE, developed by Dr. Annie Chen and Dr. Oleg Zaslavsky. I modified it according to the aim of this study. The revised version is named VOCALE older Chinese immigrants — VOCALE OCI.

This intervention, VOCALE OCI, is an online support group on an open access platform designed to promote problem solving and health management strategies in older adults. The participants are encouraged to share their age-related experience and management strategies with others in weekly discussions.

How did you first get involved in the project?

My involvement in this field began with my volunteer work at a senior center in Seattle. I had the opportunity to interact with and chat with several older adults. In that senior center, most of the participants are people with low English proficiency. One of the prominent issues they shared with me was the feeling of loneliness and social isolation, such as cultural and linguistic barriers, and also transportation difficulties.

What they told me is that they feel they have no eyes, no ears, and no feet. Because they cannot understand the language, they cannot see the signs. Or even if they go out to shop, if they have questions, they cannot ask the staff. And they don’t have feet because some of them do not know how to drive and don’t know how to even take the bus. And because of those disadvantages, they’re kind of isolated.

The situation was also exacerbated because of the COVID-19 pandemic. Even now, some seniors also share that they are fearful of going out due to the risk of infection, so some of them still stay at home, and if they want to join any activity they would choose an online version.

This experience deeply impacted me and motivated me to address these issues, leading to my current research project.

Has there been anything that surprised you so far while working on this project?

I feel like the resilience and potential of the elderly might actually be beyond what we imagine. The seniors I’ve met (my research participants) have really inspired me. Initially, I thought my research was all about creating an online community to help them, but they also enriched my thinking and life with broader perspectives and experiences, which has been incredibly rewarding and precious to me.

I’ve discovered the diversity among the elderly; each of them is like a rich book with so much to reflect on and learn from. Despite the many difficulties and obstacles they faced in their migration process and adaptation, the vitality they’ve shown throughout this journey has been a huge inspiration. I believe this has been a very valuable and profound learning experience.

Having studied abroad myself, I’ve had similar experiences, but they’ve faced many more challenges and difficulties. I really admire the wisdom of the elders, and it makes me think we should be more humble in understanding and comprehending the life experiences of different people, respecting everyone’s thoughts and individuality.

Emilie Martel-Rousseau is a DNP student in the Adult-Gerontology Primary Track and the de Tornyay Center for Healthy Aging’s 2023-2024 Myrene C. McAninch Doctoral Scholar. Her mentor is Assistant Professor Maya Elias and her de Tornyay Center research project is the “Dementia Action Collaborative Provider Survey.” 

What interests you about healthy aging?  

I always enjoy caring for and connecting with older adults. As I was entering this program, I wanted to focus more on what I can do for healthy aging because I think it is an area that will be more and more important with the increasing number of older adults. It’s definitely an area of need that I feel I’m comfortable in. 

What has your past experience working with older adults been?   

When I was in university, I lived with my grandmother, and I was her care helper. And then I did a lot of volunteering in retirement homes through nursing school. I help older adults in my community, for example with their groceries, so they can continue living autonomously. I love getting to know what is important in their lives. As a nurse, I have not worked in a geriatric clinic specifically, but a lot of our healthcare is with older adults and these are the patient visits I really look forward to.  

So when I was trying to further my career and thinking about the DNP program, I was thinking, what do I want to do? What makes me most happy? What do I like the best? Since then, my goal has been to be a primary care provider for older adults. It was a great decision! 

Could you talk a little bit about what the Dementia Action Collaborative is and what they do? 

The Dementia Action Collaborative is a team across Washington State of public and private partners. They are working to prepare communities and the healthcare system for the increasing number of people living with dementia. In 2023, they updated their plan to address Alzheimer’s disease and related dementias.  

Your project with the de Tornyay Center is a survey with the Dementia Action Collaborative. How did you first get involved with that work? 

My first year at UW, I was part of the Health Equity Circle, which is an advocacy group of healthcare professional students. Our team was planning to lobby the Washington State Legislature. I was looking up different legislations I thought would be valuable for our team to lobby for, and at the time, the Dementia Action Collaborative was putting in a request to get renewed for their program to continue. 

So that’s how I first found out about the Dementia Action Collaborative. I lobbied for them, and it was successful. I think it was a unanimous decision for it to pass and continue. 

That’s how I got interested in it. I thought, wow, that’s so cool, I would love to be a part of the collaborative. Then when I saw that the Dementia Action Collaborative was looking for a DNP student to help them with this project, I was like, okay, that’s my first choice. I thought maybe I could get my foot in the door that way. It’s been an awesome opportunity so far. 

With the survey that you’re doing as a part of your project, who are you surveying and what are you hoping to learn? 

The survey is a needs assessment of healthcare providers in Washington State. We are hoping to learn the barriers, challenges, and successes of identifying and caring for people living with dementia from providers working on the frontlines.  

We’re trying to get input from any provider that cares for older adults. Our primary target is primary care providers (PCPs). We also want to reach allied healthcare providers, so that could be the dentist or the eye doctor that sees the older adults and can connect the older adult to appropriate resources. The goal is to understand how our current healthcare system is caring for people living with dementia so that we can target areas to improve on.  

What types of questions are you asking them? 

We ask about screening, diagnosing, referring, and care management for people living with dementia.  We also ask healthcare providers what they need and are interested in terms of education and opportunities to improve their own practice. 

How are you and the Dementia Action Collaborative hoping to use the survey results? 

We will congregate and analyze the responses to the provider survey. We’re hoping to see what would be most helpful, where are the biggest gaps in our system right now, so that we can make changes and improve care. The results will also serve as a baseline to compare future surveys to and monitor progress in dementia-related care. 

Why is this project important to do? 

The Dementia Action Collaborative updates their statewide plan to address Alzheimer’s every five years. They just updated it in 2024. We hope the survey will get provider input, buy-in, and information from the front-line workers, so that we can make relevant and effective changes.  

Has there been anything that surprised you while working on this project?  

This is my first time being a professional leader in my DNP role. I’m learning a lot of leadership skills, such as leading meetings and proposing recommendations to higher-ups, which is exciting and useful for my future career.  

Hsin-Ni Lee is a UW School of Nursing BSN student and the de Tornyay Center for Healthy Aging’s 2023-2024 Myrene C. McAninch Undergraduate Scholar. Her de Tornyay Center project is on “The Relationship of Ageism, Aging, and Music on Cognitive Health: Perspectives of Mandarin-Speaking Older Adults,” and her project mentors are center director Basia Belza and center predoctoral scholar Sarah McKiddy.

Why did you choose nursing?

It all started with my mom because my mom is also a nurse, and she is a nursing instructor in Taiwan. So I grew up in the environment. It felt familiar to me. I remember I would go to school with her as a child. Going into all the skills labs and looking at the equipment and mannequins, it was really fascinating to me.

Also, when I got the chance to go into hospitals, whether it was going in myself or going with family members, it was cool to see the nurses use their skills. It made me think, oh, I think that’s something I would want to do someday.

I enjoy taking care of people, too.

Could you briefly describe your project with the de Tornyay Center?

I’m using the project that I’m currently working on for my BSN undergraduate research program. We’re looking at the cultural impacts on the aging experience of Mandarin-speaking elders and how music can be tailored as an intervention to promote healthy aging or improve health for this specific population.

What’s your role in this project?

My role and my other colleagues’ role is to recruit our interview participants to do interviews in their native language. I’m doing interviews in Mandarin with Mandarin-speaking elders, and we will be asking them about their perspectives on aging, how they feel about aging, how their culture views aging, and what their aging experience is in the U.S.

In the interview we will be playing music chosen by the interview participants, and we will discuss with them, how does this music make you feel, what kind of memories or feelings does it trigger? We also are going to ask them how they think music has a benefit on their health.

How did you first get involved in the project?

I applied to the BSN undergrad research program, and when I was applying for that, they had us write about our research interest. My research interest mainly surrounds older adults because I grew up living with my grandmother and saw her having struggles with her physical decline and mental struggles, too, because she has depression. It made me interested in improving especially mental health in our older population. So I wrote about that, and I got paired with faculty and a student from the de Tornyay Center for Healthy Aging.

Why is the work in this research project important to do?

When we were doing the literature review for the honors program, I found from the U.S. Census Bureau there’s an increasing population of foreign-born adults, and a good portion of these foreign-born older adults are from China.

I also found other information on the aging population of Asian Americans. They’re more likely to have negative experiences when aging due to language barriers and the lack of social services that are tailored to their culture. I think it shows the importance of focusing on the cultural aspect of how we can make interventions for the general public and also to not forget about the minority populations.

What made you want to do research?

I’ve got a little bit of experience in research. When I was in Taiwan, I worked as a research assistant for a nursing professor in Taiwan, and her study was to find out how inner ear disorders and constipation affect seniors’ daily lives.

My role was also to go around my community and recruit these older adults and do interviews about inner ear disorders and constipation and the effects it has on their daily lives. It was a really interesting experience for me because I have never been the person to interview other people, so it really helped me practice my communication skills.

And it was just a special experience, listening to people tell me about their problems and their struggles in daily life. It made me wish that there was something I could do for them. But it also felt really cool that all the information I was collecting would be used in a way that could somehow be beneficial to their future or help people in general.

Lalipat Phianhasin, MS, RN, AGPCNP-BC is a second-year Ph.D. in Nursing Science student and the de Tornyay Center for Healthy Aging illustrator. Her faculty mentor is Dr. Eeeseung Byun. Her area of interest centers around social factors related to stroke survivors’ quality of life.

What interested you about stroke research?

I have a clinical background working with stroke patients, especially in the acute phase. My research will center around stroke survivors because, based on my experience, I know that most of them have a disability after a stroke. But health care providers mostly focus on the acute phase. What about their recovery? How are they going to go back to what important to them.

Why did you choose nursing?

It’s a long story. Members of my family are healthcare providers. My grandfather had to have long-term care. Instead of being hospitalized, we took care of him at home. So, our home was like a small primary care hospital. It was very holistic care as well because he had a tracheotomy tube, and we had to give him oxygen, he also had a gastronomy tube where we fed him through a stoma. Nursing care was really familiar to me when I was a child, and that really inspired me to take care of him and also other people as well.

What made you want to go into nursing research?

It happened when I was a nursing student and when I took care of the patients in the unit, supervised by my professor. We had a class about research applications for the patient and in the clinical practice. The professor always encouraged us to apply the articles by writing a care plan. That was very interesting to me, how research could help improve their quality of life.

Then, after I was interested in research, I felt like we could create our own research based on our specific site, specific population, because not all research is going to be applicable in all settings. We could publish our knowledge and our findings as well.

Then I found a way I could be a researcher, which is to pursue a PhD.

You wrote an editorial a little while ago about the unconscious patients and their environment. Could you briefly describe the topic of the editorial?

The article I wrote is how we should be aware of patients who are unconscious. They can still perceive the environment, even though they cannot respond to us. I just wanted to echo that message, please be aware of that, and value them and treat them and respect them as a human.

Why did you think it was important to write the article?

I feel like sometimes health care providers, we don’t realize that. Maybe because they have seen a lot of patients like this. I think it would be great if we can create a guideline where, if we have patients who are unconscious, just let them know and explain, our plan of care.

What is your background and history with art?

When I was a child in elementary school, I loved drawing. I loved painting and all kinds of art, but I loved drawing and painting specifically. My family knew that I loved it, and they sent me to take a course. They wanted me to have like another activity that I liked.

What do you like about drawing and painting?

I feel like it’s freedom, it’s a kind of freedom. You can create without boundaries, because sometimes in everyday life, you can do this, you cannot do this, based on social norm of things, especially in my country. They’re very conservative sometimes.

But the art, drawing and painting, is a kind of way that we can express our emotion. We can express everything without harm to others.

Is there any connection between your art, nursing and research for you?

I feel like nursing is art and science. Art has a broad definition. To me, I feel like the skill in my art supports skill in nursing and research as well. Because every time when I would like to draw, I have to plan and organize and I am a visual person. Before I draw something, I will have a picture in my head. I feel like it trains me to think in this way. This kind of process can apply to nursing and doing research to plan and prepare for the next step of what I am going to do both in clinical practice and nursing research.

What aspects of nursing are more of an art to you?

It’s the art of communication. We have to build trust, and that’s where you need the art of communication. And I think we can gain valuable information that sometimes is very little, but it’s significant to our patient’s improvement.

Yanjing Liang is a first year PhD student and one of the de Tornyay Center for Healthy Aging’s predoctoral scholars. Her research areas of interest include aging-related medical issues.

Why did you choose nursing?

The original reason is my family members have some chronic diseases. I learned nursing so that I could take care of them and provide them with health knowledge.

After I chose nursing, I think nursing chose me at the same time.

I like nursing. It can be personally fulfilling, because it provides opportunity for lifelong learning and professional development. I like connecting with people, and nurses often develop strong relationships with patients, their families, and interdisciplinary colleagues.

There was a time when I worked as a volunteer in a hospice care institution in my first year as a college student. I learned about integral role of nursing. I helped the nurses, social worker, and accompanied and talked with patients with advanced cancer, and took care of their children. I felt a strong sense of achievement, and at that time I felt being needed.

I decided to be part of this integral role, and that’s why I say, I chose nursing and nursing chose me.

What got you interested in research?

During my fourth year of college study, I found some clinical problems in clinical rotation, but there was no new evidence. So I thought maybe I needed to learn some research skills to improve clinical conditions.

What research did you do in your Master’s program, before you came to UW?

When I was a first year graduate student, I was exploring my research direction. I participated in 2 or 3 projects.

The first one is that I had the opportunity to participate in a fundamental medicine research project exploring the phenotypes of biofilm formation in bacteria, such as streptococcus mutants, in a wet laboratory. It let me know what research is from a different perspective.

After that, I started my clinical rotation at the head and neck cancer department and I discovered that the diagnosis and treatment can cause severe side effects for this kind of patient, such as psychological symptoms, which can lead to reduced social interaction and possible isolation.

So with this in mind, I conducted graduate research on improving social isolation among head and neck cancer survivors. I conducted a psychometric study on validating a social isolation measurement tool and used it to investigate the factors of social isolation among head and neck cancer patients.

Has there been anything that surprised you while working on those research projects?

For head and neck cancer patients, their average age is approximately greater than 55 years old. They experience more difficulties than I realized. However, due to the differences in culture backgrounds, our participants were different in expressing their emotions compared to related studies conducted in other countries.

This suggests to me that we need to pay attention to the impact of a multi-cultural background. In conducting future studies, we need to focus on cultural background and what their social interaction style is.

What interests you about healthy aging?

I think the ultimate goal of doing research is to serve the public, so that our research can benefit society.

If we are able to conduct interventions for elderly patients, we can better promote healthy aging and reduce their burden of experiencing disease.

Healthy aging actually is a big topic. It doesn’t just focus on elderly. It runs through the whole life span of a person.

Is there anything else you would like to add?

I think the head and neck cancer patients, this kind of patient has loss of body function brought by the aging process, and additionally, they have to experience the damage caused by treatment and caused by disease.

This made me realize the study of aging is actually a complex study. Because some of the older adults, they may experience chronic disease, and at the same time they experience some function reduction from aging. So we need to account for a wide range of circumstances and need to analyze differences between each individual and provide tailored interventions and health education.

Jaemie Lam is a BSN student. During winter quarter in 2023, she traveled to Japan as part of the Keio University Short-Term Nursing and Medical Care Studies Program to learn about challenges of an aging society. UW students attending the program were supported by the Center for Global Health Nursing and the de Tornyay Center for Healthy Aging.

Why did you choose nursing?

It was a long process. I believe my interest in nursing sparked from my interactions with nurses and nurse practitioners throughout the years during my battle with atopic dermatitis, also known as eczema. Through clinics and urgent visits, I was inspired by the role of nursing as I witnessed how I received care and their role in the medical care team. So it was definitely always in the back of my mind, but I never fully considered it until recently when I started doing CNA work.

