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Search Results for: Duke Family Support Program
The Behavior and Physiology in Aging – Research Training Program
The Duke Hartford Foundation Center of Excellence
Claude D. Pepper Older American Independence Center (OAIC)
Duke Aging Center Family Support Program
Bryan Alzheimer’s Disease Research Center at Duke
Duke Memory Disorders Clinic
Behavioral Medicine Research Center
Geriatric Training Program for Physicians, Dentists, and Behavioral and Mental Health Professions
Center for Spirituality, Theology, and Health
Computing and Statistical Laboratory
Chinese Longitudinal Healthy Longevity Survey (CLHLS)
Research Participant Registry
The Behavior and Physiology in Aging – Research Training Program, funded by NIH for the past 32 years, supports postdoctoral fellows with career interests in aging who train in Duke research programs in which aging research is ongoing. Areas of interest may include medical anthropology, exercise physiology, psychology, and nursing. Fellows attend weekly seminars in the biomedical, social, and psychological aspects of aging as well as in professional development. An important component of the seminar is the annual research ethics module.
The Duke Hartford Foundation Center of Excellence, supported by the Hartford Foundation, concentrated on “early recruitment to academic geriatrics” and focused on providing research opportunities for Duke medical students in geriatrics from 1988 – 1994. During 1997 – 2006, our Center of Excellence concentrated on a critical period in the development of academic faculty: the transition from clinical fellowship to junior faculty and subsequent development towards an independent career as clinician-investigators and clinician-educators. The current Center of Excellence focuses on developing academic geriatrics faculty whose research, teaching, and clinical care will lead national efforts to meet the health care needs of our older citizens.
The Claude D. Pepper Older American Independence Center (OAIC) with funding by NIA, focuses on understanding and treating dysmobility associated with aging. Following the first designation of the Aging Center as Pepper Center in 1992, the second Pepper Center grant, awarded in 1999, included cores that provided service to other funded research projects, as well as to Pepper-specific projects. A third Pepper Center grant, awarded in 2006, is exploring approaches to understanding and modifying multiple pathways of functional decline through research and faculty development. In collaboration with various Duke departments, divisions, and centers, the OAIC supports mentored research of junior faculty; pilot research projects; an analysis core; a biological studies core; and developmental projects in biomarkers, metabolomics, and database development.
The Duke Aging Center Family Support Program, in collaboration with the Bryan Alzheimer’s Disease Research Center at Duke and the N.C. Alzheimer’s Association, with funding from the NC Division of Aging and Adult Services, provides the following free services to all North Carolina residents: confidential, personalized tips on caring for people with memory disorders; a comprehensive information packet on Alzheimer’s disease and a Caregiver newsletter delivered twice a year; telephone help with care decisions, coping strategies and evaluating service or residential care options as well as help selecting support groups, education programs, online information or books.
A large program project in Alzheimer’s disease supports a number of neuroscience and genetic investigations into the basic biology involved in this disease. This program project works in conjunction with the Duke Memory Disorders Clinic which identifies patients that have been thoroughly worked up as potential human subjects for scientists who are studying dementia. Another center, the Behavioral Medicine Research Center, was first funded in 1985, and continues to expand its role. Several of the major projects in that center are focused on aging effects on health and thus bring those investigators to interact with the programs in the Aging Center.
The Geriatric Training Program for Physicians, Dentists, and Behavioral and Mental Health Professions is a HRSA-supported program supporting fellowship and other training efforts that assist physicians, dentists, and behavioral and mental health professions who teach or plan to teach geriatric medicine, geriatric dentistry, or geriatric behavioral and mental health.
The Center for Spirituality, Theology, and Health, in collaboration with the Center for the Study of Aging, has received two awards from the John Templeton Foundation to: 1) solicit, award and coordinate seven research projects which would investigate how religion/spirituality influences individual and community health, and 2) form and maintain a community of scholars, build network of senior and junior researchers in spirituality, theology and health.
The Computing and Statistical Laboratory operated by the Center permits easy access to large data bases and statistical analysis software packages. Both faculty and trainees can also access this facility through personal and laptop computers throughout the building or via modem or DSL facilities from other campus locations or at home. Statistical support to aid investigators and trainees in planning studies, analyzing data and learning how to use statistical software packages is also available in the computing laboratory. This expert statistical assistance is freely available and given in a one-on-one tutorial basis so that trainees and faculty can learn to develop the most appropriate study designs and use the most effective data analysis programs available.
SHIN Receives Benenson Award in the Arts!
