Arkansas State University

Tech and Aging

By Jessica Camp, MSN, APRN, AGCNS-BC
College of Nursing & Health Professions, Arkansas State University

It appears that more older adults are using technology in their daily lives (Davis, 2019). According to a study by AARP, mobile devices and computers are the primary technology used by this population (Anderson, 2017, p. 3). To a lesser extent, older adults reported managing their healthcare and learning with this technology. Another study by PEW Research Center Older Adults and Technology Use (Smith, 2014) found that:

Six in ten seniors now go online
Just under half are broadband adopters
Younger, higher-income, and more highly educated seniors use the internet and broadband at rates approaching—or even exceeding—the general population
Internet use and broadband adoption each drop off dramatically around age 75
27% of older adults use social networking sites such as Facebook, but these users socialize more frequently with others compared with non-SNS users
E-readers are as popular as smartphones

Sadly, however, Davis (2019) points out that the design of technology used by older adults rarely focuses on them. This article aims to shed a bit of light on some of the technology that may be useful or even helpful for older adults and technology that is actually designed for the older adult.

Interestingly enough, these are not the only technology-based items, nor services, available to older adults. Currently, there is a multitude of technological products marketed specifically for older adults. Nextavenue contributing write Patricia Corrigan shared an overview on several tech items that can help older adults who serve to maintain their independence, such as:

Wearable battery-operated emergency alert systems (such as Philips Lifeline), which detect falls and summon help
The Apple watch (Series 4), which monitors your heart rhythm and detects falls
Some cell phones (such as GreatCalla), which offer emergency response buttons
Voice-controlled devices (such as LifePod), which work with “smart” speakers to remind you when to take your medication or head to a medical appointment
Cameras, microphones and motion sensors (Evermind makes one version), which monitor your regular activity — or signal a lack of it to your caregiver (2018, para. 2)Surprising to this author, there is a company offering transportation normally available through the use of technology to older adults. One company provides transportation for older adults by turning traditional on-demand transportation systems (like Uber, for example) already in place into senior-friendly transportation. Older adults can call an eight-hundred-number and press a few buttons once registered, to obtain a ride, and even return home all the while sharing information with the family about their activity through messaging communication. This service charges twenty-seven cents per minute currently in addition to the service rate charged by the transportation company for the travel. Unfortunately, it is not yet available in all parts of Arkansas. However, the zip code 72002 for Little Rock provided the following rates (from their website):
Not surprising, there is more than one company that markets cell phones, including smartphones, to our older adults. One such company touts that they are the home of the “original easy-to-use cell phone” (Greatcall, 2019a, para. 1). They also offer a family caregiving device that includes a wearable communicator designed for two-way communication, fall detection, and GPS locating features that are reportedly waterproof. Further, they offer a version of this that tracks fitness and looks similar to the traditional wearable device providing the same features (Greatcall, 2019b). Another company offers more conventional cell phones with some additional services designed for urgent and emergent communication around the clock (Snapfon, 2019, para. 1-3).

Ride Fare:
$3.60 base fare + $0.76 per mile + $0.15 per minute (with a minimum fare of $7.60)

and
Concierge Fee:
$0.27 per minute

* Please note that during periods of high demand, our vendors may include a surge charge (gogograndparent.com, 2018)

Despite older adults still reporting skepticism regarding technology, the trend is up on use for most aspects. This article shows that there is no shortage of new ways technology is being garnered to help out older adults. Let this article encourage you to learn more about how technology can assist your older adult patients, your family or even yourself.