Going through UW’s program has solidified my passion for nursing because of the requirement of critical thinking skills, cultural humility, and a lifelong learning process, which are values I hold closely.

What interested you about the program?

As I was taking electives for my Public Health major at UW, I was taught that Japan had the longest life expectancy. I was intrigued to learn more about Japan’s healthcare system and their methods that result in their long-term life expectancy. Through the class, I had also learned that the US’ life expectancy is nearly not as long and I was interested in grasping experience as to why that was the case.

By immersing yourself into another country, you learn about their culture, different perspectives, and different lifestyles. I was mainly interested in this program for this reason as well. It opens up your mindset to be a better healthcare professional. In a sense, I think I learned significantly more as an exchange student in comparison to when I had solely traveled to Japan.

I also didn’t know we were going to be interacting with students from South Korea, China, and the UK. This broadened my perspectives because I got to learn from their healthcare systems as well, see how different their nursing programs are, how different their jobs are, how different their schooling is, how different their lifestyles are, and many more. It was life-changing as we applied our global health perspectives when tackling our global healthcare issues.

What was the most interesting experience during your trip?

Robo-care. The program designated a specific day where we got to learn about Japan’s most recent innovative care. It was life changing to witness how Japan incorporated artificial intelligence and robots in the form of an assistive device either on hips or extremities to provide support when lifting or ADLs. These devices could either be placed on or attached with leads. It was fascinating to see how the leads were able to control an extremity through nerve stimulation of the brain and allow the user to regain functions needed for daily living.

What was your favorite part of the program?

Definitely interacting with students from all around the world. I made lifelong friends with future nursing students from all over the world as we navigate challenges in our nursing careers together. It is comforting to know that we can rely on each other in difficult situations. As I stay in contact with them, it’s amusing to see how different our lives are, yet very similar as well. I am also very thankful to have met CJ through this program. We had not known each other prior, but we now share such core memories and experiences that I will now cherish indefinitely. I have learned a lot through my interactions with everyone and am forever grateful that I had the opportunity to participate in this short term nursing exchange program at Keio University.

CJ Rivera is a BSN student. During winter quarter in 2023, she traveled to Japan as part of the Keio University Short-Term Nursing and Medical Care Studies Program to learn about challenges of an aging society. UW students attending the program were supported by the Center for Global Health Nursing and the de Tornyay Center for Healthy Aging.

Why did you choose nursing?

Both of my parents are LPNs, so I had early exposure to what nursing was aside from the medical management aspect of it. I found interest in the way that I could align my passions for health equity, social justice, connecting with others, and caring for the human body through nursing.

What interests you about healthy aging?

When I got my CNA In 2020, I started off working in memory care. Before that, I had no prior health care experience with a geriatric population, and I found that I really liked it. I want to be able to use my career in nursing to help vulnerable populations, and right now, I believe geriatrics is the one that I connect to the most. Additionally, my grandma has dementia and lives at home with me, and I have found unique strategies to make caring for her easier on the both of us. Being a family caregiver has taught me a myriad of ways that I can recreate a more comfortable aging process for people that don’t have the privilege of aging at home.

What do you like about working with older adults?

I loved hearing about people’s life stories, and I feel like it was the easiest population to practice narrative medicine with, which is where you treat people and not just the disease or their disability. I appreciated their company and found the care that I was providing to be extremely rewarding.

What interested you in the Keio University program?

I’ve never travelled out of the country before, and I knew that Japan is known as the “super-aged” society. If I ever did get an opportunity to study aging from abroad, I would want to do it in a place that is known for having the healthiest elderly people.

Also, having a personal connection to Asian culture, I wanted to see the lifestyle differences between aging in East Asia, and then aging as a Southeast Asian in the US. I was curious about what factors of their daily life like activity levels, diet, etc. possibly contribute to their extended life spans.

What was the most interesting experience of your trip for you?

We went to a complex of houses that are owned by a health care company called Aoi Care. We got to meet the owner of Aoi Care and tour the community of around four houses that are just for elderly people. There was one house that was just for elderly people with Alzheimer’s and dementia. We were allowed to go inside while the residents were there, and see what their day to day life is like. It was just for a couple of hours, but I thought it was so special because the care was very holistic compared to aging in a facility in the US.

They lacked a lot of the strict rules that facilities for elderly people have in the US. They didn’t lock the doors, so the residents could roam freely around the community. They also didn’t have scheduled meal times. They were allowed to use appliances like stoves, kettles, irons, etc. Their food was also cooked by a traditional Japanese chef who uses dashi powder to increase the appetite and food intake of the residents. Rather than having a dietitian or a nutritionist prepare healthy meals, they found that eating culturally familiar and traditional flavors actually helped the residents increase their nutrition more readily, which is important to maintain as you age.

Did anything surprise you?

We got to shadow nurses at Keio University Hospital, and I think I was surprised at how similar the workflow and dynamic was to working in a hospital in the US. The US healthcare system has such a bad reputation, so I thought I was going to go there and see a complete change, and it really wasn’t that different. The nurse to patient ratios, equipment, and documentation were all very similar to the US. I was also surprised to hear that similar nursing stress levels and staffing crises are present in China, South Korea, and the UK when discussing the nursing workforce with the other students participating in the program from those countries.

What was the most interesting thing that you learned?

We learned about a free program called dementia supporter training. It’s basically the same as those training modules that you do every time you get a new job, but anyone in the general public can do them to learn how to care for people with dementia, since such a huge portion of their population is elderly. It was interesting to realize that in Japan, they try to normalize dementia. But in the US, it’s pretty taboo. It’s something that you don’t want people to know about. You don’t want people to talk to your elderly parents or grandparents that have dementia because it can be embarrassing.

I learned that the shame aspect of dementia comes from the majority of people being uninformed about what it is, or how it manifests in elderly people. Since we try to hide our aging population in the US, people don’t get the chance to understand dementia, but in Japan there’s no shame aspect of dementia and aging because their elderly are still acknowledged as members of society.

Is there anything else that you’d like to share?

I want to encourage other students to apply for opportunities like this. If they see like a global health learning opportunity come up in an email, open it up and actually read through it, because you never know what you might be able to get out of it! This program really expanded my world view of aging, and healthcare in general and I am excited to see how it influences my perceptions of other related experiences in the future.

Tedra “Teddi” Hamel is an Accelerated Bachelor’s in Nursing Science student and the de Tornyay Center’s 2022-2023 Myrene C. McAninch Undergraduate Scholar. Her project is “Understanding Age-related Psychological Changes: A Secondary Data Analysis”. Her faculty mentor is Dr. Basia Belza.

Why did you choose nursing?

Coming from a background in outdoor education, I am used to working with a group of ten students for four or eight weeks. It’s a life changing experience for those students, but it’s a small population to work with. I wanted my next profession to be more accessible to more people. I hope to work in the ER at some point. The ER is a place where you serve anyone and everyone –people don’t have to be healthy enough to go on a backpacking trip. So it’s about giving my energy and resources to more people instead of just ten at a time.

What made you want to do research?

I come from a liberal arts background. My BA was in history and I had to do a thesis for graduation. I did a full year of research during my senior year of undergrad. I feel like doing research helps you delve into the issues of a field in a way that you might not fully get if you’re just working.

Could you briefly describe your project with the de Tornyay Center?

My project will be on the psychological changes that are self-identified in older adults, using the Engaging with Aging framework initially developed by Doris Carnevali.

The main framework of Engaging with Aging is identifying coping mechanisms and adaptations that older people are already using.

I’ll be analyzing the transcripts that have already been collected and looking for broad themes of psychological changes with the hope of identifying strategies and resources, that older adults already use themselves to get through those challenges and changes. Knowing these adaptations can be very helpful for those that work with older adults.

What sort of psychological changes are you looking for in the transcripts?

What I’ve seen is that a lot of it is changes in emotional feelings, or how emotions are expressed, or all of a sudden they’re feeling a lot of sadness or feeling less emotion. So, how their psychological understanding of themselves and their feelings change over time.

Why is this research important to do?

I like this project based on the fact that we’re hearing older adults’ voices on how they are experiencing aging, instead of just applying blanket techniques, or band-aids, or what we think is right.

I know the Engaging with Aging research is informing providers on good ways to support older folks in their own self-identified strengths and adaptations versus just applying something outside of them.

What interests you about healthy aging?

I was young when three of my four grandparents died, but my mom’s mom lived until 2019. She had dementia for the last seven years of her life, and seeing her go through that and seeing my mom support her was eye opening. Our society doesn’t have good solutions or good structures in place for everyone that has to go through aging. I think that sparked my care and passion for it.

Then, the last few years I’ve been working in rural health in Eastern Washington as a medical assistant and also an EMT, and there’s so many people in the older population that just don’t have the resources. It’s really hard to live out there, and so the EMS system is used a lot to support them. If they fall at home, they’ll call 911 and then the EMTs get sent out there to help them get up.

There’s only 12 beds in the local assisted living facility and there’s always a year long wait list. So people tough it out at home, even though that area receives up to four feet of snow every winter. It was a really interesting place to get introduced to aging at home because a rural place is a totally different ball game than the city. So I got curious about how we help folks age gracefully in our society.

What are your plans after graduation?

I do want to get ER experience here in the city. I want to be a flight nurse at some point in the future. That environment really suits my skill set but that would allow for a lot of other work too. I could see myself being a clinical nurse in my small community in eastern Washington. That position is a really cool combination of nursing skills. You set up flu vaccine clinics at the local assisted living centers, as well as being the nurse at the local urgent care, etc. You end up working with the whole population. But mostly I’m planning to graduate, and probably work in a hospital for a few years to get experience.

Dariga Tugan is an ABSN student and one of the de Tornyay Center’s 2022-2023 Healthy Aging Undergraduate Scholars. Her project is “A descriptive analysis of variability in exercise (VO2 Max) to address differences in physical function and alleviation of symptoms in older adults living with HIV”. Her faculty mentor is Dr. Allison Webel.

Why did you choose nursing?

I chose nursing because it’s an interesting blend of arts and sciences where you get to tailor your care to the patient’s needs. I wanted to master the art of spreading love during times of fear and uncertainty in people’s lives. Spreading joy, helping people heal, and understanding the human body with its interactions in medicine is beautiful to me.

What interested you about nursing research?

I absolutely love research. In my free time, I’d often print out articles from PubMed and just read through them. But the reason why I got interested in research was, unfortunately, health care is extremely racist. A lot of our research is catered to white males.

The way that our health care system works is the therapies, the medications, even the non-pharmacologic therapies are all based on research, which is primarily done on white males. So, entering the space where you can advocate for more diversity and bridge that huge lack of diversity in research, specifically with people of color, was a big interest to me.

What interested you about healthy aging?

I started off my nursing career in a nursing home around 2020. I became passionate about alleviating suffering for those during the final stages of their lives because oftentimes I was the last person that patients would see as they passed. The reason for this is our facility didn’t allow any visitors during the height of the pandemic, and I began to ask myself questions. How do I utilize my privilege of being the last person they see to ensure that they are suffering less? Is restricting access to seeing their family really benefiting or keeping older adults safe in the pandemic?

I would see how this nursing home specifically would charge patients fifteen thousand dollars a month for subpar care. I got really interested in brainstorming new ideas and solutions to address healthy aging and the gerontology populations. It was these ideas that drew me to join the honors route for the BSN program to better understand and create awareness around the need for quality nursing homes, especially for the people who can’t afford them.

Could you briefly describe your project?

It’s a descriptive analysis of variability and exercise to address differences in physical health, aka the VO2 max, in older adults living with HIV. VO2 Max is a measure of cardiovascular fitness and aerobic insurance based on the maximal oxygen consumption of individuals in a defined exercise protocol.

There’s a myriad of research surrounding VO2 Max in older adults, and it’s actually the strongest independent predictor of future life expectancy in both healthy and individuals with cardiorespiratory disease.

We have a lot of studies on VO2 Max and exercise in older adults, as well as exercise in older adults living with HIV, and VO2 Max and HIV specifically. But my study would be addressing the gaps in our knowledge. Specifically, the data will be surveyed using VO2 max at baseline and excelerometry at baseline between decades of people in their fifties, sixties, and seventies.

A lot of these studies also do not focus on older adults with HIV, so data that compares the age groups would be of utmost importance.

I did a literature review and there’s a call for action to have better definitions and studies on interventions that can improve physical function and VO2 Max in HIV-infected patients. I think that these data that I analyze can inform and empower older adults living with HIV to engage in strategies to improve their physical function.

What are your plans after graduation?

I plan on working in ICU, but I am dual enrolled in a post-bacc premed program right now, so I’m applying to medical school in October. I love pharmacology and pathophysiology. I think that becoming an ICU nurse and then going to medical school will allow me to study more pathophysiology, but also bring an interesting nursing perspective, which is holistic.

Is there anything else you want to share?

I’m an immigrant from Almaty, Kazakhstan, and not many people know what Kazakhstan is. But it is the ninth biggest country in the world. It was a part of the Soviet Union, so they speak Russian there. It has a huge Russian culture. A lot of the background is also Muslim. So you have the Muslim culture, the Russian culture, and our own Kazak culture, which is a nomadic culture, which is beautiful because you have such an intersection of so many different personalities and viewpoints.

It’s allowed me to be diverse in my own thinking and the way I approach people and solutions. My own family is Christian. Balancing my relatives being Muslim and then my own Christian family, it’s all balanced like the yin and yang of life. I love being an immigrant, and I like being from Kazakhstan.

(Article correction: The original article mentioned a lack of women in research before 1976, which has been removed, as there were clinical trials before that date which included women).

Michael Drake is a 4th year BSN student, and the recipient of the 2021 Queen Silvia Nursing Award, hosted by the Queen of Sweden. Drake’s idea for the award is a platform that allows patients and their caregivers to easily share information with medical providers. His areas of interest include acute care, palliative care, end of life care

Why did you choose nursing?

Years ago, my mother was diagnosed with a terminal illness. I quit my job and school to be their full-time end-of-life caregiver, up until her passing in March of 2018. After she passed away, I felt that I could not go back to what I was doing before. I love nursing and was inspired by our hospice nurses, so I decided then and there that I would become a nurse. It’s one of the best decisions I have ever made.

What has been an unforgettable experience during your time at the school of nursing?

In spring quarter, I needed to care for my partner’s grandfather, who was going through their own end-of-life, which required me to travel to a small town in Colorado. This meant that I’d be missing some of my clinical days and hours, so I was concerned that my teachers wouldn’t be understanding. That wasn’t the case at all – two of my clinical teachers, Gaylene Altman and Amy Walker, were extremely supportive and gave me the flexibility I needed to care for my partner’s grandfather. Amy Walker went one step further and mentored me throughout that experience – completely of her own volition. The support I received has been the highlight of my time at UW.

How has your experience with the school of nursing helped with your career trajectory?

Well, I’m a high school dropout – I really struggled through school for a long, long time. So, even though I got good grades in my pre-reqs at Bellevue College, I really didn’t think I would get into a place like UW. It means a lot to me that I got into the School of Nursing at UW. Being educated by leaders in the field, having experiences, especially clinical experiences, I would not have had at other nursing schools has made me a more well-rounded student and nurse.

Could you briefly describe your idea for the award you received?

The idea I submitted for the Queen Silvia Nursing Award is a platform for caregivers of patients to store and share important information for their care. For example, if you are a family caregiver of someone with dementia and you are working with an organization that sends certified nursing assistants (CNA) or respite caregivers, you can share information through this technology platform to let the new caregivers or CNAs know who the patient is, what they like, what they dislike, what medications they are on, what to do in an emergency, how to navigate the house, and how to accommodate language and communication preferences.

If you are a physician and you’re receiving a patient who has autism, a caregiver or family member can use this service to send a QR code so that the provider can see what they need to know prior to their first visit. Does the patient have sensory issues? Does the patient need earmuffs or dimmer lighting because of sensory needs? What’s the best way to communicate to the patient? Is the patient verbal or selectively mute? All of this information is important, and sometimes is requested and recorded by a medical assistant or the front desk, usually before the first meeting with the provider.  However, it can take a lot of time and relies upon the patient or family caregiver to verbally report the information.  The platform I’m working on gives patients and their caregivers access and ability to edit this information and share it safely to anyone who needs it.