Jaewook (Jay) Shin (T 16, HDV 16) has received the prestigious Benenson Award in the Arts from the Benenson Award Committee. The title of Shin’s project is Music as Medicine –Bringing Music to Residents at Durham Nursing and Rehabilitation Center. During his postgraduate year (2016-17) while he is also working on a master’s degree, Shin will be working with a local nursing home—Durham Nursing and Rehabilitation Center—to introduce targeted music to the residents there. According to his Benenson Award Recommendation, Shin, “…strongly believes that the long-term care residents at the DNRC have significant holes in their lives that can be filled with music, and that they can benefit psychologically and socially from this intervention. His ideas are supported by a growing literature that shows the remarkable impact of personalized music on older adults with dementia.” Shin will be developing personalized music interventions to see if there is an impact on quality of life.
EMERY Publishes Thesis in Yale Publication
Eric Emery (T 13, HDV 13) has just had his senior thesis accepted for publication by the Yale Review of Undergraduate Research in Psychology. This annual publication selects the best and most original psychology research from undergraduates around the world. Emery’s Human Development/Senior Honors Thesis work was supervised by his faculty mentor Sharron L. Docherty, PhD, PNP-BC, FAAN, an Associate Professor in Duke’s School of Nursing. Emery is currently a Research Assistant at the National Institutes of Health.
Duke University offers an undergraduate certificate in human development which involves the following:
- A curriculum emphasizing the complimentarity of biological, biomedical, psychological and sociological disciplinary perspectives.
- A research apprenticeship with a Duke faculty member.
- A senior seminar.
- Advice for curriculum planning.
- Skills in the conceptualization, implementation, evaluation and communication of developmental research.
Note: The Undergraduate Program in Human Development offers a certificate. It does not offer a major.
Sponsored for Trinity College by the
University Council on Aging and Development
Click here to read our Mission Statement
Click here to read our Learning Objectives
Click here to read our Assessment Goals
A total of six (6) courses is required to complete the curriculum for the Certificate in Human Development. These courses are described in the Undergraduate Bulletin and are listed below as well.
- HDV 224: Human Development (also listed as SOC 224)
- One of the following two courses:
HDV 260: Psychosocial Aspects of Human Development (also listed as SOC 260 and Psy 236)
PSY 474S: Biological Psychology of Human Development
- HDV 401: Research Apprenticeship in Human Development
- HDV 450S: Senior Seminar in Human Development (to be taken during the student’s final semester)
- Two (2) elective courses from the list of biological, psychological, and sociological courses affiliated with the HDV Program and listed below.
For more information, download and complete the application available at the following link: Information Request
FACULTY STEERING COMMITTEE and ADVISORS
Deborah T. Gold, Ph.D.
Professor of Medical Sociology
Departments of Psychiatry & Behavioral Sciences, Sociology, and Psychology and Neuroscience
Box 3003, Duke University Medical Center
Room 1507, Blue Zone, Hospital South
Faculty Steering Committee
Linda K. George, Ph.D.
Professor of Sociology
Departments of Sociology, Psychiatry and Behavioral Sciences, and Psychology and Neuroscience
Associate Director, Duke Aging Center
Box 3003, Duke University Medical Center
Room 253, Soc-Psych Building
Phone: 919-660-7530 OR 919-660-5605
Fax: 919-668-0453 OR 919-660-5623
Kathryn E. Gustafson, Ph.D.
Assistant Professor of Medical Psychology
Department of Psychiatry and Behavioral Sciences
Box 2739 Duke University Medical Center
2424 Erwin Rd, Suite 504
Durham, NC 27705
Robert J. Thompson, Ph.D.
Professor of Psychology
Department of Psychology and Neuroscience
Room 236 Soc Psych
Box 90086 Duke University
Durham, NC 27708
Phone: 919- 681-9655
The research apprenticeship provides an unusual opportunity for students to develop skills and participate in a research experience. The HDV Program identifies and matches students and mentors. Research findings are reported in the Senior Seminar.
Pre-medical and pre-law students as well as majors in the social and behavioral sciences have worked successfully on developmental research in labs, clinics, and programs at Duke and elsewhere. Previous topics include the following: abortion, addiction, adult cognitive styles, aging, cell change, depression, divorce, health services, immune system change, moral judgment, premature infants, retirement, self-concept, sickle cell anemia, and talented youth.