Smith, (2014). PEW report. Older Adults and Technology Use. PEW Research Center. Retrieved on January 14^th, 2019 from http://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/

Anderson, M., & Perrin, A. (2017). PEW Report. Technology Use Among Seniors. PEW Research Center. Retrieved on January 14^th, 2019 from http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/

Abrahms, S. (2015). 3 Must-have cell phones for seniors. Retrieved on January 17^th, 2019 from https://www.forbes.com/sites/nextavenue/2015/06/17/3-must-have-cell-phones-for-seniors/#238490ce6cce

Greatcall. (2019a). About us. Retrieved on January 17^th, 2019 from https://www.greatcall.com/about-us

Greatcall. (2019b). Feel safer on the go. Retrieved on January 17, 2019 from https://www.greatcall.com/devices/lively-mobile-medical-alert-system

Snapfon & Excellcious Communications LLC. (2019). Easy to use features. Retrieved on January 17, 2019 from https://www.snapfon.com/big-button-cell-phone/

Snapfon & Excellus Communications LLC. (2019). sosPlus mobile emergency management services. Retrieved on January 17, 2019 from https://www.snapfon.com/sos-plus/

GoGoGrandparent. (2018). How it works. Retrieved on January 17, 2019 from https://gogograndparent.com/

Corrigan, P. (2017). Technology can help us age in place, if we let it. Nextavenue: Where Grown-ups Keep Growing. Retrieved on January 14^th, 2019 from https://www.nextavenue.org/technology-age-in-place/

Anderson, G.O. (2017). Technology Use and Attitudes Among Mid-life and Older Adults. AARP Research. Retrieved on January 14^th, 2019 from https://www.aarp.org/content/dam/aarp/research/surveys_statistics/technology/info-2018/atom-nov-2017-tech-module.doi.10.26419%252Fres.00210.001.pdf

Interdisciplinary Collaboration in Simulation Education

By Dr. Patricia Guy-Walls, LMSW; Dr. Evi Taylor, LCSW and Sarah Eberwein, BSW
Arkansas State University

Simulation, particularly in healthcare, is becoming a popular modality for clinical education and training (Davies & Alinier, 2011). Through the creation of realistic scenarios and the use of innovative equipment, students are able to practice skills in real life like-settings until they are mastered (Green, Tariq, & Green, 2016). Simulation education enables students to gain the necessary skill sets needed for successful careers that cannot be acquired solely from textbooks and lectures. Simulation creates an opportunity for orientation to new procedures, exposure to rare clinical situations, assessment of knowledge, and evaluation of skills (Green et al., 2016). When providing optimal care, healthcare providers must be able to communicate with patients, their families, and other treatment team members. Therefore, interdisciplinary collaboration is an important factor in simulation education as it allows students to experience teamwork with students from other professions (Manning, Skiff, Santiago, & Irish, 2016). The Department of Social Work’s Simulation Training and Research (STAR) House is a new innovative approach in the College of Nursing and Health Professions at Arkansas State University. The STAR house was developed to “mimic” the conditions and tasks professionals may encounter while in a community setting. This article will provide a discussion of the STAR House and discuss how simulation training across disciplines can enhance students’ learning.

STAR House

Research consistently shows the effectiveness of simulation education in allowing students to practice their skills in real life-like situations. The benefits of simulation and interdisciplinary collaboration are well established in the literature (DiVall, Dolbig, Carney, Kirwin, Letzeiser, & Mohammed, 2014, 2014; Ertmer et al., 2010; Manning et al., Lateef, 2010 2016; Mooradian, 2008). The success of simulation education played a key role in the development of Arkansas State University’s Simulation Training and Research (STAR) House, the newest addition to the College of Nursing and Health Professions.

The STAR house is a furnished 2 bedroom, 1 bath house on Arkansas State University’s campus that can be staged to create a wide range of realistic experiences. For instance, social work students will practice family therapy skills in a real house, with a family, role-played by other students. The house can be staged with drugs, foul smells, bugs, loud noises, etc. and students will practice how to respond and provide services in these real-life like situations. The house can also be staged for students to assess safety for child welfare classes. There are video cameras throughout the house that record the students. This allows them to be evaluated by professors, classmates, as well as themselves. Watching the recordings provides valuable feedback as it enables students to see the techniques they need to improve.