Patients do a lot of the stuff my idea wants to do already, but they do it with a pen and paper, or they print out their information and put it in the folder. When I was taking care of my mother, I kept all of her medications in an excel spreadsheet, and I would just share it with people who were coming in. Often they didn’t know how to use excel so that was difficult. So, my idea is to make information sharing for patients easier by being accessible and easy to use, especially because a lot of healthcare information systems are not any of those things.

Where are you at with this idea?

It is in the customer research and discovery phase. I just got done with the University of Washington’s CoMotion’s I-Corps program. I got to interview many, many different people, which was a lot of fun. I’ve got a wide variety of perspectives on this problem I’m trying to solve with QRx. Currently, I have a design prototype that demonstrates how it will work, but the systems behind it and all that stuff is going to have to wait until after I graduate.

What have you been hearing in the interviews?

That the problems people experience in our healthcare system with care coordination and transition management are a huge issue. For example, I talked to a healthcare worker at a local clinic. They’re a specialist who had a patient come in with a problem that originally happened in another hospital, which required them to get an MRI scan. The patient got the MRI scans either at that hospital or another organization, probably a small diagnostic clinic, so the specialist couldn’t see them easily. In a perfect world, you would call in to the clinic and say, “Hey! I have patient ‘so-and-so’; could you please send me those MRI scans? The patient wants you to share it”, and they send it over.  However, it isn’t that easy, and even if they decide to send the MRIs it can still take weeks to receive them. Often patients can’t wait a week because they have a serious health issue, so instead the specialist will just order another MRI. This is totally unnecessary, and the patient pays for that, or if that patient is on Medicare or Medicaid, then we all pay for it. Also, for some procedures like X-rays, they and others get exposed to radiation unnecessarily.  So, talking to that specialist and other providers, they wish they had a way for patients to share that information easily.

I had one interview with a person who was a patient that saw lots of physicians.  They talked about how they have to bring medications to physicians’ appointments, who often spend lots of time struggling to reconcile it all.  The patient told me of a time it took three hours for a new provider to go through all their medications and past medical history. Let’s say they had a list or a program or solution to help facilitate that process, like the one I’m proposing – that would have made the patient and the physician’s experience a lot better.

What interests you about healthy aging?

I think the value of a society is in how it treats the most vulnerable. Older adults, especially older adults of color or from marginalized backgrounds, are not treated very well in the United States. This is the case for all people with dementia, but especially African Americans with dementia – they are not given the attention or the care that they deserve. I think that is awful and unacceptable, and I personally feel that it is important to work with groups of patients and populations that need that attention, that compassion, and someone to be there for them when it’s difficult, to advocate for their needs. That’s why I like working with older populations; at least in the United States, these patient populations are not a priority for our culture, and as a nurse it’s a priority for me. That’s the reason why I want to work in palliative care. Palliative does work with lots of people with dementia, and you generally work with older adults going through a serious illness.

What are your plans after graduation?

I’ve had a great education at the University of Washington, but I am a nursing student in the pandemic, so that has definitely affected my educational opportunities. So I am trying to get a nursing residency for after graduation in something that will expose me to lots of different experiences and give me a well-rounded education on how to provide care. I’m looking for something in acute care or emergency care, and after a few years, I want to move into palliative care. In palliative, it helps if you have acute care experience in intensive or emergency departments. So I’m aiming for both of those with the eventual goal of moving into gerontological palliative care.

Is there anything else you want to share?

If anyone comes from an engineering, technical, or user experience design background in medicine that’s interested in solving these problems, definitely contact me! I’d love to talk to people who are passionate about solving the types of issues my idea is trying to solve!

Meaghan Oakes is one of the de Tornyay Center for Healthy Aging’s 2021-2022 Healthy Aging Doctoral Scholars. Oakes’ de Tornyay Center project is “Improving Advance Care Planning within the Geriatrics Department at Confluence Health”, and her faculty mentor is Dr. Katie Kemble.

What are your areas of interest?

My areas of interest are family practice and health across the lifespan. I like the idea of watching patients grow, whether they’re elderly and grow into old age or they’re young and grow to become teenagers. I am looking forward to having a patient panel that I get to know well and helping them meet their health goals.

Why did you choose nursing?

I was always interested in medicine, and nursing seemed like a natural path for me. I love the holistic aspect to patient care. And I wanted to go back to school to become a nurse practitioner because I wanted to have more autonomy and be able to provide broader care to patients.

What’s been an unforgettable experience during your time at the school of nursing?

Our rural health rotation. I’ve had one with Confluence but also had great rural health experiences elsewhere. I enjoyed getting to know the communities I was in and providing care to whole families in areas that may not have the same amount of resources.

How has your experience at the school of nursing helped you with your career trajectory?

UW is a great DNP program that’s not only helped me to become a family nurse practitioner, which was my goal. They also help prepare you for leadership and making changes at an individual and systems level.

What interests you about healthy aging?

As a family nurse practitioner, I’m interested in caring for patients throughout the lifespan, though I do enjoy working with the geriatric population. What’s exciting about caring for an aging population is being able to support them in meeting their healthcare goals, because usually they have pretty concrete ideas of what they want to do with their lives and how they want to age. It’s great to help them do that.

Could you briefly describe your project with the de Tornyay Center?

The purpose of my project was to improve advanced care planning with Confluence Health. With the help of my agency contacts, I ended up implementing a pilot program to improve their advanced care planning [ACP] for geriatric patients within the palliative care department.

That involved creating and implementing a workflow process so that everyone from the receptionist to the medical assistant to the provider served as a touch point for advanced care planning. The goal is for the patients to understand what an advanced directive is, feel comfortable thinking about what they want for their health care in the event that they can’t speak for themselves, and to have resources to navigate completing those documents. This process can be overwhelming and confusing.

What does the workflow process you created look like?

I created a process map. The workflow process was divided by role, but then from top to bottom, it was organized from when the patient arrived to an appointment onward, including the receptionist calling them before they even had the appointment. So thinking about the whole patient experience, trying to find different touch points for advanced care planning. Within that workflow map, there was a referral process so that patients could have more time with the ACP team to talk and work through that paperwork and get to know a little bit more about what advanced care planning is.

How does that differ from what they had before?

Most of it was provider-driven so there wasn’t a standard workflow. The department I worked in was palliative care. They’re really interested in advance care planning. That’s an important part of what they do. Being able to work with people that were interested in this project was helpful because I got great feedback and because it can be difficult in a short period of time to implement a pilot program.

What interested you about this project in particular?

Advanced care planning is not something that we talk about very often. I think we’re all hesitant to think about death and dying. Advanced care planning can serve as an empowering way for patients to have control over their health and to communicate their healthcare wishes to their healthcare team, so we know what they want for their health.

I worked in an emergency department as a nurse before, and I have seen the impact that not having an advanced directive can have. Patients will arrive to the ER and you don’t know what their wishes are. So you do the best you can, but that doesn’t necessarily mean that’s what they wanted.

Why is this project important to do?

I think it’s important because a lot of times even providers and healthcare workers don’t know how to approach the topic. There’s a lot of fear around talking to patients about this, not wanting to upset the patient or they don’t feel like they have enough knowledge around the topic to appropriately address it. Time is also a big barrier. Every adult should have an advanced care directive, and we are all far from that. It’s a pretty big problem that isn’t often addressed in healthcare.

Was there anything that surprised you are working on this project?

There are always some unforeseen barriers, COVID being one of them. It can take a lot of time and flexibility to implement any change, but I was pleasantly surprised with how passionate the department that I worked with was about this project. In school, they prepare us that change is hard and it takes time, which is all true, but it was great to have amazing agency contacts and team members who were willing to take my suggestions and run with them.

What are your plans after graduation?

Ideally, finding a family practice to work in, but keeping my options open and see where I land.

Lia Kaluna is the de Tornyay Center for Healthy Aging’s 2021-2022 Germaine Krysan Undergraduate Scholar. A fourth year BSN student, her project is Identifying Key Landmarks of Central District’s Historically Black Neighborhoods. The project is a part of the Seattle SHARP study. SHARP Portland was originally developed by Raina Croff, PhD, an anthropologist at Oregon Health State University. A local team is now developing SHARP Seattle based on the findings from Dr. Croff and her team. Kaluna’s faculty mentor is Dr. Basia Belza.

Why did you choose nursing?

Originally, I chose nursing because I wanted to support and promote the wellbeing of people in vulnerable states. That transitioned to promoting their health holistically, by looking at more than physical health, like people’s mental health, spiritual health, and social environments. I love nursing because it allows me to encourage and empower patients to care for themselves as best as they can.

I also really like the diversity of the field. You can transition to different areas of care, like research, community health, and critical care. Those are all things that I could do over my entire career and still feel like I’m contributing meaningfully to healthcare overall.

How has your experience at the school of nursing helped with your career trajectory?

The School of Nursing provides students with really good connections. I joined the VALOR (Veterans Affairs Learning Opportunity Residency) program at the Seattle VA because of it, and that was a connection to support an underserved population.

Also, the School of Nursing is focusing a lot on teaching community health and ambulatory care, so preventative care and the outpatient setting. All my healthcare experience before starting nursing school was inpatient. We will always need inpatient care but it’s crucial to meet patients before problems manifest and use preventive care to promote health. UWSoN has given me a greater perspective on holistic, lifelong care, rather than just acute inpatient.

What are you plans after graduations?

There are two different tracks on my mind right now. One is the critical care route straight out of undergrad and then pursuing further education to become a nurse anesthetist. I also have an interest in community-based care, working with Pasifika community members in promoting their health. As kanaka maoli (Native Hawaiian), I feel an obligation to supporting and serving my Pacific Islander (PI) communities. I intend to return to Hawai’i where I can serve and commune with fellow kānaka and work in a community health clinic for kānaka.

What is the research project you’re working on with Ola Pasifika?

Ola Pasifika is a Pasifika led research lab at the UW School of Social Work. Ola Pasifika has partnered with several WA based Pacific Islander community organizations, such as the Pacific Islander Community Association of Washington (PICA WA), an organization that serves the health and social needs of Pasifika people statewide. With PICA WA, our principle investigators are collaborating with the PI community to create a community health model, which aligns with my aspiration to work in community health with Pasifika people.

With Ola Pasifika, I’m analyzing focus group interviews our lab conducted in collaboration with PICA WA. The focus groups documented the health and economic experiences of different Pasifika communities, like the Marshallese, Tongan, and Samoan communities. Our researchers are looking at what the community believes would benefit their health and economic wellness during the pandemic, as well as how COVID has affected their resilience and health through access to welfare, education, development of community resources, and Pasifika networks of support. For example, with COVID-19 social distance policies, it’s much harder for these Pasifika communities to gather socially, like in church and other community gatherings, as a form of resilience. Social gatherings are prominent places to share information and life experiences, engage in cultural practices, and maintain kinship, which is protective of mental and spiritual wellness.

How did you first get involved with that work?

Ola Pasifika posted an application on Instagram. I applied to work with them because I am committed to revitalizing my culture and engaging in PI community spaces. I wanted to socially engage with other PI community members and give back to my community. I’ve attended cultural clubs at UW for community and social interaction, but Ola Pasifika gave me an opportunity to engage in research that serves the greater PI community. Western-supported research often does not comprehensively capture the experiences of these communities, especially queer and transgender Pacific Islanders (QTPI), which contributes to an overall lack of health interventions that are for and informed by them. Ola Pasifika intends to use the knowledge of QTPI community informants to develop culturally-relevant interventions to promote health.

I grew up in Seattle and I’m mixed identity. So, while I am kanaka, I haven’t always been able to participate in my community as much as I wanted to. I am working through understanding the complexity of my identities while building community. Ola Pasifika provides a unique opportunity for me to learn about and invest in my communities and become more aligned with our collective values. Revitalizing my culture and contributing to my community’s resilience are lifelong commitments I hold gratefully and fiercely.

How did you first get involved with the SHARP [Sharing History through Active Reminiscence and Photo-Imagery] study?

I applied for the UW nursing honors program and was given a list of potential projects to join and support. I was interested in SHARP Seattle, because it is an opportunity for me to collaborate with local Black communities and support a culturally celebratory and community-informed project. As a person of color, I also have an ethical responsibility to invest in anti-oppressive work that supports the BIPoC community at large. My positions of privilege incentivize me to engage further and enter spaces humbly. I must support BIPoC communities and our collective demands for equity and social justice.

Why is are projects like SHARP important?

SHARP Seattle intends to promote the cognitive health of local older Black adults. SHARP addresses the need to create programs for and informed by Black communities, because there’s a lack in Western research. I’ve learned that older Black adults are at higher risk for Alzheimer’s and other dementia related illnesses due to various systemic barriers and social determinants of health, signaling a need for relevant health promotive interventions.

The project focuses on the Central District because it homes historically Black communities. However, due to gentrification, many Black community members have been displaced and the neighborhoods’ dynamics have changed drastically. This poses a problem for older Black adults who then lack tight-knit community and socialization, factors that promote successful aging in place. It promotes cognitive health to be embedded communities where we have a sense of belonging and history and can maintain meaningful social engagement as we age.

SHARP is creating walking routes that can prompt discussion around landmarks that are identified as significant to historically Black Central District neighborhoods. The routes prompt reminiscence, socialization, and exercise, and promote cognitive, social, and physical health.

In my coursework, when we talk about gerontology it tends to be from a White perspective, so having this opportunity is unique. It makes me look at gerontology in a different way. I know that there are many different disparities that older adults face, but I hadn’t explicitly considered aging in my view of intersectionality until I began working on this project. It’s a new perspective.

What’s been an unforgettable experience during your time at the school of nursing?

My community health clinical was an unforgettable experience at the school of nursing. It was my first nursing clinical, and my group partnered with the University District Children’s Center (UDCC) to work on a community-based participatory research (CBPR) project. It was the first time I was introduced to a CBPR model, which I use in my research with Ola Pasifika and SHARP, so it was unknowingly critical to a lot of the work I’m doing now. It’s encouraging to build my skills and make connections between my work throughout my undergraduate career.

Learning about community-based participatory research expanded my view of research and emphasized the importance of partnering with the community to support their ideas and goals in health and wellness. I had a limited understanding of what research could be before this clinical, so engaging in this clinical widened my perspective. I was also interested in understanding how to promote a community’s health rather than an individual patient and understanding the dynamics and challenges in that work.

The UDCC was particularly fun to work with because we got to hang out with kids after about a year being in the pandemic. We weren’t back to being fully in-person, but my clinical group got to visit the site a few times and that uplifted my mood and was really exciting. I’m so grateful to have been able to do some of our community health clinical in-person and work with this community site.

Claire Kane is the de Tornyay Center for Healthy Aging’s 2021-2022 Myrene C. McAninch Undergraduate Scholar. Kane’s areas of interest are nurse-midwifery, women veterans, perinatal substance use disorder. Her de Tornyay Center project is, “Exploring Women Veteran’s Experiences of Substance Use Disorder Treatment in the Puget Sound Veterans Affairs Healthcare System: A Mixed Methods Approach”, and her faculty mentor is Dr. Ira Kantrowitz-Gordon.

Why did you choose nursing?

My background is in perinatal substance use disorder treatment, so the treatment of pregnant and postpartum folks who have substance use disorders or addictions. I saw how the nursing model of care can provide holistic and comprehensive care to that population, which not only needs outstanding clinical and medical care, but also needs an array of social services and advocacy. I felt like nursing and particularly nurse-midwifery would prepare me well to work with those populations and provide the holistic type of care that they need.

What’s been an unforgettable experience during your time at the school of nursing?