Students should register for HDV 124 during their sophomore year and begin planning for their apprenticeships at that time as well. Research papers from the apprenticeship are sometimes revised for presentation at scholarly meetings or publication in scientific journals.
|EVANTH 101/101D||Intro to EVANTH|
|EVANTH 220||Human Evolution|
|Biology 154||AIDS / Emerging Disease|
|Education 243S||Children, Schools, and Society|
|Education 321S||Infancy/Early Childhood Educational Program|
|Psychology 103||Developmental Psychology|
|Psychology 106||Biological Bases of Behavior|
|Psychology 325||Social Development|
|Psychology 339S||Life Span Analysis|
|Public Policy 243S||Children, Schools, and Society|
|Sociology 349||Sexuality and Society|
|Sociology 350||Changing American Family|
|Sociology 263||Aging and Health|
|Sociology 264||Death and Dying|
**NOTE: Students may count ONLY two (2) courses toward both their major and their Human Development Certificate.
THE CLASS OF 2014
Miryea R. Ayala
Tara Gavcovich (Distinction in Human Development)
Kyler Shumway (Distinction in Human Development)
THE CLASS OF 2013
Lorelei Phillip (Distinction in Human Development)
THE CLASS OF 2012
Ziwei Wang (Distinction)
THE CLASS OF 2011
Bernice Ponce de Leon
THE CLASS OF 2010
THE CLASS OF 2009
Leigh Ann Samsa
THE CLASS OF 2008
THE CLASS OF 2007
Bette Ann Schlossberg
THE CLASS OF 2006
KUO WINS AWARD
Patricia Kuo (Psychology, 05; Human Development Certificate, 05) was recently awarded the American Society on Aging’s Undergraduate Paper Award.
Patricia, under the guidance of Professor Judith C. Hays of the School of Nursing and the Aging Center, did research using the Duke EPESE data and submitted her paper, Life satisfaction and depressive symptoms among highly religious and non-affiliated elderly persons of the North Carolina community. Her award was presented at the 2005 Joint Conference of the American Society on Aging and The National Council on the Aging in Philadelphia in March 2005.
HOLMAN WINS DEPARTMENTAL HONORS FOR PAPER
Regi Holman (Sociology, 05; Human development certificate, 05) won the Ida Harper Simpson Undergraduate Writing Award from the Department of Sociology for 2005. Regi’s paper was entitled, My Daddy Wants Tenure: Academic Family Men, the Normative Expectations of Today’s Family, and Implications for Current University Family Policy. Regi completed her human development research with Professor M.E. Hughes of the Sociology Department, and her research apprenticeship paper was entitled, the rich get richer: a study of education differentials in marriage.
My research interests over thirty-five years at the Duke Center for Aging have evolved from early studies with Drs. Linda George and Elizabeth Clipp of the emotional, physical and financial consequences of caring for a family member with dementia, to evaluating outcomes of dementia-specific care practices such as providing trained in-home respite care workers and individualized family education to reduce negative mental health effects of providing family dementia care. Later, I collaborated on National Institute on Aging multi-site studies of the effectiveness, benefits and limits of Alzheimer’s special care units in nursing homes, culminating in a collaboration with UNC Sheps Center investigators titled “Families Matter in Long-Term Care”, a group randomized trial funded by the National Institute on Aging. “Families Matter” was designed to help families work with staff and residents to create a role for themselves that would benefit the resident’s quality of life and improve family/staff relations. The paper published in the journal, Seniors Housing and Care, won the journal’s Outstanding Research Paper award.
Families of assisted living and nursing home residents were helped to develop plans for their visits which included activities categorized as “doing things”, “getting around”, “looking good” and “eating well”. Families of residents with dementia did not differ in their frequency of visits from other families, but they spent more time on nutrition, mobility and discussing care with staff. Overall, the program decreased family burden and improved resident quality of life. Residential care staff also reported less burnout and greater partnership with families. However, personal care staff reported greater burden and frustration and felt less in partnership and more controlling by families than their supervisors. We learned that creating, roles for families may foster a greater sense of responsibility, but perhaps a concomitant realization that they hadn’t been doing as much as they could or should, which resulted in increased family guilt and conflict.
Currently, I am working with Bobbi Matchar, MSW from the Duke Family Support Program on the “Alzheimer’s Medical Advisor” project funded by the National Institute of Nursing Research, led by UNC geriatrician, Dr. Philip Sloane, with team members from the UNC Sheps Center.