The STAR House can be used by a variety of students including, social work, child advocacy, counseling, psychology, sociology, criminology, occupational therapy, physical therapy, nursing, and disaster preparedness. Community agencies such as the Division of Children and Family Services (DCFS) and law enforcement officials will also utilize the STAR house to conduct trainings. Each discipline can stage the house accordingly to provide an environment allowing students/workers and a team of individuals to practice and strengthen their skill sets.

The STAR House will utilize approaches that correspond with the way most adults learn: inductively, from specific to general, and through practice and feedback. This environment will provide an opportunity for students and professionals to improve their knowledge while assessing their skills. Participants will have the opportunity to develop skills for gathering and evaluating data, environmental assessment, effective interviewing and problem-solving. Students from multiple disciplines will participate in real-life situations where they can apply skills learned in the classroom and garner knowledge while dealing with real problems in a controlled, collaborative, learning environment. This new tool will add an essential component of professional practice through case studies and examples that present challenges that arise in everyday professional practice.

In conclusion, simulation education has been proven to be an effective and preferred method for learning among interdisciplinary teams. Research shows simulation has been instrumental and effective in demonstrating health care situations across the life span from how to handle emergency situations in labor and delivery (Davies & Alinier, 2011) to providing safe practices in home health care for seniors (MacDonald, Galbraith, Halliday, Smith, & Willett, 2013). Students and professionals utilizing simulation education experienced improvement in many areas including confidence, critical thinking, contextual perspective, logical reasoning, reflection, and communication (Ertmer et al., 2010). They also gained knowledge of their own roles and the roles of students from other professions (DiVall et al., 2014). As the first simulation house in Arkansas to be connected to a college campus, the Social Work Department housed in the College of Nursing and Health Professions has been given an extraordinary opportunity as a trailblazer to provide students with simulation experiences. Based on the current literature, it is anticipated that the students utilizing the STAR House will enhance their knowledge base (Lateef, 2019), improve retention of material learned (Oliva & Compton, 2009), and improve their communication and interactions with various healthcare professions (DiVall et al., 2014; Manning et al., 2016) which should allow them to provide more effective services to patients/clients.

References

Davies, J. & Alinier, G. The emergence of simulation-based clinical training outside of the Westernworld. Retrieved from https://www.researchgate.net/publication/275599317_The_growing_trend_of_simulation_as_a_form_of_clinical_education_a_global_perspective

DiVall, M. V., Kolbig, L., Carney, M., Kirwin, J., Letzeiser, C., & Mohammed, S. (2014). Interprofessional socialization as a way to introduce collaborative competencies to first-year health science students. Journal of Interprofessional Care, 28(6): 576-578. doi: 10.3109/13561820.2014.917403

Ertmer, P. A., Strobel, J., Cheng, X., Chen, X., Kim, H., Olesova, L., . . . Tomory, A. (2010). Expressions of critical thinking in role-playing simulations: Comparisons across roles. Journal of Computing in Higher Education, 22(2): 73-94. doi: 10.1007/s12528-010-9030-7

Green, M., Tariq, R., & Green, P. (2016). Improving patient safety through simulation training in anesthesiology: Where are we? Anesthesiology Research and Practice, retrieved from http://dx.doi.org.10.1155/2016/4237523

Lateef, F. (2010). Simulation-based learning: Just like the real thing. Journal of Emergencies, trauma, and shock. 3(4), 348-352

Manning, S. J., Skiff, D. M., Santiago, L. P., & Irish, A. (2016). Nursing and social work trauma simulation: Exploring an interprofessional approach. Clinical Simulation in Nursing, 12(12): 555-564. doi: 10.1016/j.ecns.2016.07.004

MacDonald, K., Galbraith, Y., Halliday, K., Smith, K., & Willett, T. (2013). Simulation for at-home care for seniors: An environmental scan. Toronto, ON: SIM-one; 2013