This is the first quarter that we were in the hospital. We had two days a week where we’re on medical-surgery floors at Harborview or Virginia Mason or other hospitals. It’s been really valuable to apply skills that we learned in the classroom to the in-person care of patients, and learning collaboratively with my classmates in small groups. We debrief each day and talk through our cases. It’s been awesome to learn from each other and also have each other’s support in learning how to provide in-person care.

How has your experience at the school of nursing helped you with your career trajectory?

I was interested in the de Tornyay Center scholarship and working with the center. Being in the nursing program afforded me that opportunity. I am hoping that my involvement with this program and the center will help provide me a little bit more knowledge and experience with women identified veterans that I can then use to inform my future practice.

Could you briefly describe your project with the de Tornyay Center?

I am working with researchers at the VA to explore women veterans’ experiences accessing substance use disorder treatment through the VA.

Women fare significantly worse than men when using web-based alcohol interventions. These findings in the civilian population are mirrored among US veterans, as evidenced by women veterans experiencing worse outcomes compared to their male counterparts after the completion of the VA’s web-based alcohol intervention, VetChange. Research is needed to inform changes to VetChange that could improve outcomes for women veterans. So, we are designing a study protocol to collect data from women veterans with alcohol use disorder and clinicians treating women veterans with alcohol use disorder about their opinions of the current VetChange program. The protocol explores the ways in which the web-based intervention can improve recovery-related coping behaviors in order to adequately address women veterans’ alcohol use disorder.

How did you first get involved with the project?

I was interested in this topic and saw that there were research funds available. I contacted my mentor, Ira, and asked if he’d be willing to support me. Then, I connected with a researcher at the VA, who has focused a lot of her work on women veterans’ substance use disorder treatment and gave me the opportunity to assist with this project

What interested you about working with women who are veterans?

I mentioned my background is in perinatal substance use disorder treatment. I became increasingly interested in the growing rates of substance use disorders among women identified veterans. Veterans from the Iraq and Afghanistan conflicts are now seeking care from VA facilities and we have more women veterans than we ever have before. I was interested in whether or not the VA system at large was meeting these patients’ needs, because it originally was not designed to provide women focused care.

Why is this research and project important to do?

Women are the fastest growing segment of the US military. We do have data from the VA showing that more and more of them are accessing substance use disorder treatment. And we have studies among the general population that show gender-specific substance use disorder treatment improves outcomes and is valued by patients. So it’s important to assess whether or not gender-specific care is also valued by women veterans and whether or not it plays a role in improving their outcomes.

Another thing is that there are very few VA facilities throughout the country that offer gender-specific care. So we need more research to understand women veterans’ feelings and their experiences with it to inform whether or not more substance use disorder treatment interventions should include it.

Why might gender-specific care be helpful over general care?

There are a variety of reasons, one being that some women tend to feel safer in those environments, both in-person and virtually. Also if you’re having a women only or a gender-specific group, you can cater the content a little more. The facilitators can design modules around topics that may be more relevant. Sexual harassment is a prevalent issue in the military and we know it’s disproportionately experienced by women compared to men in the military, although it affects men as well. So, for example, some gender-specific women VA programs do incorporate content around trauma, sexual harassment, and coping when that might be a factor that’s affecting your substance use. There also might be content on motherhood or other reproductive health topics.

What interests you about healthy aging?

I am especially interested in the perspectives of older adult women veterans who have participated in VetChange, because we know that this population tends to experience more difficulties accessing online treatment interventions.

Beyond that I’m also interested in how age effects women’s experiences seeking care and whether or not they feel like their individual needs associated with their stage of life are being met with the services available to them. We know that veterans and folks with substance use disorders tend to have higher morbidity and mortality rates. Ensuring that they have access to treatment that meets their needs promotes healthy aging.

What are your plans after graduation?

I’m in the ABSN to Doctor of Nursing Practice, Nurse-Midwifery program. I’m hoping to work as an RN during at least the first year of the DNP. Then long term I plan to work as a nurse-midwife. I would love to provide care to veterans who need those services. I think the cool thing about midwifery is that you not only provide perinatal and postpartum care, but you can also be somebody’s primary care provider, so I could see patients across the lifespan.

France Chu is one of the de Tornyay Center for Healthy Aging’s 2021-2022 Healthy Aging Doctoral Scholars. A PhD in Nursing Science Student, Chu’s areas of interest are technology for older adults and implementation science, as well as health literacy and information management. Her de Tornyay Center project is “Implementing Task Sharing of Tele-mental Interventions in Primary Care”, and her mentors are Drs. Oleg Zaslavsky, Erin Abu-Rish Blakeney, and Brenna Renn (University of Nevada).

Why did you choose to go into nursing?

You go into nursing because you want to help people. You want to have some impact on improving people’s lives and quality of live. That’s why I went into nursing. Also, my whole family is in the field. My mother is a nurse, my sister is a nurse, and my brothers are all physicians.

What’s an unforgettable experience you’ve had during your time at UW?

My PhD cohort. We try to support each other and whenever we get together and do projects together, we try to make sure that everybody is successful.

How has your experience at the School of Nursing influenced your career trajectory?

I’m a medical librarian and started working again at a large health system. Having the nursing background and now getting my PhD has made me more credible and more comfortable with talking to physicians, nurses and researchers, because now I understand the research experience.

How did you  start working as a medical librarian?

By accident. I was interested in informatics back in the 90s. I couldn’t find any sort of nursing school or even health sciences program that talked about informatics. So somebody suggested I try a library information science program and I did. When I got out, informatics was still not that big and my advisor said well, you can become a medical librarian. Then I just fell into academic medical librarianship, supporting medical and health sciences schools of all types.

What made you decide to come back for a PhD in Nursing Science?

I’ve always had that idea in my head that I needed to do my terminal degree. I didn’t know whether I wanted to go do a PhD in Information Science or a PhD in Nursing Science. It seemed like my questions were still so patient care focused and less about the information science side of things. So nursing had a better fit.

Had you done research before your PhD in Nursing Science?

As librarians we do quality improvement. I wondered if we were really capturing what we wanted to capture. Did we ask the right question and get the data in the best manner? Earning a PhD helped me think more comprehensively about designing any sort of project, either quality improvement or research.

Could you briefly describe your de Tornyay Center Project?

Originally the plan was to investigate a technology-enhanced psychotherapy, that you would use in primary care to manage mild depression in older adults. Then, the pandemic happened so we had to flip quickly to more of a broader intervention looking at tele-mental health with the strategy of task sharing. The team would share the task of mental health services. Certain components would be done by a person who is not specially trained. So either a medical assistant or the nurse would do a little bit of brief psycho-therapy. And if they see that it’s not getting better, they would advance it up to the primary care provider and then to the specialist.

We did a survey and then we did interviews with the survey participants who agreed to be interviewed. We’re going to see how the primary care providers and mental health specialists feel about task sharing these technology-enhanced mental health interventions. Specifically looking at synchronous technology, like telehealth using video conferencing tools, text messaging, chat services, tele-monitoring using wearables like a Fitbit or Apple watches. We did ask about asynchronous things, such as the patient portals, and we talked a little bit about emails.

What interested you about this research project?

The implementation science aspect of it. I was interested in learning more about what implementation science is and what you study. One of the strategies is task sharing and that’s an implementation strategy that’s often used in low and middle income countries. It’s used in high income countries, but not really called out. I wanted to see, are people aware of what it is, and do they like it. Especially since a lot of medical assistants, as they do this, can creep into the primary care providers scope or into the mental health specialists’ scope, so there’s that issue of scope creep.

Why is this research important to do?

The studies have shown that mental health can be done in primary care, but as a previous primary care provider, I never did it because it seems like it takes too much time. Also, I wasn’t comfortable doing it. I think that this research would help inform the primary care providers, you can do this and you can share the tasks among your team.

It can help improve depressive symptoms in older adults. They tend not to want to see the psychologist. They just want to see their primary care providers. So I think it’ll have an impact on patients who are mildly depressed, especially older adults.

What interests you about healthy aging?

We’re all getting older. As a middle-aged person, I want to see studies that could help me and my family and friends age in a healthy way. I’m seeing it in my parents. My parents are both frail and one of them has a dementia diagnosis and I’ve seen them not age healthily. I’m trying to think about ways to intervene with them now, so that they can have a good quality of life. Some way to make their last few years more comfortable for them.

What are your plans after graduation?

I have a medical library position working at a large health system. With this position and with my degree I’m probably going to be outreaching to the nursing department. They have a large nursing research institute that I’m hoping to get involved in and hopefully start working with them on implementation science. Also, maybe get involved in and start some research myself.

Is there anything else you would like to share?

I’m trying to encourage more nurses to go into implementation science research. If anybody’s interested, I’m happy to talk about it.

Dr. Hyejin Kim is a post-doctoral scholar with the School of Nursing. She is working with Dr. Azita Emami and researchers at the Karolinska Insitute in Sweden to study stress and music therapy in people with dementia and their caregivers. 

Why did you choose nursing?

There was no question. I always wanted to make a difference as a nurse. I worked as a nurse in South Korea in the neurology and organ transplantation units. I was responsible for making the patients feel safe. When my patients told me thank you for saving my life, it was an incredibly rewarding feeling. That isn’t found in every career.

After working as a nurse, why did you want to move into research?

When I was an undergraduate student, I remember one day in a clinical class my professor asked me, do you know why ICU patients should be repositioned every two hours? I had never thought about it. She explained that nursing is science and nursing practice is based on evidence. That was my a-hah moment. When I was a nurse, I realized that what I really wanted was to contribute to nursing science. So I pursued a master’s degree and came to the United States.

What interests you about healthy aging?                                           

I love older adults. People in the world are living longer than ever before. Healthy aging ensures independence and productivity as we age. As people age, they often experience stigma and discrimination related to growing older. But I don’t think old age means the end of the road. I’ve seen that older adults who are staying physically, mentally, and socially active are more likely to think positively and recover from illness more quickly than those who are not.

Did you have any previous experience working with older adults before going into research?

During my time as a master’s student in South Korea, I was involved in aging research projects within my previous mentors’ funded grants, such as fall prevention and physical activity. By serving as a research assistant and project manager, I became increasingly interested in late life cognitive impairment. My ultimate plan is to develop effective biobehavioral interventions for people at increased risk of Alzheimer’s disease.

Could you talk a little more about the project with Dean Emami and your role in it?

The ultimate goal of the study is to reduce the levels of stress among persons with dementia and their caregivers by giving them effective music therapy. We collected saliva samples as non-invasive biomarkers of stress before and after the music intervention. This project is conducted in Sweden and I am working closely with a multidisciplinary research team. As a post-doctoral fellow, my primary responsibility is to analyze data and disseminate the research findings. We hope that our music intervention would help improve the quality of life for persons with dementia and their family caregivers living at home.

Why is this project important?

It is important to reduce the levels of stress among people with dementia and their caregivers because the high levels of stress could affect both physical and mental health, and ultimately, the quality of life.

What interested you about this project?

Before joining the University of Washington, my research has focused on people with mild cognitive impairment (MCI) and people who are cognitively intact, but experiencing subjective cognitive decline. I didn’t have any experience in intervention studies. This study was interesting to me because interventions are important for people with dementia. I wanted to expand my knowledge and skills in the area of dementia research.

What was the focus of your dissertation?

I was interested in individuals’ thoughts and feelings about their health conditions, their so-called illness perceptions, and how their illness perceptions influence self-management behaviors such as physical activity and medication adherence. I examined two conditions, type 2 diabetes and mild cognitive impairment as common physical and mental disorders.

Interestingly, persons with mild cognitive impairment were less likely to view their disease as chronic and controllable compared to those with type 2 diabetes. They felt they had a lower understanding of their health condition compared to people with type 2 diabetes.

How would hope that this research would be used?

I think nurses and other health care providers who are counseling people with late life conditions, they should consider patients illness perceptions when discussing self-management behaviors for health promotion. The next step would be, how can we change their illness perceptions to improve self-management behaviors.

You also competed a study on brain scans for individuals with mild cognitive impairment, what did you find?

In that paper, we explored factors influencing decisions to pursue a brain scan among persons with MCI, mild cognitive impairment, and their care partners, family caregivers. We wanted to know how they felt about scheduling a brain scan. Participants were likely to focus on the benefits of learning their brain status rather than possible drawbacks or limitations of doing so. It’s interesting because right now, there’s no treatment or cure for cognitive impairment, but people with MCI really wanted to know their brain status. The majority of participants described that by learning their amyloid scan results, they can get more information about their brain status and they can plan ahead.

Sarah McKiddy is a first year PhD in Nursing Science student and the de Tornyay Center’s 2021 pre-doctoral scholar. Her faculty mentor is Basia Belza. Her research interests include neurocognitive disorders, healthy equity, and building the evidence to support music as a therapeutic intervention.

Why did you choose nursing?

Through a culmination of my mom’s cancer treatment years ago and the quest for more engagement with my community, I viewed nursing as a field with opportunities to continually self-reflect and evolve from patients, colleagues, and daily experiences. Nursing has an increasingly diverse role and scope. I also considered it to be quite daunting, especially coming from a musical background, but equally fulfilling.

Through my mom’s experiences, I know the profound impact nurses can have on a person’s basic comfort, needs, and outlook. I held this sentiment close to my heart in my decision to pursue nursing.

Was there anything that made you decide to make the transition to nursing?

I taught violin lessons in a variety of settings, from private lessons to youth orchestras to public school programs. I often noted disproportionate access to music education, like students not having a functional musical instrument or discontinuing music lessons due to transportation issues. I began to see a myriad of disparities and it was one of the reasons I reevaluated how I could help more as a teacher. I wanted to do more on an internal level with the people I met, which led to a field that would teach me the knowledge and skills to care for those in vulnerable settings or conditions.

How do you feel like your musical background connects with nursing?

Listening to and performing music was a retreat for me throughout my life, but I also found it to be a way to connect to others; it has cathartic, introspective, and healing qualities. Nursing also has these intimate and communicative elements.  I also did outreach as a violinist. I played my violin at hospitals, nursing homes, and assisted living facilities. Often, residents shared the extent to which the music transported them and, in doing so, comforted them.

How did you become interested in healthy aging specifically?

During my nursing studies, I was introduced to healthy aging and how it pertains to quality of life and preserving one’s dignity at all life stages. Healthy aging invites inclusive and positive dialogue on our shared aging experience.

Have you done any past work in healthy aging?

I started a chapter of the Youth Movement Against Alzheimer’s at my nursing program in Boise. I learned about the organization through attending the de Tornyay Center’s Ignite Aging Symposium last year. The movement’s mission is spreading awareness about Alzheimer’s and other dementias while engaging the youth in sharing information for this population.

Other nursing students joined, and we had the opportunity to work with the Alzheimer’s Association Greater Idaho Chapter, which was a remarkable glimpse into an organization committed to a community-driven vision and practice.

I learned more about dementia’s impact on care partners and family members, along with the scarcity of resources. It can be an overwhelming and complex experience for the entire family unit. I recognized there was a potential gap in support, but I did not realize the magnitude.

What made you realize you wanted to get involved in research?

The nursing process requires you to constantly inquire, assess, and examine the holistic picture of any patient. My desire to get involved in research strengthened throughout my courses and clinical experiences. I recognized a theme of patient advocacy and engagement with diverse and underrepresented populations in the nursing research literature and I wanted to distill my experiences into applied research.

I am grateful for the wonderful mentors who inspired and encouraged me to improve the outcomes of patient populations through critical thinking and self-led projects rooted in research methodologies. I saw nursing research as a pathway to rigorously examine and sift through what I was learning about, what I was seeing in the hospitals and community, and then try to identify ways to address gaps in care. Nursing research can serve as the antidote to apathy, stigmas, and inequalities in society through evidence, clinical implementation, and community involvement.

What were the projects you worked on in your undergraduate nursing program?

One of the first evidence-based projects I worked on was on music therapy and its effects on people living with dementia. Based on a literature review, my research group provided basic recommendations for implementing music therapy techniques into nursing practice.