When people with Alzheimer’s disease or related dementias develop new symptoms, such as cough, abdominal pain, or fever, their family caregivers must decide whether the problem is minor enough to try treating at home, or whether to go to a physician’s office or the emergency department. This can be challenging when the person with dementia has difficulty communicating accurately how s/he feels or resists going to an office visit or evaluations by medical professionals. Families need tools to help them evaluate and manage symptoms that could represent new or evolving medical illness in a family member with Alzheimer’s disease.
The “Alzheimer’s Medical Advisor” is a series of materials in development to help family caregivers of persons with dementia deal with these issues. It consists of internet-based, written, and video tools to help concerned family understand, identify, communicate with health professionals, and make decisions about medical problems. The materials will: 1) inform families about common medical problems experienced by persons with dementia; 2) help family caregivers decide what to do next when their family member has a new or exacerbated medical problem; new physical symptom; 3) provide a way to record and communicate information that doctors want to know; and 4) provide home care tips for common medical conditions in persons with dementia.
Please take some time to view the History of the Center, compiled by George L. Maddox, Ph.D., below in whole and in its parts.
The Geriatric Evaluation and Treatment (GET) Clinic, part of Duke’s Center for the Study of Aging and Human Development, is both a service and a resource for the elderly and their families. Since its founding in 1967, the Clinic’s purpose has been to help persons over age 65 cope with the challenges of daily living and health maintenance – a goal that often is made more difficult by chronic illness and the aging process. Core staff members include physicians trained in geriatrics, internal medicine, family medicine and psychiatry, as well as social workers, psychologists and nurses. All have special training and substantial experience in caring for older adults with geriatric conditions. As part of the Duke University Medical Center, the Clinic enjoys access to many other specialists in surgery, medicine and allied health, including physical and occupational therapists. The GET Clinic also serves as a clinical research site. Because of the need to increase knowledge about the normal and abnormal aspects of aging, the opportunity to participate in research activities is offered to some patients. Research functions of the clinic are separate from the service functions, and participation in research projects is entirely voluntary. We look forward to working with you.
Harvey Jay Cohen, M.D.
Center for the Study of Aging and Human Development
The GET Clinic provides a variety of services to older people and their families. They include:
- Medical Evaluation and Treatment of problems common in later life, including (but not limited to) arthritis, osteoporosis, urinary incontinence, shingles, post-shingles pain and multiple medication use. Clinic staff members are skilled in the assessment of elders with multiple problems. The goal of treatment is to help patients participate as fully as possible in the activities of daily living.
- Cognitive and Psychiatric Evaluation and Treatment of conditions such as memory problems, confusion, dementia, depression, anxiety and thought disorders. In addition to having a social worker on the team, the clinic is closely associated with the Duke Family Support Program and can arrange referral to this important resource for family members of patients with Alzheimer’s disease and other disabling illnesses.
- Social Evaluation and Counseling for caregiver stress, adjustment issues for seniors and family members, problems of daily living and problems managing individuals with a dementing illness. The clinic also provides information about community resources that help older people continue living in their own homes.
- Level of Care Consultation to evaluate the need for appropriate care and to plan for it, if necessary.
TO MAKE AN APPOINTMENT
Currently, we accept appointments by physician referral only. Clinic staff members work cooperatively with the patient’s physician to develop a treatment plan that can be carried out in the home community in conjunction with the patient’s primary care provider. All information obtained through the assessment and evaluation in the Clinic will be shared with the family and referring physician as requested by the patient.
Please ask your physician’s office to contact us at 919-620-4070 between the hours of 8:00 – 4:30, Monday through Friday. The Clinic is located at 2580A Stead Bldg, DHS Blue Zone, 200 Trent Drive. Our full information is as follows:
Geriatric Evaluation and Treatment Clinic
Divsion of Geriatric Medicine
Medical Director: Mitchell T. Heflin, MD, MHS
Duke University Medical Center
Durham NC 27710
Physical Address: 2580A Stead Bldg, DHS Blue Zone
200 Trent Drive
Durham, NC 27710
VISITING THE CLINIC
The patient’s first visit takes from one-and-a-half to three hours. During this time, the patient and his/her family will be seen by a number of staff members. Because we make a complete assessment of each patient’s physical, psychological and social condition, it is not unusual for one or two physicians, a social worker, a nurse and other members of the clinic staff to take part in the examination. It is important that a copy of the patient’s medical records be sent or brought to the clinic for the first appointment. This allows staff members to prepare for the patient’s visit. Patients also should bring all the medications that they currently are taking, including non-prescription drugs. The GET Clinic honors private medical insurance, Medicare and Medicaid.