Mooridian, J. K. (2008). Using simulated sessions to enhance clinical social work education. Journal of Social Work Education, 44(3): 21-35. Retrieved from https://search.proquest.com/docview/209795274/fulltextPDF/560CE290E39347E4PQ/1?accountid=8363

Oliva, J. R., & Compton, M. T. (2009). What do police officers value in the classroom? A qualitative study of the classroom social environment in law enforcement education. Policing: An International Journal of Police Strategies & Management, 33(2): 321-338. doi: 10.1108/13639511011044911

Taghva, A., Rasoulian, M., Bolhari, J., Zarghami, M., Esfahani, M.N., & Panaghi, L. (2010). Evaluation of reliability and validity of the psychiatry OSCE in Iran. Academic Psychiatry, 34(2): 154-7

Watters, C., Reedy, G., Ross, A., Morgan, N. J., Handslip, R., & Jaye, P. (2015). Does interprofessional simulation increase self-efficacy: A comparative study. BMJ Open, 5(1): 1-7. doi: 10.1136/bmjopen-2014-005472

Creating a Gerontology-focused Health Fair

New CNHP ASU Logo

by Jessica E. Camp, MSN, APRN, AGCNS; Addie N. Fleming, MNSc, RN, CCRN; Valerie Fielder, BS, CDP, and Samantha M. Hollis, BSN, RN, CDP
Edited by Dr. Susan Hanrahan and Dr. Linda Tate
Arkansas State University, UAMS Center on Aging Northeast & Schmieding Home Caregvier Training Program, St. Bernards Medical Center

The committee designed a health screening event for older adults, their caregivers, and professionals that provide care to older adults. Northeast Arkansas has a large number of elderly, care givers, and a large variety of professional services. The event was designed to bring everyone together. It was planned for November to increase attendance by avoiding other area events and in conjunction with National Family Caregiver Month. The Fair gathered more than 200 patients and 90 vendors from the community. This article shares the successes of the event and the opportunities for next year.

Advisory Panel
The Center on Aging had a vision for the event. The mission and vision were shared with the team during recruitment and revisited at the initial meeting. An advisory panel consisted of the many health professionals, community members, university faculty and leaders from services for older adults in the area was invited to participate.

Health Screenings
The local university, ASU, provided a great foundation for creating a health screening event.

The physical therapy department provided “timed up and go” (TUG) screenings aimed at identifying balance issues and risk for falling. Social work faculty provided anxiety and depression screenings. Communication Disorders students provided hearing screens in a private room. Nursing students provided blood pressure checks, height, and weight and body mass index screenings. Dietary Approaches to Stop Hypertension (DASH) diet education was given verbally and in writing to persons at risk for or currently experiencing hypertension. Exercise, weight loss and the DASH diet can help control chronic illnesses, such as heart disease and diabetes, making it important information to share with older adults and their caregivers (Cash & Glass, 2015, p. 1047).

The Arkansas Department of Health provided vaccinations based on the Center for Disease Control and Prevention (CDC) recommendations for adults and older adults (Cash & Glass, 2015, pp.18-21). Hilltop Eye Care and Southern Eye Associates provided vision screenings and education on cataracts and glaucoma. St. Bernard’s Imaging Center conducted bone density screenings as well as total cholesterol, anemia, and glucose laboratory screenings. Higginbotham Family Dental provided dental screenings. Additional professionals were invited and provided services or information about services.

Transportation
Transportation for the public was not available to the event. This was noted by some persons unable to attend as a barrier. Requests to public transportation and local churches to enlist transportation assistance were not met. For the 2018 event, negotiations are in process.

Communication
Some screening groups left before the event ended which participants complained about. Critical conversations with the voluntary service professional groups will need to take place early in the planning of the 2018 event to ensure the professionals stay for the whole event, which could include shortening the event.

A secondary communication issue was not being able to hear announcements made at the event stage. With exciting activities such as the mayor’s appearance and a physician’s panel, it was difficult for the audience to hear anywhere past the first row of vendors. This is an opportunity that can be corrected for the 2018 Senior Expo (Larsen, 2018).