I also worked on focus group questions for gathering student nurse feedback on incorporating telehealth into a curricular clinical setting. It was timely and significant to gain perspectives on telehealth from current students soon to enter the workforce. The project contributed to a telehealth program proposal for psychiatric mental health training in Idaho.

Alongside Dr. Renee Walters, I conducted a study on self-compassion, resilience, and professional quality of life with nursing students and faculty. Through collecting baseline data, we wanted to better understand the coping strategies for promoting longevity and optimal wellbeing in an ever-evolving work environment.

Do you have plans after graduation?

I hope to stay involved with community-based projects and contribute in a meaningful way to healthy aging initiatives.

Shumenghui Zhai is a third-year PhD in Nursing Science Student. She was awarded the 2021 Western Institute of Nursing Carol A. Lindeman Award for a New Researcher for her work, the first UW student or faculty to win the award since 2008. Her dissertation is about tech-enabled solutions for sleep research in children with chronic conditions and their caregivers. Hui’s dissertation faculty mentor is Teresa Ward.

What made you choose nursing?

Most of my family members are healthcare professionals. My grandma was one of the first female professors dedicated in the nursing education in China. I have sincere respect for nurses and other health care professionals. Listening to my family members’ stories, watching them practice, and feeling their passion for helping patients deeply influenced my career choice. For me, nursing is above and beyond a job, but also a belief and lifestyle. I want to contribute my knowledge and skill to help patients and their family caregivers, especially those underserved and underrepresented.

How has your experience with the school of nursing helped you with your career trajectory?

First of all, the faculty members and staff are incredibly resourceful, passionate, humble, and creative. They inspired and motivated me with their wonderful research mindset, solid and compressive knowledge and skills. Learning and working with them unlocked my passion and desire to be a good researcher in the future.

In addition, the school of nursing always provides us the platform for interdisciplinary researchers to share and talk their work and thoughts, stimulating more innovative ideas and possibilities to be boundless. I am lucky to be part of this inspiring community!

What’s been an unforgettable experience during your time here?

During my past three years studying here, I truly appreciate the student-centered environment in the school of nursing. I can feel students’ needs are the first priority here. Faculty members and staff are super supportive, positive, encouraging, and connecting with students. Whenever I need help or guidance, the faculty members or staff are always there to support, and work together with me to explore potential options and strategies. I felt fully respected and empowered.

I also appreciate how flexible the system is. It allows us to have sufficient time and space to explore what we really want to do for our research, and gives us incredible freedom to decide which topic, what skills we want to build for our career.

Could you briefly describe your project with Asian Counseling and Referral Services?

Asian American and Pacific Island (AAPI) older adults age 65 and older represent one of the fastest-growing populations in the U.S. and face a public health crisis: dementia. AAPIs are at high risk for under-detection of cognitive impairment and delayed diagnosis and suboptimal management of dementia. Yet, data on dementia and AAPIs are limited. Cultural appropriate intervention programs for AAPIs, especially its sub-groups, are missing. To better understand AAPI older adults and to develop future interventions, we explored the knowledge, perceptions, and beliefs of memory loss and dementia among older Korean, Samoan, Cambodian and Chinese ethnic groups using focus groups. We also examined culturally relevant facilitators and barriers to their participation in a brain health program. It has been a truly fantastic journey to collaborate with Asian Counseling and Referral Services. Every person there is amazing,and I am so grateful for receiving tremendous support from the de Tornyay Center.

Was there anything that surprised you while doing this project?

People often oversimplified AAPI as one group with the same characteristics. However, when we were doing this project, we realized how diverse the AAPI community is. AAPIs face unique challenges and struggle in silence. We were surprised to learn that most of our participants believed memory loss and dementia were a normal part of the aging process. We were also surprised by the overwhelmingly negative perception and the cultural stigma associated with memory loss and dementia among them.

Why is this work important?

The number of AAPI older adults is fast-growing and expecting to grow more than 350% (from 1.6 million to 7.6 million) in the next 50 years. Most older AAPIs do not report symptoms of dementia to a health care provider due to many barriers, like the limited English proficiency, inadequate knowledge about the risk factors of ADRD, and misconception and cultural stigma associated with dementia. We need to help: know their culture, raise their awareness, get them connected, support them with recourses and intervention, and improve their quality of life and reduce the burden of their caregivers.

How would you like to see this research and your findings used?

I hope this project can help or inspire other researchers in studying cross-culture population. Another hope is that the findings can help AAPI older adults get more attention and support. One of our ACRS collaborators, Dr. Gail Li, plans to develop and test a multidomain brain health intervention tailored to the AAPI population. Our findings can inform her team in creating a more culturally appropriate intervention for AAPI sub-groups. In addition, since our research population was multi-culture and multi-language (four ethnicities with four languages), we developed several standard operation protocols to keep each operation step consistent and ensure the data quality. These protocols could be adapted for many other studies.

What interests you about healthy aging?

During my first year PhD study, I had a fantastic opportunity to join a multidisciplinary team of senior students and faculty, where I engaged with a 90 plus -year-old nurse blogger, learned to conduct qualitative research, and co-authored a thematic analysis publication. Based on this experience, I became more interested in healthy aging, especially in the AAPI population. While reading the literature and conducting focus group discussions with older AAPIs, I realized how much they are struggling and how lonely they are. They are a group that has long been ignored. They need to be seen, and supported.

What are your plans after graduation?

I want to be a researcher and a teacher. I want to transfer what I’ve learned about research to the next generation of nursing scholars: start with love for people; be curious and boundless, ask more good questions, enjoy the research process, provide evidence from data, disseminate data to stimulate better work, and help more people.

Olga Yudich was one of the recipients of the de Tornyay Center’s 2021 Pathways to Healthy Aging Award and one of the de Tornyay Center’s Healthy Aging Scholars. A recent DNP graduate, her project was ‘ Improving Coordination of Care of Highly Complex Geriatric Patients in Primary Care’. Her faculty mentor was Hilaire Thompson.

Why did you choose nursing?

My mom was a nurse in Ukraine. Back in high school, I was going between business and the medical field, and she suggested I try nursing. I started working at a nursing home and fell in love with my residents. That job reassured me that nursing was for me.

What about that experience at the nursing home made you realize this was what you wanted to do?

Their stories. It was probably the hardest job I’ve ever had, but coming into work with my cup of tea and being able to sit down, have breakfast with them, and get to know them — they really did become my family. I learned so much.

Aside from taking care of them and helping them with their basic needs, I wanted to help them with social services and help them live a long healthy life by managing their health care as well.

What has been an unforgettable experience during your time at the school of nursing?

My clinical experiences have been amazing. I have met some incredible people. Despite COVID, it’s been amazing to watch everyone adapt and work together to help us get through school and support us.

How has your experience at the school of nursing helped with your career trajectory?

The faculty have done a good job helping us figure out what we’re most passionate about and giving us the freedom to pick and choose what we want to focus our research and papers on.

What interests you about healthy aging?

I enjoy the population. I think the complexity of their care is challenging but the most rewarding. The happiness you feel when you connect someone to social services they need or make a difference in their care, it’s the greatest thing. Helping them age at home should be a goal, especially with them living longer. I don’t think this can be done if we just focus on health needs and managing co-morbidities without assessing whether they can afford their food, whether they’re safe at home, whether they can get around and get physical activity. It goes back to independence and quality of life and ensuring they are able to age with dignity and independence.

Could you talk a little bit more about your project with the de Tornyay Center?

I partnered with County Doctor Community Health Centers in Seattle. They have two primary care clinics. I worked with them on creating a navigation tool, because there we found that there’s a knowledge deficit among the staff when it comes to connecting older adults to local social services. The tool that I created was aimed at mapping local care resources and partnering with these organizations.

Our healthcare system and our social care, they’re so fragmented and our healthcare system is complex in itself. We don’t really have a common platform, and it creates a problem when trying to take care of a person holistically. This tool helps the staff become more familiar with the resources in order to help older adults navigate social resources.

What does the navigation tool look like?

I decided to use SharePoint because I felt like it could be accessed easily throughout the normal workflow. I also liked how after I would be done with my project staff members could continue to edit and update the page. A binder would limit who could access it and could go out of date quickly. I thought the most important part of this tool was that it could be sustained and staff can keep it up to date long term.

How did you first get involved with the project?

We chose our top five topics for our DNP project, and this one seemed like the perfect fit. It had the population that I’m the most passionate about and I’ve learned how much the social determinants of health impact health outcomes. I’m very passionate about including that when I’m when I’m serving patients and making sure I’m aware of their needs. Assessing for those needs is so important, so it was the combination of the topics that stuck out to me when I was picking my project out.

Was there anything that surprised you while doing the project?

When I first started, I was a little overwhelmed because of how complex this is. The root of the problem is that we don’t have a common platform for social care and health care. But when I did the assessment and sent out the initial survey, I learned that there’s small things that can be done to improve system navigation. That included increasing awareness of social services and creating a tool like this for the staff.

Why is this project and work important?

We have a growing aging population. Older adults are living longer, and living longer with multiple co-morbidities. Often these co-morbidities require social services for adults that become weak at home and more frail. They may need help with nutrition or assistive devices or help with chores. Things to help them age in place, to be able to remain in their community and not have to have their independence taken away. Anything to keep them in their own space, I think, is important for quality of life.

Are there other similar collection of local resources?

The local organizations do a good job of having resources on their websites easily accessible. They have links and PDFs of things like food banks, places older adults can get meals, or senior centers. It’s a matter of connecting primary care, which was what my focus was on. I pulled from what’s already out there to create a more accessible tool so the staff wouldn’t have to go and look for things on the Internet.

What are your plans for after graduation?

I’m currently studying for the DNP certification exams and applying for jobs. Nothing set in stone, I’m just exploring what’s out there right now.

Claire Han was the de Tornyay Center’s 2020-2021 Germaine Krysan Doctoral Scholar. A recent DNP graduate, Han’s project was ‘Tailoring Chronic Disease Management Care Pathways to Older Adults and their Caregivers in Adults Family Homes’ and faculty mentors were Hilaire Thompson and Kristen Childress.

Why did you choose nursing?

When I was between five and eight years old, my mom had severe anemia, and went to the hospital multiples times in a year. Most of the time I followed her to her appointments. When I visited hospitals, the nurses and physicians were always kind to my mom and me. After three years of treatments, my mom fully recovered, and I thought that being a nurse or physician would be a good career where I could help sick people.

What has been an unforgettable experience during your time at the School of Nursing (can be general or specific)?

The School of Nursing provided great opportunities for interdisciplinary training. Interprofessional education sessions and guest speakers from different disciplines during the DNP courses were great experiences. Taking courses outside of the School of Nursing gave me an opportunity to work with students in different disciplines. I learned a lot from them by expanding my perspectives on how to do nursing research and provide patient care. Dr. Hilaire Thompson, the chair of my DNP project and mentor, always challenged me to think about the connection between nursing research and clinical application, by considering the feasibility, value and benefits of nursing research.

How has your experience at the School of Nursing helped you with your career trajectory?

The School of Nursing trained me well by providing experience in both clinical-based practice and clinical research during the DNP program, as well as intensive research trainings during my PhD program at UW.

The School of Nursing also provided great mentorship. I met great faculty mentors who are my role models in my career development. They provided insight into my future career as a primary care provider, nursing researcher and educator. They taught me professionalism, and trained me to be good scholar, a good person, a good team member as well as a patient advocate. Several nursing faculty at the UW have worked as a nurse clinicians, researchers and educators. Their roles gave me the motivation to pursue a DNP degree after completing my PhD degree.

What made you realize you wanted to do research?

When I started my job as an ICU nurse, I was not aware how closely research is associated with clinical practice. Later, when I joined an evidence-based practice nursing task force team, I realized that every clinician should know and utilize research for our clinical practice. That moment gave me a strong passion to pursue evidence-based practice in my career.

I have been working as a nurse for 8 years in ICU and in geriatric areas. Given my clinical background, I am interested in research to improve self-management of older adults with chronic diseases and their symptoms.

What interests you about healthy aging?

I am interested in maintaining dignity, self-care ability, and quality of life as we get older.

What is your healthy aging related project?

My project is to develop chronic management care pathways for home health aides and older adults in adult family homes. This care pathway is a simple step-by-step guide to managing heart failure, diabetes, and hypertension in adult family homes.

Has there been anything that’s surprised you while doing this project?

There are growing numbers of adult family homes, which are home-like environments for older adults. Eighty percent of older adults have at least one chronic disease in adult family homes. More than 80% of older adults in adult family homes rely on home health aides as unlicensed formal caregivers. Despite the demands of quality of care in older adults, I found that there was lack of education, guidelines, and resources for home health aides on managing chronic diseases in adult family homes. It is significant finding, and I am glad that I can bring up this issue through my DNP project and in-depth literature review.

What interested you about this project?

I was interested in developing practical tools, or care pathways, to guide caregivers, tailored to adult family home settings. In adult family homes, there are no nurses or nurse aides. The caregivers are not medically licensed. So, they need education and guidance in managing older adults’ chronic diseases, specifically in hypertension, diabetes and heart failure, the most common diseases among older adult residents in adult family homes.

Why is this work important?

With my project, my ultimate goal is to improve the quality of caregivers’ skills and knowledge in managing the chronic diseases of their older adult residents and improve their confidence in caring for residents by providing evidence-based practice. This project will contribute to community and public health in the geriatric population.

What are your plans after graduation?

With my DNP degree and as a primary care provider, I would like to work with older adults in long term care, skilled nursing facilities, home, and hospice care areas. Also, I would like to continue my DNP project to improve symptom management and self-care of their chronic diseases in older adults in adult family homes.

Susie Cho was the de Tornyay Center’s 2020 Myrene C. McAninch Doctoral Scholar. A PhD student, Cho’s project was ‘A Qualitative Thematic Analysis of the Facilitators and Barriers to Self-care Practices in Care Partners of People Living with Dementia’ and faculty mentor was Tatiana Sadak.

Why did you choose nursing?

I was fond of what my grandfather did as a physician and so I would always go into his clinic whenever I had a chance. I think my admiration for what my grandfather did as a healthcare provider led me to go into health care and more specifically, nursing.

What has been an unforgettable experience during your time at the school of nursing?

The most unforgettable experience would be my first year of the Ph.D. Program. It was exciting to meet students from different fields studying different things and even from different countries. We would often talk about our goals and the passion that led us to enter this program. One of the most outstanding commonalities we had was that we were all on the same boat going through a drastic change from being a clinician to becoming a researcher. It was encouraging to have those colleagues. The memories that I have from my first year of the program are especially unforgettable because we don’t get to see each other as often as we want these days.

What made you want to transition into research?

I was heavily trained as a clinician before I entered the Ph.D. program. I noticed that I was asking myself more theoretical questions, which required me to think more philosophically. I wasn’t able to answer those questions because I didn’t have the right tools or know how to approach scientific questions. For these reasons, I transitioned into research that allowed me to expand my knowledge to a broader field of nursing as well as in psychology, sociology, and other relevant areas.

What kinds of questions?

I’m interested in palliative care and integrating that into the patients’ care trajectory, especially in patients with advanced cancer. Some questions are around when does one realize one’s terminality, especially when making decisions related to palliative and end-of-life care? And what accounts for such differences between individuals and within the same person at different times of life?

Could you describe your project with the de Tornyay Center?

It is a secondary data analysis study developed as a part of a larger study on a tool called “Managing Your Own Wellness (MYOW).” MYOW is a comprehensive measurement tool that intends to capture care partners’ self-care behaviors of people living with dementia (PLWD). Some of the questions that they asked during the interview were: How is your self-care practice? How are you doing it? Is there anything that’s preventing you from doing it? Is there anything that facilitates it? I’m taking that part of the interview data and analyzing the themes that emerge from the data.

Has there been anything that’s surprised you while working on the project?