Lisa Gwyther, MSW, education director at Duke University’s Alzheimer’s Disease Research Center was quoted in the June 21, 2015, issue of Parade magazine as saying
“A lot of unmet needs are being responded to spontaneously – to fill the needs for inclusion, for less stigma about the disease and for more focus on quality of life.”
The quote was in an article by Paula Spencer Scott on “People Power: How grassroots campaigns are easing the burden of caring for someone with Alzheimer’s—and improving patient quality of life.”
The articles also says,
“After social worker Bobbi Matchar held an eight week education program at Duke University for people recently diagnosed and their care partners, the group grew so close nobody wanted it to end. So they called themselves ‘the Alphas’ and three years later, still meet monthly at a local restaurant, along with later graduates of the Duke class. ‘It creates a sense of community among people who didn’t choose to have the situation and who often have to quit their old communities at work and church,’ says Matchar.”
Matchar, MSW, is an assistant to Gwyther in the Duke Family Support Program.
Duke School of Nursing
Tolu Oyesanya, PhD, RN is an Assistant Professor at Duke University School of Nursing. She is a graduate of University of Wisconsin-Madison (BS ’11, MS ’12, PhD ’16), and she completed her post-doctoral fellowship in Brain Injury Research at Shepherd Center in Atlanta, GA. Her research program centers on care of persons with traumatic brain injury (TBI) across the treatment continuum, as well as support of their family caregivers. Her current research focuses on transitional care needs of patients with TBI and their family caregivers, with an emphasis on improving post-discharge self- and family-management of care. More specifically, she is developing tailored transitional support strategies to meet the needs of aging persons with TBI and aging family caregivers.
The Research Education Component (REC) recognizes that training in aging research faces several unique challenges, including difficulties recruiting geriatricians into research careers and a lack of training in the principles of aging research by other medical disciplines.
The objective of the Research Education Component will be to develop the next generation of researchers who will become leaders in integrating basic science and clinical insights into innovative interventions promoting reserve and resilience in late life.
Cathleen Colón-Emeric, MD, MHS
Associate Director-Clinical at the Durham VA Geriatrics Research Education and Clinical Center (GRECC), Adjunct Faculty at the Duke School of Nursing and Duke Clinical Research Institute
Current research focuses on the epidemiology, prediction, and prevention of osteoporotic fractures in elderly persons, and in improving the quality of care delivered to residents in skilled nursing facilities. Ongoing projects include a large, administrative database study of osteoporosis screening in men, a randomized trial of different staff education strategies to improve fall prevention in nursing homes, and several clinical demonstration projects. In 2017, Dr Colón-Emeric received the Clinical Sciences Research Mentoring Award from the Department of Medicine, and in 2018 she was appointed Associate Dean for Research Mentoring for the School of Medicine.
Kimberly Johnson, MD
Associate Professor of Medicine
Associate Director of the CTSA KL-2 program
Dr Johnson leads the Duke Center for REsearch to AdvanCe Healthcare Equity (REACH), where researchers study the effect of a clinician communication coaching intervention—teaching empathic skills and eliciting participatory behaviors—on the quality of communication in cardiology encounters with African American patients; test the use of a mobile app for African American patients receiving palliative care in the ICU and their families to self-report needs, obtain information about patient/family needs, and access decisional support; and develop and pilot test an implicit bias training intervention for providers.
CURRENT SUPPORTED PROJECTS
Research Education Component
Daniel Belsky, PhD
Quantification of molecular signatures of resilience in aging
My interests involve investigation of the molecular signatures of resilience to early-life adversity. These include analysis of the association of early-life disadvantage with accelerated aging in midlife, analysis of CALERIE trial data to test if caloric restriction slows biological aging, and analyses to compare multiple methods to quantify biological aging. Additional research aims to identify risk factors in early- to mid-life that can be ameliorated or reversed, and measurement of the effectiveness of these amelioration strategies.
Rasheeda Hall, MD
Resilience in older dialysis patients
I am a nephrologist with both clinical and research interests in geriatric assessment for kidney disease patients. My Pepper-related research aims to understand how dialysis initiation may contribute to changes in physical function and if there is a resilient phenotype of patients who either recover or maintain physical function after dialysis initiation. This research is conducted through primarily data collection from patients aged 65 and older who receive dialysis. I plan to use this information to determine if routine functional tests and other aspects of geriatric assessment are feasible in the dialysis setting.