Professionals
Health professionals, caregivers, and patients were targeted to receive education during the event. Several vendors voiced a desire to attend the planned educational sessions, but were unable because they were also manning a booth at the event. In post-event discussions, it was decided that a separate educational event targeting health professionals could be a solution.

Vendors
While the volume of local vendors involved in the first annual event surpassed the goal, there were still challenges. Discussions with leaders of another local annual health fair shared tactics that prevented vendors from leaving their event early, such as imposing fines or not inviting them to future events.

In summary, these services met the needs of many older adults. Senior Health Fairs bring value to the intended audience. Targeted health fairs, such as this one, provide more opportunities for older adults to interact with health professionals in the community. With the success of the first event, the 2^nd Annual UAMS Center on Aging Northeast’s Senior Expo is scheduled for November 9, 2018.

References:

Cash, J. C. & Glass, C. A. (2016). Adult-gerontology practice guidelines. New York: Springer Publishing Company.

Larsen, P. (2018). Lubkin’s chronic illness: Impact and illness. Burlington, MA: Jones & Bartlett Publishing.

Rhoads, J. & Peterson, P. S. (2018). Advanced health assessment and diagnostic reasoning (3^rd ed.). Burlington, MA: Jones & Bartlett Publishers.

Does the use of hearing aids improve balance — fact or fiction?

by D. Mike McDaniel, Professor of Communication Disorders / Arkansas State University

Recently, a team of researchers from a prestigious medical school published the results of a study in which they reported that hearing aid use apparently resulted in improved balance within an elderly sample of hearing impaired individuals (Rumalla, Karim, and Hullar, 2015). These findings were subsequently summarized in a second tier publication favored by, and directed at those, who dispense hearing aids. A recent internet search using “hearing aids” and “improved balance” as key words resulted in an alarming number of sites across the country that dispense hearing aids citing the article and its claims as a marketing tool. Given the fact that the elderly have the greatest risks for falls, which are the leading cause of injury and death in the elderly, and the elderly exhibit the largest incidence for hearing impairment, if the use of hearing aids do improve balance then certainly this information should be disseminated from within the scientific community following extensive clinical trials.

The method by which the medical school chose to assess and report balance was primitive and did not represent current state-of-the-art technology. Fortunately, the Arkansas State University Physical Therapy Department does have computerized posturography which is assessed via a sensory organization testing device. The device is a NeuroCom Balance Master. Through the combined effort of the Communication Disorders and Physical Therapy Departments, researchers were able to replicate the original study. Researchers used a similar population of adult experienced hearing aid users, the same research design, and the more sophisticated NeuroCom Balance Master.

The recent abstract of the AState replication project is as follows:
“The purpose of this study was to evaluate the balance of experienced adult hearing aid users with and without their hearing aids via Computerized Posturography (CP). CP was accomplished by employing the Sensory Organization Test (SOT) on the NeuroCom Balance Master. The SOT assessed each participant’s balance and the strategy used to maintain balance in six progressively challenging conditions. Twenty two adults using bilateral at-the-ear hearing aids participated in the study. All participants completed all SOT protocols with and without their hearing aids. No statistically significant differences in participants’ balance were identified regardless of the presence or absence of their hearing aids during SOT. These results failed to support previous research, which indicated that amplification of auditory input could benefit balance in individuals with hearing and balance disorders. Further research utilizing randomized controlled trials is needed to resolve the disparity between the current results and those of previous studies.”

Clearly, the results of this replication study did not support those from the original research report. In short, researchers were unable to demonstrate any statistical relationship between balance and the use of hearing aids from this group of participants. Findings do support the need for a comprehensive clinical trial before claims of improved balance from hearing aid use can be made.

References:

Rumalla, K., Karim, A. M., & Hullar, T. E. (2015). The effect of hearing aids on postural stability.
The Laryngoscope, 125, 720-723. doi: 10.1002/lary.24974