The most prominent thing that arose while immersing myself in the interview data was how the care partners perceived their own self-care practices. Interestingly, the caregiver’s self-care practices’ main focus was heavily dependent on the caregiving they provided. Contextualizing the caregiving situation was critical in understanding the caregiver’s self-care behavior. Some found themselves too accustomed to taking care of the care recipient to the point where it was confusing to talk about their self-care practices without separating themselves from caregiver responsibilities.

What interested you in this topic?

I think it was the focus on the care partners. I, as a clinician, had encountered multiple situations where I had to counsel the care partners who take care of a PLWD. As soon as I heard that it was a study that focuses on the care partners and how they take care of themselves, that interested me.

Why is this work important?

While being involved in this study, I realized how much the healthcare system relies on the care provided by nonprofessional caregivers, such as spouses and children of the PLWDs. Existing data also confirm that nonprofessional caregivers play a vital part in the well-being of the dementia population. I think that’s why shedding light on their responsibilities and what that entails is important for the community’s overall health.

What interests you about healthy aging?

I’ve been taking care of older adults throughout my professional nursing career. I have always enjoyed learning from their life experiences. Also, I have always wanted to interpret their stories to help them create an environment where they can enhance their well-being.

How has your experience at the school of nursing helped your career trajectory?

There are several opportunities to do hands-on research. One is doing independent studies and being involved in research studies conducted by faculty in the School of Nursing. We learn a lot by taking courses, but they’re less practical unless we apply them in an actual research environment. The opportunities have helped me learn more about: How do we collect data? How can I analyze this? What are the processes of publication? How do we work as a team? And a lot more.

What are your plans after graduation?

I envision myself in a position where I can do research and teach nursing students and assist them in becoming nursing scholars.

Liam Malpass was one of the recipients of the de Tornyay Center’s 2021 Pathways to Healthy Aging Award. A recent DNP graduate, his project was ‘ Improving Utilization of Telehealth among Clinicians Caring for Older Adults’. His faculty mentor was Gail Johnson.

Why did you choose nursing?

Nursing was a natural career path for me. I’ve always loved helping people and have been interested in science and health. My mother works in a hospital as an educator and so I grew up in the clinical environment. Ironically, when I was younger, I thought ‘I’m never going to go into health care’. Then I found my way here and I couldn’t imagine doing anything else.

Before I got into nursing, I worked in healthcare administration supporting marketing and public policy teams. The experiences I enjoyed the most were those in which I worked closely with clinicians. There were a couple of nurses in my life who, somewhat insistently, encouraged me to become a nurse. So, I took that training and I have never looked back. I love nursing. There are endless opportunities within the profession, and you can find a job doing almost anything, whether that’s patient care or not. That provides a lot of variety and a lot of excitement.

What’s been an unforgettable experience during your time here at the school of nursing?

Going to school during a pandemic. That in and of itself is something I probably will not forget for the rest of my career. We had to become flexible and adapt, whether that was with instruction, or how we operated within the clinical environment. This experience has helped me to become resilient and more comfortable operating within a constantly changing environment. Future healthcare systems will require people who drive innovation, moving fast and implementing ideas to meet constantly evolving needs.

How has your time here at the school of nursing helped you with your career trajectory?

I already have a master’s degree in nursing with a focus on clinical leadership. I was a clinical manager when I started the DNP program, and while I truly enjoyed supporting teams, I felt a continuous draw to return to direct patient care. The DNP program trained me as an advanced practice provider and leader and prepared to meet the increasingly complex demands of our healthcare system. It’s exponentially grown my clinical and leadership knowledge and capabilities. Perhaps most beneficial has been the DNP program’s focus on understanding systemic issues that contribute to disparities in the health of our communities. The ability to apply a lens of social justice in health will continue to influence my practice for the rest of my career.

What’s interested you about healthy aging and geriatrics?

I’ve always enjoyed working with a broad range of ages in family practice. Through my clinical rotations I discovered an interest in geriatrics. I had the privilege to be paired with a nurse practitioner who cares for patients at skilled nursing facilities and who also makes medical house calls for patients who are homebound. The home visits were a truly unique experience. I was invited into people’s homes, which added an entirely new layer of understanding to the environmental factors and the social factors that contribute to older adults’ health and wellbeing. There’s a huge need and opportunity to be an expert in this area, helping people who are living longer enjoy a better quality of life.

Could you briefly describe your DNP project?

I worked with a team of providers who care for older adults across a variety of settings including nursing homes, long term care, and private residences. At the beginning of the pandemic, many of these facilities were locked down, limiting access in an effort to avoid COVID-19 outbreaks. This team had to rapidly figure out how to adapt their care using telehealth. There were a lot of issues that popped up. The team needed help to understand what could be done to improve telehealth with geriatric clients. I had the opportunity to conduct a needs assessment to understand providers’ experiences, identifying both barriers and facilitators to using telehealth.

Then, I conducted a literature review to establish how telehealth is already being used with older adults, identify best practices, and consider how to adapt to the specific needs of this team. I presented my findings to the group and made a point of care tool to help them to improve their experience using telehealth to care for their patients.

What does the point of care tool look like?

The tool is an easy-to-use, concise checklist that providers can pull up when they’re about to engage in a telehealth visit with older adults. It incorporates evidence-based best practices to use before, during, and after visits. My goal was to make the tool as easy and useful as possible. It focuses on actions, resources, and behaviors providers can use to accommodate the unique needs of older adults.

What were some of the telehealth strengths and weaknesses that you found?

Technical glitches were a big problem. It’s surprising, you know, we often say we can put a rover on Mars, but we can’t get a good signal for a video call in a nursing facility. While that’s not something we as clinicians can directly control, we can be partners in guiding improvements. Another concern was determining how to adapt telehealth to accommodate common communication impairments in older adults. Most standard equipment is not well suited to patients who might have a hearing deficit, decreased vision, or a cognitive impairment. Among our providers, there was a gap in knowledge and experience in virtually assessing patients, which contributed to discomfort in using telehealth.

A strength was the effort to include families and caregivers in telehealth visits to provide support for patients. Another great thing was working with the nurses in the nursing facilities to assist with patient assessment. The providers really relied on and got help from those nurses who were able to engage at the top of their scope of practice. Finally, providers’ ability to access health information remotely was a real asset, emphasizing the importance of electronic health record interoperability.

Why is this work important and why might it continue to be important, even after the pandemic?

The reality is that the number of people living to an older age continues to grow at a rapid rate. We’re not going to be able to meet everyone’s needs in the traditional system that we have set up now. Telehealth will be an important tool in helping us to care for the aging population, making sure that we have better care that enables people to age in place, which is something that’s important to many, many people.

What are your plans now that you’ve graduated?

I’m studying for my board exams right now, and I am excited to take on opportunities to grow the skills and experiences that I’ve developed through this project and through my studies at the University of Washington. I would love to work in a position that allowed me to further develop and refine telehealth and understand how technology can help us to promote healthy aging.

Wendy Wilson is one of the 2020-2021 de Tornyay Center Healthy Aging Doctoral Scholars. A PhD in Nursing Science student, Wilson’s mentor is Donna Berry, and research areas of interest include personalized end of life care focused on patient dignity and health disparities in access to specialized end of life care.

Why did you choose nursing?

My mom is a cancer survivor. She had a bone marrow transplant when I was very young, and I adored her nurses, so I went to nursing school. I have been an oncology nurse for 18 years. My oncology nursing experience led me to my interest with end-of-life care and terminal illness.

Why did you decide to go into nursing research?

I was a research nurse at Fred Hutch for almost 10 years, and it is by far my favorite nursing experience. To become a content expert and feel like you’re on that cutting edge creating something that helps people is really fulfilling.

What interests you about healthy aging?

My work in oncology has mostly been all adults. I feel like I’ve become a better person from my experiences at the bedside and from the relationships that I’ve had with patients I treated. I really value the life lessons I’ve learned from my patients when talking with them during their treatment. I have a high respect for elderly people and the lives that they’ve lived. I always want people to feel like what they did in their time was worthwhile and that people appreciate what they’ve contributed. I feel like I’m wiser than my years because of those shared stories and what I’ve learned through their life lessons.

What’s your research project for the de Tornyay Center?

I’m looking at patient dignity and how that affects patient experience at the end of life. The first part is defining the concept of dignity for a patient at the end of life. Then I’ll go into a meta-analysis to further support the importance of acknowledging patient dignity at end of life.

I think it’s important to recognize that end of life is part of healthy aging. Allowing a person to reflect on themselves, to share their pride in their joys and sorrows, and honoring what is important to them as they transition, I think that’s the finishing touch of healthy aging.

How did you first get involved in the work?

In Oregon, we were the first state to approve death with dignity and offer that to patients. That happened early in my nursing career, and I’ve followed it along the years. I feel like it’s an option that everyone should have access to. That program of helping a patient end their life on their terms is what got me interested in the bigger picture and the concept of dignity in dying, and how we ensure that every individual gets what they need and not a generalized approach.

Why is this research important?

Healthcare has been this pendulum that has swung between individualized patient care and this revolving door where everybody goes through the system. I think we need to come back more to individualized patient care and recognize what makes that individual who they are. What their fears and their accomplishments are, what their life has been about, and honor that at the end of life. I am interested in how we get that access to everybody to ensure they get the type of specialized care they deserve.

What has been an unforgettable experience during your time at the school of nursing?

The two most significant would be acceptance to the PhD Program and getting the de Tornyay scholarship. Both accomplishments are really an honor.

How has your experience at the school of nursing helped you with your career trajectory?

It’s helped a lot, in addition to having wonderful experiences with my professors, I have an outstanding advisor, Donna Barry. She’s an extremely motivated and accomplished person. I really respect and look up to her. She sets a precedent for what I hope to achieve.

What are your plans after graduation?

I want to come back to academia as a faculty member to continue my research and help other nurses understand the concepts that I’m researching.

Wonkyung Jung is one of the 2020-2021 de Tornyay Center Healthy Aging Doctoral Scholars. A PhD in Nursing Science student, Jung’s research is in social integration and traumatic brain injury in older adults. Jung’s faculty mentor is Hilaire Thompson.

Why did you choose nursing?

My grandfather was a medical student, but because of the Korean war he couldn’t complete his dream. He always told me that the medical profession could be valuable, and I wanted to follow his dream. I thought being a nurse and taking care of patients could benefit my life.

What’s been an unforgettable experience during your time at the School of Nursing?

After COVID-19, I’ve appreciated the technology that allows us to take virtual classes and continue our education. I’m also working as a TA in the simulation center and I enjoy sharing my experience with nursing students.

What do you like about teaching?

I really enjoy interacting with the students, learning the different ways they think, and the discussions we have afterwards.

How has your experience with the School of Nursing helped your career trajectory?

Initially, working as a nurse in Seoul for 10 years, all that I knew was the practice of nursing. After coming to the School of Nursing, my eyes have been opened to new experiences and opportunities. Working with Dr. Hilaire Thompson and other professors, they have helped lay my groundwork for how to conduct research which will be very helpful for my future career.

What’s your project for the de Tornyay Center?

A traumatic brain injury (TBI) is an unexpected event. No one expects to have an accident on any given day. Even though a TBI can happen at a moment’s notice, it can take a long time to recover and integrate socially, depending on the severity. Older adults are more vulnerable to the difficulties of returning to everyday life because of slower recovery trajectories, and worse functional and cognitive outcomes compared to younger adults. This project is aimed at identifying the factors that influence social integration after TBI in older adults at 1, 5, and 10 years post-injury. I’m considering social integration factors as productive work, community involvement, social relationships, and leisure activities.

Why is this research important?

Traumatic brain injury is one of the leading causes of disability and death. It has been defined as a “silent epidemic”.  The incidence of TBI in older adults has been increasing and outcomes in this population are worse compared to younger groups. Because of the developments in medicine, they may live longer than they would have a long time ago. The ultimate goal for this project is to improve the quality of life for those individuals after suffering from TBI.

How did you first find this project and get involved?

During my tenure as a nurse in Korea, I cared for patients with brain injuries. Almost half of them were over 65 years old. I wondered how the older patients live after being discharged, and that led me to want to do this research.

What are your plans after graduation?

I want to be a valuable asset to the nursing community by devoting myself to researching and educating present and future nurses.

Lisa Neisinger is one of the 2020-2021 de Tornyay Center Healthy Aging Doctoral Scholars. An Adult Gerontology Acute Care DNP student, Neisinger’s areas of interest are adult acute and intensive care. Neisinger’s faculty mentor is Hilarie Thompson.

Why did you choose nursing?

I had a long road to becoming a nurse. Initially, I thought that I wanted to pursue business. I finished three years towards my business degree and then decided it wasn’t for me. I ended up managing a gym for maybe seven or eight years. It was focused on helping people be healthier, but I didn’t like the sales aspect and pushing people to buy supplements. I wanted to pursue something that would still help take care of people, help them lead healthier lifestyles, but without a focus on sales.

How did you transition from managing a gym to working in a hospital?

I had been managing the gym for maybe six years at that point, and I was burned out, dealing with staffing problems and sales goals. I wanted a similar job where I could still impact people to lead healthier lifestyles. So I decided to pursue nursing and completed my prerequisites while working full time. I took a class to become a certified nursing assistant (CNA), and moved over to Port Angeles to attend nursing school. After nursing school, I got a job working in the ICU. Even though I have since moved closer to Seattle, I still commute back to work there a few days out of the month.

Why did you choose the adult gerontology acute care DNP specialty?

I’ve always worked in a hospital setting in an ICU or telemetry step-down unit, and the majority of the patients I care for are older adults. I feel like I can learn as much from them about life as they can learn from me about how to manage their illness. I enjoy taking care of people when they’re in the hospital, facing some of the worst times of their life, when they’re feeling the sickest that they’ve felt.

That ties into my project. My DNP project is working with Harborview, and I’m looking at post-discharge outcomes for older adults hospitalized for a burn or a trauma and who live in rural areas. Having taken care of a lot of similar patients in the hospital and having lived in a more rural area, I was really interested in the barriers or challenges that they had accessing healthcare after they were discharged from a big urban hospital. I want to see, are there gaps where things are missing in their care, or they’re not able to access care? How can we keep them out of the hospital and healthy?

How did you find your study participants?

I was given the 2019 registry of all the patients admitted to Harborview for a burn or trauma and sorted it to only include adults 65 and up, and then further sorted it to only include patients living in a rural zip code. I called through the list and was able to complete 18 patient interviews.

Has there been anything that surprised you while working on the project?

It’s not really surprising, but COVID came up quite a bit. Many patients were concerned about going to their physical therapy or follow-up appointments once COVID started. I think that will be an area that could be improved upon for connecting people with care, such as with telemedicine.

What interests you about healthy aging?

The older adult population is growing, and all of my nursing experience has been in the ICU, so I take care of a lot of hospitalized older adults. A lot of the hospitalizations are due to complications from a chronic disease or illness. It’s important to try to shift the thinking toward quality of life and focus more on living a healthy lifestyle and preventative care. The population of older adults is increasing. We have all these medical advances to keep people alive. But I think it’s important to not just keep people alive. Age is not just a number, it’s about quality of life and we can help these people to have healthier lives, so they can enjoy their time.

What has been an unforgettable experience during your time at the school of nursing?

I feel so fortunate to be going to UW. We have amazing instructors with amazing careers and experiences. My track has been very close-knit, and I feel so fortunate for all the experiences that we had together in the skills lab pre-COVID. It’s been hard transitioning to a Zoom learning environment and not seeing my classmates every week.

How has your experience at the school of nursing help with your career trajectory?

I value all of the connections that I’ve made from professors to my faculty clinical advisor. All these people are willing to put in the time if you need a letter of recommendation or a reference. I think that will help me as I search for a job.

What are your plans after graduation?

I am starting my job hunt. I’m hoping to find a job as a hospitalist, get a broad sense of caring for everything for a couple years, and then narrow it down to something that really interests me.

Derick Welsh is the de Tornyay Center’s Germaine Krysan Undergraduate Scholar. An ABSN student, his project is ‘Learning about the Engaging with Aging (EWA) Experience among Older Adults’. His faculty mentor is Basia Belza.