Juliessa Pavon, MD
Mobile health technology to improve hospital ambulatory activity
There is lack of a reliable and clinically meaningful way to measure mobility in the inpatient setting. Using mobile health technology such as wearable accelerometers is a possible solution. The purpose of this project is to determine whether gathered mobility data by wearable technologies predicts clinically meaningful outcomes, to understand how providers and patients would use this information, and test consumer grade activity monitors in the inpatient setting. Future directions of this work are to explore clinically meaningful thresholds of inpatient mobility activity, and develop a multifactorial mobility promotion intervention using wearable technologies that includes electronic medical record alerts to physicians and feedback to patients.
Micah McClain, MD
Genomic signatures of resilience to viral infections
My current research involves analysis of host genomic and immunologic responses in acute infections, including examining host responses to infectious challenge in vulnerable populations such as elderly and immunosuppressed individuals. Additional ongoing work focuses on defining the host response to fungal infections, tick-borne illnesses, and other emerging infectious diseases as well as the immunologic mechanisms that drive resilience to infection in human hosts.
PREVIOUS PEPPER RESEARCH SCHOLARS Since its inception, the Duke Pepper Center has produced an impressive portfolio of relevant research and innovations in faculty development. One of its many accomplishments is support and mentoring of numerous promising investigators whose careers focus on relevant aging related research at Duke. In 2009, in recognition of the contributions of these young investigators, career development and pilot project awardees, the Duke Pepper Center established a Duke Pepper Scholars Program. 2015 Richard Lee, MD, Endocrinology and Metabolism Rasheeda Hall, MD, Endocrinology and Metabolism 2014 Farshid Guilak, PhD, Orthopedic Surgery and Cell Biology Susan Nichole Hastings, MD, Geriatrics Matthew Hirschey, PhD, Chemistry and Biochemistry Kimberly Johnson, MD, Geriatrics 2013 Juliessa Pavon, MD, Geriatrics 2012 Raquel R. Bartz, MD, Anesthesiology Arati Rao, MD, Medicine Jason Allen, PhD, Cardiology 2011 2010 Timothy Koves, PhD, Geriatrics Thomas Povsic, MD, Cardiology Amy Pastva, PhD, Community and Family Medicine William Michael Foster, PhD, Pulmonary and Critical Care Medicine Matthew Peterson, PhD, Geriatrics Lee Jones, PhD, Radiation Oncology Kelli Allen, PhD, General Internal Medicine Jessica Chia, MD, Pulmonary, Allergy and Critical Care Medicine Jason Allen, PhD, Cardiology Gregory Sempowski, PhD, Duke Human Vaccine Institute David Madden, PhD, Psychiatry and Behaviorial Sciences Beverly Brummett, MD, Medical Psychology Helen Lum, MD, Geriatrics 2009 Kim Huffman, MD, Rheumatology and Immunology Deborah M. Muoio, PhD, Endocrinology & Metabolomics Jama L. Purser, PT, PhD, Geriatrics Svati H. Shah, MD, MHS, Epidemiology, Medical Genomics Heather E. Whitson, MD, Geriatrics Beverly Brummett, MD, Medical Psychology RECENT PUBLICATIONS Colón-Emeric CS, Corazzini K, McConnell E, Pan W, Toles M, Hall R, Batchelor-Murphy M, Yap TL, Anderson AL, Burd A, Anderson RA. Study of Individualization and Bias in Nursing Home Fall Prevention Practices. J Am Geriatr Soc. 2017 Apr;65(4):815-821. Minority Research Publication [Institutional access] [PMC free article] [PubMed] Whitson, HE, Johnson, KS, Sloane, R, Cigolle, CT, Pieper, CF, Landerman, L, and Hastings, SN. “Identifying Patterns of Multimorbidity in Older Americans: Application of Latent Class Analysis.” Journal of the American Geriatrics Society (August 2016). [PMC free article] [PubMed] Johnson, KS, Payne, R, Kuchibhatla, MN, and Tulsky, JA. “Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites?” Journal of pain and symptom management (April 2016). [PMC free article] [PubMed]
Mehri McKellar, MD, Division of Infectious Diseases
Dan Belsky, PhD, Geriatrics
Katherine Hall, PhD, Geriatrics
Kent Nilsson, MD, Cardiology
Katherine Hall, PhD, Geriatrics
Jennifer Dungan, RN, PhD, School of Nursing
James T. Cavanaugh PT, PhD, Geriatrics
Since its inception, the Duke Pepper Center has produced an impressive portfolio of relevant research and innovations in faculty development. One of its many accomplishments is support and mentoring of numerous promising investigators whose careers focus on relevant aging related research at Duke. In 2009, in recognition of the contributions of these young investigators, career development and pilot project awardees, the Duke Pepper Center established a Duke Pepper Scholars Program.
Richard Lee, MD, Endocrinology and Metabolism
Rasheeda Hall, MD, Endocrinology and Metabolism
Farshid Guilak, PhD, Orthopedic Surgery and Cell Biology
Susan Nichole Hastings, MD, Geriatrics
Matthew Hirschey, PhD, Chemistry and Biochemistry
Kimberly Johnson, MD, Geriatrics
Juliessa Pavon, MD, Geriatrics
Raquel R. Bartz, MD, Anesthesiology
Arati Rao, MD, Medicine
Jason Allen, PhD, Cardiology
Timothy Koves, PhD, Geriatrics
Thomas Povsic, MD, Cardiology
Amy Pastva, PhD, Community and Family Medicine
William Michael Foster, PhD, Pulmonary and Critical Care Medicine
Matthew Peterson, PhD, Geriatrics
Lee Jones, PhD, Radiation Oncology
Kelli Allen, PhD, General Internal Medicine
Jessica Chia, MD, Pulmonary, Allergy and Critical Care Medicine
Jason Allen, PhD, Cardiology
Gregory Sempowski, PhD, Duke Human Vaccine Institute
David Madden, PhD, Psychiatry and Behaviorial Sciences
Beverly Brummett, MD, Medical Psychology
Helen Lum, MD, Geriatrics
Kim Huffman, MD, Rheumatology and Immunology
Deborah M. Muoio, PhD, Endocrinology & Metabolomics
Jama L. Purser, PT, PhD, Geriatrics
Svati H. Shah, MD, MHS, Epidemiology, Medical Genomics
Heather E. Whitson, MD, Geriatrics
Beverly Brummett, MD, Medical Psychology
Colón-Emeric CS, Corazzini K, McConnell E, Pan W, Toles M, Hall R, Batchelor-Murphy M, Yap TL, Anderson AL, Burd A, Anderson RA. Study of Individualization and Bias in Nursing Home Fall Prevention Practices. J Am Geriatr Soc. 2017 Apr;65(4):815-821. Minority Research Publication [Institutional access] [PMC free article] [PubMed]
Whitson, HE, Johnson, KS, Sloane, R, Cigolle, CT, Pieper, CF, Landerman, L, and Hastings, SN. “Identifying Patterns of Multimorbidity in Older Americans: Application of Latent Class Analysis.” Journal of the American Geriatrics Society (August 2016). [PMC free article] [PubMed]
Johnson, KS, Payne, R, Kuchibhatla, MN, and Tulsky, JA. “Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites?” Journal of pain and symptom management (April 2016). [PMC free article] [PubMed]
As an undergraduate nursing student at Duke, I vividly recall preparing for “the dreaded nursing home rotation:” an experience that was widely heralded as involving a LOT of hard work with little reward–the antithesis of the high-tech Duke we all embraced. Our preparation was a combination of “handoffs” from other nursing students regarding the idiosyncrasies of the residents in our care, and, pivotally, a guest lecture from Dr. Virginia Stone about age-related changes in the sensory system and how we could use that knowledge to improve our ability to communicate with these vulnerable older adults. Our predictions about the effort required by the rotation were well-founded; however, no one could have predicted the tremendous impact of that experience on my clinical and research career. For a young health professional-in-training, the nursing home held a treasure trove of lessons about complex chronic illness, family dynamics, and health care policy, and showcased the vital influence of nursing practice on outcomes of care for frail older adults. A student-led elective on successful aging, to which Dr. George Maddox contributed, and a community health rotation in the United Kingdom exposed me to important alternative models of care for frail elders that opened up the possibility of a career in geriatrics where I could make a difference.