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

Why did you choose nursing?

My first interest has always been health and wellness. I received my first undergraduate degree in sports medicine. I worked in a hospital with a Tier II trauma center for a few years, first as a medical scribe, and then as a cardiovascular technician. I thought that I wanted to be a doctor, took more classes, then decided that I did not want to spend another four years plus in school. But I still wanted to be in medicine. I started delving into nursing and realized this is flexible and I’m making a huge impact on the well-being of people.

I will mention what got me into health. Growing up in middle school, I was not really interested in sports or activity in general. I started playing football and the importance of health started to become apparent to me. Then during my high school years, my dad had cancer, and he passed away when I was in high school. I learned there are certain things he could have done differently with environmental and nutritional habits. Knowing I could help other people lower the risk of this happening in their own lives, that was the start of it. Also, helping my grandparents with healthy habits and lifestyle choices inspired me to do more for the aging population.

What has been an unforgettable experience during your time at the School of Nursing?

I think the biggest thing that UW has that I haven’t seen in my previous education is a lot of anti-racist views, making sure that nurses are coming out with perspectives on social justice and equity. I think that’s very important. It’s the first step to being able to come with a perspective of non-judgment to any person.

How has your experience at the School of Nursing helped you with your career trajectory?

Being able to work in the de Tornyay Center for Healthy Aging, which aligns with what I believe. I found the opportunity to work with the center through emailing them and it progressed from there. That turned into a specific project where I’m working with aging over the lifespan. I only have one year in the ABSN program, so I want to gain as much experience as I can within the UW community.

Could you briefly describe the Engaging with Aging (EWA) project you’re working on and your role in it?

I will be helping interview those who are 65 and older and asking them about challenges that they’ve experienced, how they’ve navigated through the process of aging and what are their concerns. We will be analyzing data, compiling everything together, then looking for opportunities for further research. It’s all virtual. We’re not doing this in person because of the COVID risks involved.

What interests you about healthy aging?

When I started working as a personal trainer, a lot of the people I saw were over 65. After someone would go through physical therapy, if they wanted to do more, that’s when I would work with them. I would help them get moving and continue their progress. I enjoyed troubleshooting problems that they had with mobility.

I think it’s important to acknowledge that we have a large population of adults over the age of 65. There’s a need for information on how to better care for that group. We don’t want to just extend life. We want to increase quality of life. I know that sometimes, people who are younger may not be as empathetic because they’re not that age yet, so they don’t understand.

What made you realize that you wanted to get involved in research?

My freshman year of college, there was an opportunity to work with younger kids. We developed physical education programming and compared it to physical education programs set up by the school or the state. We tested baseline data: mile run time, how many push or pull ups, how well they can control and catch a ball. The programming actually turned out to be very beneficial and was implemented in certain schools.

The most recent research I assisted with was at my previous job at Cedars Sinai, a hospital in Los Angeles. I had the opportunity to do research directly with the Smidt Heart Institute alongside my mentor and research supervisor, who is one of the cardiologists in the clinic. I was the main data collector, I even contributed in writing the research paper. I had more responsibility in this research which allowed me to learn a lot more. To be brief, the research was on testing a single lead ECG device that measured the heart’s electrical activity and was interpreted by a secondary device such as iPad. If effective, this device would be used by the patient instead of the healthcare worker, limiting the number of times the healthcare worker would have to enter the room, reducing potential exposure to COVID-19. The experience working at this hospital was invaluable and I was grateful for the opportunity.

Research is not the only thing I want to do, but I like doing it when I can. I, like many other healthcare workers, enjoy problem solving.

What are your after graduation?

I want to start in the ER, where I can get a myriad of everything and gain more knowledge on emergency preparedness, then I would work my way into specializing after that. I would like to continue advocating and working with older adults in my practice and continue implementing my background in exercise science.

Shih-Yin Yu is a PhD in Nursing Science student, with research interests in gerontology and rural health care. She recently published an editorial in the Journal of Gerontological nursing, ‘Let’s Build a New Normal: Transitioning in Hope‘.

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

Why did you choose to go into nursing?

When I was little, my parents worked out of town, so I was raised by my grandmother. She is one of the reasons why I’m interested in older adult populations. She passed away when I was 16 years old. I learned to treat patients with dignity from the nurse who cared for my grandmother. For me, nursing is not only a career, but a pathway to cultivate being a person who can help others in need. Nursing completes my life.

Why are you interested in healthy aging?

When I was an oncology nurse in the hospital, one in 10 patients were older adults. I still remember one of them was 100 years old. She lost her hearing; however, we had good conversations through sign language. She patiently showed me her creative sign language when I didn’t know what she meant. We both laughed when we tried to understand each others’ sign language. Although she couldn’t hear anything, she shared her experiences with me. Sometimes older adults teach me more than what I learn from books. They help me discover new perspectives about life.

Have you had other experience working with older adults?

I had a volunteer experience in Taiwan doing home visits with older adults. I got research ideas from that experience.

What’s your current research topic?

My current research is working on reducing health disparities to improve health care access equity in older adults. There’s an urgent need for health care access in rural settings. I hope the gap between rural and urban healthcare can be minimized, and I hope my research can bridge that gap.

What interested you about that topic?

When I see barriers to health care in rural settings, I ask myself: what can I do differently to overcome those barriers? I want to make changes and be part of the solution for these issues.

I found insufficient information in the current scientific literature for rural older adults. After a conversation with one of the older adults who live in rural areas in the United States, I realize many of them wanted to stay on their land after they retired from their work. The country’s population is aging and that comes with increased healthcare needs in rural areas. Healthcare professionals should be well prepared for these urgent needs across countries and different languages.

What has been an unforgettable experience during your time at the School of Nursing?

I won’t forget the warm environment that faculty create for students at School of Nursing. Many encouragements keep me hanging in there and moving forward. I will never forget the School of Nursing support system, which provides me with practical and emotional support.

How was your experience at the School of Nursing helps with your career trajectory?

In the School of Nursing, I’ve learned how to conduct research thoroughly as a student. I’ve also considered joining a medical team in Taiwan to serve as a volunteer in rural or underserved communities during summer in Taiwan, Nepal, Cambodia, or other countries. I think social service will be part of my career, and those experiences will help me be able to serve others.

Could you briefly summarize the editorial you wrote for the Journal of Gerontological Nursing?

This editorial’s main point is to draw attention back to older adults in nursing homes, who may not be able to speak up for themselves. Many people want to go back to their new normal; what about those older adults, if they have no choice but to stay in nursing homes, waiting for their children or grandchild to come to visit? Health care professionals and health care systems need to find new ways to keep older adults connected and minimize the negative outcomes of mental health.

What inspired you to write on this particular topic?

I got the idea at midnight. When COVID-19 hit, I felt a little bit of social isolation. I was thinking of some older adults I knew in nursing homes in the United States. One question came to my mind: Is the new vaccine our way back to normality?  I don’t have an answer for this question at this moment, but I know their lives aren’t waiting for this resolution forever. Instead of waiting for this uncertain answer, we must think of solutions to continue providing quality care for them.

What are your plans after graduation?

I plan to do a post-doc after I graduate. Then I would like to return to Taiwan to teach and do research.

Hillary Frey is the de Tornyay Center’s Myrene C. McAninch Undergraduate Scholar. A BSN student, her project is ‘Identification of Triggers that Alert Older Adults to Prepare for Age-related Changes’. Her faculty mentor is Shaoqing Ge.

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

Why did you choose nursing?

I landed on nursing mostly from bits and pieces that I liked from previous jobs. It’s a good fit for my skills and interests. I like the hands-on care, the focus on disease management from a social and a scientific perspective. I like to have a role in community and public health. Especially with advanced degrees, there’s opportunities and training to participate in leadership and systems change.

What were those things in other jobs that you found that you liked?

I worked as an anesthesia technician in a hospital which was hands on and fast paced, and I liked that. After that I worked as a research coordinator in a neurology clinic with patients with multiple sclerosis and Alzheimer’s, so I was mostly working with an older population. I saw how chronic conditions can make it difficult for people to age with health and dignity. I became interested in the systems that were preventing them from aging how they wanted to or weren’t supporting them in aging how they wanted to. I realized that there’s a lot more to helping people achieve health than hands on care. Nursing seemed it would incorporate both of those things.

What has been an unforgettable experience during your time at the School of Nursing?

My ambulatory care clinicals this year have been really memorable. I’ve seen a lot of nurse-led visits for managing chronic conditions. The visits are pretty long and interesting because the patients open up to the nurses about their medical conditions and a lot of other social, economic, and lifestyle concerns.  I used to think that the nursing role in outpatient care was simple and straightforward, but my clinical showed me that nurses get involved in so many different aspects of a patient’s life. These visits incorporated all the aspects of nursing care that I’m interested in.

How has your experience at the School of Nursing helped you with your career trajectory?

A big reason that I picked the School of Nursing at UW was because they had an honors research program and the healthy aging center. Those are two things that I knew that I wanted mentored experience in. I am participating in the honors program and I’m doing a project on healthy aging. I’m happy that the honors program worked out because that was something that I had to apply to. Having a research mentor in that field, I can see that it’s going to help guide my career path.

What interested you about the healthy aging field?

I’ve always preferred communicating with older and aging populations. I think they have a lot of wisdom to share and not necessarily the support that they need to age in a healthy way. That’s where healthy aging research comes in!

What made you realize you wanted to get involved in research?

I was transitioning from working as an anesthesia technician where I had a very clinical role, and I was searching for a role that was distinctly different. I wasn’t ready to commit to a certain career path yet and I was just looking for a job that would help inform my future career choices. I landed in research and I enjoyed it. Once I started doing research, I realized that there was so much knowledge and conversation happening behind the scenes of clinical care. We need people doing this research to change and inform how care is provided. I like thinking of the big picture and that’s the biggest driving factor for why I like to engage in research. The day to day work also taps into my detail-oriented side that likes to make lists and keep things organized.

What is your research project and your role in the project?

My project will look at what prompts people to prepare for age related changes, which are the normal developments and changes associated with aging. It’s in the really early stages right now, but it’s a satellite project of my research mentor’s larger study that explores a concept called Engaging with Aging. The concept comes from an interesting blog written by a woman who is 97, was previously a nurse, and currently publishes a lot of thought pieces on her own aging process.

I think there are six people working on the main project and my mentor is involving all of us each step of the way. We are all currently conducting interviews with study participants. I’m learning a lot. I’ll be able to use data from the interviews for my own satellite project as well.

Why is this work important?

I think the studies that work within the Engaging with Aging framework are promoting a proactive involvement in the aging process. Hopefully, a proactive approach will help older adults remain more independent even when age-related changes happen.

There’s a lack of research to define the aging process and therefore have some evidence-based interventions that promote healthy aging. There’s a lot of work to be done in the field of healthy aging.  If there’s one thing that I personally learned from working in research, it’s that it takes a really long time to conduct research and then translate that research into evidence-based practice.

What are your plans after graduation?

I want to apply to work on an intensive care unit that has a population that is generally older. Hopefully working with patients with neurological conditions. I want to do that for a couple of years, and then apply to a doctorate program for acute care gerontology. I see research coming into my career more after I pursue the doctorate, where I can participate in studies as a doctorate level nurse.

Alisa Strayer, MSW, MPH, is a recent alumni of the UW Master’s of Social Work and Master’s of Public Health programs. She worked with the Dementia Action Collaborative on implementing and assessing the Dementia Friends program in Washington State.

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

What got you interested in healthy aging?

After graduating from college, I worked at an organization, called Fountain House, which is a community center for people with mental illnesses. I worked at one of their independent living buildings that was specifically for older adults, and many of them had dementia. That was the first time I had worked with older adults. I fell in love with the people I was working with. They were kind and tough and hilarious. Even though the job was hard and the things they were facing were even harder, talking and laughing with them made each day fun.

After about a week on the job, I knew that working with older adults was where I wanted to spend my time and my energy. I wanted to be an advocate with them. The world turned away from each of them as they grew older. They felt like they didn’t have a right to be upset when their benefits were cut for no reason or when their prescription wasn’t ready on time, causing huge medical consequences. They thought that they didn’t deserve any attention or rights because that’s what society had shown them – that after a certain age, especially if you have a disability or are not White, you don’t deserve more than the most basic necessities. That was what made me want to be an advocate around aging.

What was your project?

The Dementia Friends program is a 90-minute talk that discusses what is dementia and what can we do as individuals to support people with dementia. It teaches participants skills on how to interact with people with dementia. It follows a train the trainer model where presenters reach out to their networks and give these talks. The people the presenters give the talks to are called dementia friends.

In August 2018, Marigrace Becker, from the UW Memory and Brain Wellness Center, and I, in partnership with the Dementia Action Collaborative, began implementing the Dementia Friends program here in Washington. We started the program in King County, Jefferson County and Yakima County. We implemented and evaluated the Dementia Friends program to see: is this program effective? Is it changing people’s attitudes towards people with dementia? And how can the program be improved?

How did you get involved in this work?

I was looking for a project where I could work on destigmatizing aging. I was introduced to Marigrace Becker, who knows just about everything about mobilizing people to destigmatize dementia. She was looking for somebody to implement Dementia Friends and to evaluate it. It was a perfect overlap.

What interests you about destigmatizing dementia?

From those early experiences working at Fountain House, I had seen the lack of respect for people with dementia. My grandmother also had Alzheimer’s disease. My own family and I responded to her differently as her symptoms progressed, often infantilizing her or dismissing her while she remained very conscious of every slight. I am grateful that she was an incredibly strong woman and told us in no uncertain terms that she was still the same person she had always been and refused to be infantilized, fighting back on the stigma and the disrespect that so many people face through their dementia diagnosis. She helped us understand how to support her and learn how to advocate for her. That is probably what first taught me about destigmatizing dementia.

Alzheimer’s Disease and other dementias are devastating, but the fear that surrounds the diagnosis makes the experience much worse than it needs to be. Our society responds to people with dementia with fear, with stigma, isolation, treating them as having no humanity. I’ve talked to people, even in the aging field who say, ‘Oh, this person has dementia. They’re basically just a vegetable’. Things that are horrific. It made me want to see how we can change that script and change people’s minds. People with dementia shouldn’t be left with that as the only reaction people give them. It makes their lives a living hell. It doesn’t need to be that way. People with dementia remain the people they have always been, people with awareness of how they are treated, people with feelings, and sensitive emotions – but the ways they need to communicate does change. We need to learn how to change how we communicate with and support them, not abandon them. We also need to support the care-partners taking on the tremendous emotional and physical challenge of supporting their loved ones with little monetary or logistical support available.

What did you find in your evaluation?

For the Dementia Friends, the people who attended the Dementia Friends presentations, their attitudes towards dementia did improve. After this one 90-minute talk, there was a change both in their knowledge about dementia and their comfort with people with dementia. They also said they appreciated a chance to talk about dementia and share their personal experience with it. There are just not a lot of opportunities to talk about it.

The feedback that we got from the presenters of the program was that they enjoyed the experience of leading the Dementia Friends presentation, engaging with people and connecting with them about dementia. But they also said that there wasn’t as much support as they could have needed, especially for presenters who had less experience organizing presentations. They suggested a few areas to improve support, such as by enhancing their training and providing logistical support to organize presentations.

How do you plan on using that feedback?

Since both the participants and the presenters were quite positive about the program and there were measurable improvements in people’s attitudes towards people with dementia, the Dementia Action Collaborative decided they wanted to continue implementing Dementia Friends across Washington State. Each region in Washington will be implementing Dementia Friends and managing the implementation of it. As they roll out their program, they will need to provide additional support based on the feedback from the evaluation, such as enhancing training and providing logistical support to organize presentations. Many of these regions will continue evaluating their programs so we hope to see if these adjustments are addressing the feedback we received from our presenters.

Why is this work important?