After holding a series of clinical positions in both residential long-term care and geriatric community mental health, I joined the faculty of the fledgling Program on Aging at University of North Carolina at Chapel Hill (UNC-CH). There I learned the power of interdisciplinary team collaboration with medicine, social work, and rehabilitation professionals, who worked together to infuse geriatrics content into health professions curricula, provide clinical consultations in primary care, and engage with community partners to provide alternatives to nursing home care – work that I pursue to this day as co-leader of Duke’s newly funded Geriatric Workforce Enhancement Project (GWEP). I launched my research career with Drs. Virginia Neelon and Mary Champagne, as we led the first NIH-funded study at UNC-CH School of Nursing, focused on describing the natural history of acute confusion (delirium) in hospitalized elders. The NEECHAM scale, one of the first clinical measures of delirium was developed during this study, along with additional important insights such as the vulnerability of delirious patients to under-nutrition while hospitalized. Under the mentorship of Dr. Carol Clarke Hogue, I completed my PhD in nursing examining the combined effects of cognitive and physical impairment on disability among nursing homes residents with dementia. During this time, I returned to the “Duke orbit” by accepting a position with Dr. Stephanie Studenski, as a Clinical Nurse Specialist on an inpatient rehabilitation service at the Durham Veterans Affairs (VA) Medical Center, later transitioning to a position within the Durham VA’s Geriatric Research, Education and Clinical Center (GRECC). Today I continue my work at the Durham GRECC as a core investigator. I also serve as a tenured Associate Professor at the Duke University School of Nursing, and Director of the Duke Geriatric Nursing Center of Excellence, a member of the John A. Hartford national CGNE network, a focal point for integrating scholarship in research, education, and clinical practice in nursing care of older adults at Duke. One of the signature accomplishments of the Duke CGNE has been the development of the Duke NICHE (Nurses Improving Care of Health System Elders) programs, in partnership with colleagues in the Duke University Health System.
Two overarching aims drive my current research program: (1) How best to design, implement, and evaluate care approaches to improve the quality of life of older adults who have major neurocognitive disorders, and (2) How best to accelerate the process of implementing scientific discoveries in residential long-term care to improve resident outcomes. To address those aims, I am engaged in a variety of interprofessional research and education teams. Three ongoing studies illustrate how my program of research is unfolding. One study I currently lead focuses on establishing the feasibility of preparing master trainers to teach direct care staff Adaptive Dementia Care skills in governmentally-run nursing homes in the US and in China. Funded by the School of Nursing’s NIH-funded ADAPT Center, this study examines the amount of time required to teach registered nurses how to observe behavior sequences and adapt their care approach based on patient behavioral responses to specific approach and cueing techniques during basic care. Ultimately, the goal is to develop a scalable approach to teaching caregivers essential person-centered dementia care skills, taking into account cultural differences in the dementia care experience. Key collaborators on this study include Cheng Yun, Chief Nursing Officer at Huadong Hospital, one of the top geriatric hospitals in China, and Dr. Bei Wu, Director of International Research at the Duke School of Nursing. This project is helping to lay the foundation for ongoing collaborations between the School of Nursing and other key academic partners, including Duke Kunshan University (DKU) in China.
A second ongoing study, funded by the VA’s Health Services Research and Development (HSR&D) Quality Improvement Research Initiative (QUERI), for which I serve as site-principal investigator, involves a mixed-method, multi-center study, to examine the processes required to implement a home safety toolkit (HST) for Veterans who have dementia. Disciplines involved include advanced practice geriatric nursing, neurology, occupational therapy, and systems engineering. In a prior randomized trial, the HST was effective in improving caregiver self-efficacy and reducing caregiver burden. We are now examining clinical processes to promote rapid dissemination of this toolkit among primary care providers within two regions in the Veterans Health Administration (VHA). The ultimate goal of this work is to understand processes that support rapid adoption of evidence-based dementia care practices within large, integrated health care systems.
A third line of research, conducted in collaboration with Duke School of Nursing faculty colleagues Drs. Kirsten Corazzini and Lisa Day, concerns strengthening nursing practice in nursing homes at the clinical microsystem-level, to prevent avoidable hospitalizations. Building on work supported with funding from the Health Resources and Services Administration (HRSA) that supported a Dementia Grand Challenge to motivate improvements in care of people with dementia by linking continuing education learners, pre-professional learners, and faculty, we were approached by a nursing home corporate leader to assist with teaching nursing staff assessment skills to increase their capacity to prevent avoidable hospitalization among their residents with dementia. Dr. Day, who is an expert in situated learning, developed a continuing education series, using narrative pedagogy and unfolding cases to teach nursing home staff how to more effectively use approaches from INTERACT-II: a national program to prevent avoidable hospitalization. Early results are promising, and have led to a recent NIH submission by Drs. Corazzini and Vogelsmeier (University of Missouri) to study these approaches in a multi-state trial.
My colleagues and I welcome the opportunity to work with undergraduate students, graduate students, post-doctoral fellows, and faculty from a variety of professions and disciplines who share our passion for generating and implementing research-based approaches to address the many challenges facing older adults who live with major neurocognitive disorders and other complex chronic illnesses that lead to a need for long-term care.