There’s not a lot of space for conversations around dementia and there are limited opportunities to learn about it unless you’re actively a care-partner. Most of the people who attended the sessions were not care-partners. It gives them a chance to think about dementia and confront the ways that we treat people with dementia, or fear dementia as this abstract thing of the future. I think the Dementia Friends program provides hope and skills if they or a loved one develops a type of dementia. I think it’s important to shed some light and understanding and gentleness on this issue that is surrounded by a lot of fear and darkness and isolation.

What are your plans now that you’re graduating?

I’m on the job hunt, and I am still tangentially involved in the Dementia Friends program. I care a lot about continuing to spread dementia awareness. In Seattle and Washington in general, there’s a lot of energy around aging and dementia. It’s something that I’ve been honored to be able to be a part of and learn from the tremendous wealth of knowledge here. I want to add whatever limited perspective I can to the ways we think about not just aging, but how aging intersects with so many other issues that need to be addressed urgently, like racism. For example, when someone grows older, all the discrimination they have faced will continue to impact them, whether that is daily racist actions or whether it is the long-term health impacts of pollution that they were exposed to from not having access to safe housing due to redlining. This will impact how someone ages, how they develop an illness or disability as they age, the services they have access to, the support system they have, etc.

Dementia and aging advocates need to have these other needs and identities at the front of their minds when they talk about dementia, otherwise we will only ever be advocating for the wealthy and White. These are not profound statements, but I hope to be someone in the field who can keep the conversation coming back to how we can see people with dementia as full complete people, not just struggling with dementia, but with all that came before dementia and all that will come with the diagnosis.

Qian Tu, PhD, DNP, ARNP, is a recent alumni of the UW School of Nursing’s DNP-Adult Gerontology Primary Care Nurse Practitioner program.  She received the de Tornyay Center’s 2020 DNP Pathways to Healthy Aging Award. 

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

What is your Doctor of Nursing Practice (DNP) project?

I developed a depression toolkit for an adult family home, with screening tools and prevention and treatment activities. Adult family homes function similarly to nursing homes, but they use houses in the neighborhood to provide care to up to six residents. They provide 24-hour care service, but while nursing homes at least have LPNs or RNs on board, this type of adult family home only has what are called home aides.

I looked at the literature to see what interventions have been shown to help depression, especially focusing on what has been done on the community level. Most of the literature is focused on patients 65 or above, but there are a few studies that are 60 or above. Studies use all kinds of activities, including video conferencing, laughter yoga, and animal assistive programs. The interventions I suggested in my project all proved to be effective in at least one study, although they do not compare to the standard of care for depression, cognitive behavioral therapy.

One intervention stood out — physical activity. It doesn’t necessarily have to be cardio physical activity, it can be more focused on helping them to improve their stability, flexibility and ability to get around. Physical activity is the only one of the interventions in the scientific literature with a randomized control study showing that they have similar effects to the standard treatment of depression with cognitive behavioral therapy.

Why is this project important? 

In the literature, researchers found that depression is very significant among older populations, but at the same time it’s generally underdiagnosed and undertreated. The symptoms for depression are different in older adults compared to younger people. They may have some memory issues. They don’t feel well. That’s why it’s kind of hard to detect if you don’t have effective tools.

How did you suggest detecting depression in older adults as a part of your project? 

The first screening tool I use is very simple, it only asks two questions: During the last month, have you been bothered by feeling down, or depressed or hopeless? Have you often been bothered by having little interest or pleasure in doing things? It’s very straightforward.

If they answer yes to any of those questions, then we will do a more detailed geriatric depression scale. That will differentiate them from mild to moderate to severe depression. All the interventions I proposed are non-pharmacological, no medication involved. This project is more focused on reducing mild and moderate depression or preventing depression in someone who hasn’t developed it. If the patient has severe depression, we will refer them to the mental health professionals, because that’s above and beyond the scope of what we can do using non-pharmacological methods.

Why it important to have non-pharmacological interventions?

Older adults often have other health conditions and already may be on other medications. The more medications you take, the more adverse side affects you may have, and there are more chances of drug to drug interactions. That’s why we, if possible, want some non-pharmacological methods to help older adults. Depression particularly, it can sometimes be treatable with non-pharmacological methods if it’s in the early stage.

Was there anything that surprised you while you were working on this project?

One thing that surprised me is that simply improving social interaction with another person can help decrease depression. Small steps, like making handmade crafting projects as a group will work too, including for patients with dementia. The interaction doesn’t even have to be face to face. There’s a program where the participant used video conferences with family or friends, once a week for ten weeks, and there’s a big improvement in their depression.

What interested you about this project?

I really love geriatrics, my first nursing job in this country was working in a nursing home. I feel like this population sometimes gets neglected by society, and they don’t get the care they deserve. I want to do more to help them have a better quality of life.

I also have a personal preference for older adults because I was brought up by my grandmother. When I was born, both of my parents were working full time, and my grandma was retired so she took care of me until I went to elementary school. Then when I was in third grade my grandma had a stroke and she moved in with us until she passed away at the age of 87.  In her last couple of years, she got dementia, she couldn’t recognize any people around, and they were just strangers to her. She would eat a meal and then forget once you took the plate away. That stuck in my mind a lot, when choosing nursing as a career. I felt very satisfied by taking care of her at home.

It’s fun to work with the older population, they are filled with so much wisdom from their lives, so you learn so much by talking with them.

Why did you choose nursing?

I feel so satisfied and fulfilled in nursing. My mom worked in a hospital, so I grew up with the hospital as my playground. Back then you could bring your kid to work. So, we — a bunch of doctor’s kids, nurse’s kids, administrator’s kids — just played in the hospital during the summer or winter vacation. I was immersed in the medical field at a very young age. When I went to high school, we had a general college entrance exam, and before the exam you have to fill out what school you want to go to. All my desired schools were medical schools. We have medical universities in China within which there are all specialties under the health sciences, such as medicine, nursing, pharmacy, dentistry, nutrition, etc. My teacher asked if I wanted to consider something else, and I said no. I cannot imagine choosing a career out of the medical field. It’s not an option in my eyes.

Anything else about your work or background that you’d like to share?

I originally came to the US from China to get my PhD in Nursing Science. My DNP is my second doctoral degree. I choose primary care because after I worked in long term care and the hospital, I saw a lot of patients come in because they lacked primary care. They delayed treatment for too long and ended up in the hospital. There’s a huge need for primary care.

What made you come back for your DNP?

With a research degree, you basically have two routes to go, one, you can go teach in a four year college or community college, and the second route is you continue research in a research focused school like UW. The first route you have to have extensive clinical experience, but I came from another county, so I had zero clinical experience in the U.S.. The second route, if I want to do research and go to a research- intensive school, I have to go through post doc training, and for my field of PhD research, I would have to move across the country. At the time I had a baby to raise, so I wanted to stay and go get my clinical experience first. But while doing my clinical work, I found my true love. I still enjoy research, but I feel like direct interaction with patients, that makes me feel more fulfilled.

Alexa Meins, PhD, BS, is a recent alumni of the UW School of Nursing PhD program. She received the de Tornyay Center’s 2020 PhD Pathways to Healthy Aging Award. 

All interviews have been edited for length and clarity. 

Find more scholar spotlight interviews here. 

What is your dissertation on?

My dissertation explored green exercise, or physical activity while in natural spaces, for older adults. I partnered with Seattle Parks and Recreation’s Sound Steps programs to gain insight into how we can make urban park walking programs appealing for older adults and what kinds of health benefits are received from participating in this type of programming. Findings from this study can inform future program development and expansion. They also show us that physical, mental, social, and spiritual health can all benefit from green exercise.

How did you get involved in this research?

I work in the outdoor industry as I’m going to school. I’ve had a lot of conversations in my work life about how people have had to modify how they engage in the outdoors as they age. I knew Basia Belza, who became my chair, did a lot with the walking groups in the mall. And I thought, what if we took that walking group outside.

I was at a coffee shop and I saw the Seattle Parks and Recreation catalog for that season. They had the full catalog and then they also had this lifelong recreation catalog sitting next to it. It’s this whole set of programming that the city offers for adults age 50 and above. They have walking programs and hiking programs. Basia said she knew the people that are doing this and it went from there. It was really a couple of things all happening a t once that just clicked together.

Why is this research important?

More and more we have things that keep us inside. Also some of the research says that as we age, our exercise decreases a lot. Exercise is really important for mobility and independence, for managing different health diseases and for preventing them.

The green exercise literature says that being outside can not only have multiple health benefits, but also increase people’s willingness to continue exercising. This is a great opportunity because we aren’t really looking at older adults right now within green exercise literature. It’s not only really great for everyone’s health, but it also might help solve this this problem of motivation to keep exercising. And the more that we can understand why people are choosing these programs, what is important for them, what are the needs of older adults in an outdoor space, then we can also look to expand programs or make more programs appealing to this age group.

What are some of the ways that you found that more could be done to cater to their specific needs?

There’s some logistics that are very easy to build into programs. One of them being, how did they get to the program? They drove, so parking was important. Having an onsite bathroom was important. Another thing that came through was a need for socialization. There’s a large amount of people in my study who are retired. They don’t necessarily have all the same ways of meeting people that they used to. Having programs that happen consistently at the same time every week not only gives them structure to their day and their week, but also makes it so that they’re able to develop these deep social connections and friendships with other people they are walking with. Also a lot of them say that the social group makes it so they can feel safe. They’re around other people that could get help if something happened, like a fall.

What interests you about the healthy aging field and aging research?

When I was trying to figure out what my topic for my dissertation was going to be, this idea of green exercise was really important. I saw in my dad, who’s a big skier, how my wintertime dad is very different than my summertime dad. I see how much better his health and his happiness is when he’s able to get outside. We’re seeing a lot of really great benefits of green exercise in research, but mostly for children and young adults. There’s this big opportunity for studying outdoor exercise for older adults.

How did you first realize that you wanted to do research?

Back when I was doing my anthropology degree, I had to do a research project. At that time, I was a rower and recognized that high level athletics created a unique health culture around exercise. So I went on to do my thesis on the pain experience of Division I athletes. That was the first time that I really had the opportunity to dive in and do some research. It opened up this whole world.

What was it about research that appealed to you?

The type of research that I do is qualitative, so for me, it’s being able to give a voice to people. I love the interview process. Everyone has their own life experience, but it’s amazing to see how many people have shared experiences. The more that we know in health care about what people are going through in their life then the better we are able to address their needs and take care of their health.

Anthropology has a very rich tradition in qualitative methods. I’m excited to bring my background in qualitative methods to this project and incorporate quantitative methods as well. By using both we can get the numbers and we also learn from getting their experience. Sometimes it surprises you with what you can find.

What have you found when putting them together?

We were doing walking interviews through urban parks and some of our public indoor spaces with these older adults, while they were doing the activities. I realized that there’s some misunderstandings happening with this survey. The theory that I’m using says essentially when you are exposed to nature you can get these extra health benefits around mental health and stress, and there are factors that identifies it as a restorative environment. I had included a survey that asked about these factors.

One of the questions is, rate on a scale of zero to six “to stop thinking about things that I must get done, I like to go to places like this.” Some were saying, going to the park helps me disengage and really enjoy this moment. Then others say, I sought out going outside because this is when I have the time to think. They’re looking at these at these spaces completely different, even when I give them the same prompt. Combining the survey questions and interview uncovered this potential problem. Maybe before we go into larger studies we need to look at if this survey translates well for this population.

Is there anything else that you would like to share?

One thing that I think drew me to Nursing was that there is a willingness to embrace holistic approaches to healthcare and to be focused on prevention as well as disease management. There’s so much potential here for enabling people to continue enjoying the activities that they love through aging, making some of these considerations, so that our public spaces are still accessible to all.

Najma Mohamed is a first year BSN student. During winter quarter in 2020, she traveled to Japan as part of the Keio University Short-Term Nursing and Medical Care Studies Program to learn about challenges of an aging society. UW students attending the program were supported by the Center for Global Health Nursing and the de Tornyay Center for Healthy Aging.

All interviews have been edited for length and clarity.

Find all scholar spotlight interviews here.

What interested you about the Keio University program?

I was interested in pediatrics, but the program centered on aging populations and elderly care. That was very different from what I was hoping to get into in the future. I thought if I had more experience and more knowledge about that particular area it could also be something I want to explore.

What interested you about healthy aging?

My family’s originally from Somalia so for us, when it comes to aging, it’s the women who take care of the aging and their elderly parents. When you have an aging population there is a burden on the caregivers. In Japan a lot of what I learned was different ways that they mitigate that. I thought I could come back and apply it to my own community and figure out how we can take care of our elderly people without placing undue burden on the woman who are caring for them.

How do they mitigate that burden on caregivers in Japan?

If you’re over 75, you’re entitled to two visits a week from a nurse in your own home to care for you. People tend to be healthier and get better when it’s their own personal space and they have control over it. We also did a visit to this community where you have the elderly living there and the nurses taking care of them living there as well. It removes stigma and creates a healthy and open environment.

What was the most interesting experience of your trip?

We rode bikes to go visit the homes of the people we were doing nurse visits with, and I haven’t ridden a bike in forever. Over there, they don’t have bike lanes and I spent much of the trip swerving through people and cars. Bikes over there are used as a huge means of transport for nurses, but here, going to clinicals I either drive or take a bus. It was an eye-opening experience to see how different the transportation that they rely on is.

What were the nurse visits like?

We did two. In one of them, the family was very much involved. Seeing how the nurse separately communicates with the family and the patient, and then brings them back together, I thought was really interesting.

The nurse put so much care and effort in. We watched the nurse make food for their patient, feed them, and give them their medication, they had to get that all done within two hours. They did extra stuff to make the patients smile, they really knew their patients very well. Having eight patients as a nurse is tough, but they handled it really well.

Was there anything that surprised you while you were there?

Their shifts were really different, we have the night shift and day shift here, but they have 8 hour shifts. In Japan, you don’t really get to pick your own schedule, you just tell them when you’re available and they schedule you for one of their three shifts. In Japan and Korea, nurses don’t have as much power. I was telling them that we just had a strike with nurses feeling unsupported and how when something’s not going well you can voice your opinion and make a change. But over there it’s a lot more difficult. There’s more hierarchies for nurses.

What did you learn about aging while you were there?

One thing that was reemphasized for me is aging with dignity. That was one of the biggest aspects of our program, understanding that people are more than their symptoms. People want to live and die with dignity. So to hear it being emphasized everywhere we went, I thought that showed the commitment and dedication the Japanese have to healthy aging.

Why did you choose nursing?

No one in my family is in healthcare. I wanted a major where I could make a difference in my community and still be able to support my family. People come to us on their worst days and being able to make a difference no matter how small means the world to me. The other thing that drew me to nursing was how flexible it was. There are so many roles a nurse can take on and every day brings something new.

What’s been an unforgettable experience during your time at the school of nursing?

This quarter, I am doing a clinical in community health and it’s been amazing. I spend majority of my time working with elementary school students and every day I learn something new from them. I always leave at the end of the day smiling, reminded of why I wanted to pursue nursing. The nurse there serves as a cornerstone for the entire school and witnessing that has taught me a lot about the role of a nurse in community health.

How has your experience at nursing helped you with your career trajectory?

After being at the school of nursing, I know for a fact that I want to go back to school after graduating. I hope to get my DNP at UW and expand my scope into working with communities. I can say without a doubt that all of the faculty, staff and peers at the school of nursing have helped me grow.  Just being able to say I’m a Husky Nurse, I love it.

What are your plans after graduation?

I wanted to work as a travel nurse for a few years, but I heard it’s difficult to do that your first year without experience. So first year, I’m hoping to be able to work at UW and focus on community work. My plans for the future are likely to change because I feel like I discover something new about myself everyday.

Anything else?

I really loved the program, I honestly didn’t know that I would like it as much as I did. With the other students that were with me, every morning we’d wake up and say I can’t believe we have this opportunity, we’re so grateful. They allowed us to participate in so many things that we weren’t expecting, like being able to go to people’s homes. They were constantly having to translate for us — it slowed things down — but they were so accommodating. It was one of the best experiences of my life.