Presidential Symposium: From Global to Local: An Age-Inclusive and Rights-Based Approach to Gerontological Education

In June 2020, the Gerontological Society of America (GSA) joined in solidarity in the movement to condemn the entrenched racism undermining American society and build upon a gero-rich international historical base of supporting human rights. However, as gerontological educators, we need to expand on the conversation of racism to the broader global discussion of inclusivity and elimination of discrimination. A global focus on human rights of older persons, which began in 1982 at the World Assembly on Aging and has led to the current discussion of the proposed UN Convention on the Rights of Older Persons. The Academy of Gerontology in Higher Education (AGHE) is GSA's education group of colleges and universities that offers education, training, curricular innovations, and research programs in the field of aging. The work of this group is grounded in an age-inclusive and rights-based perspective, and members are committed to an international view demonstrated through AGHE’s tagline Global Leaders in Advancing Education on Aging; This symposium explores the role of age-inclusivity and a rights-based perspective in gerontology and geriatrics education and offers both challenges and best practices for moving forward. The first presentation explores the meaning of age-inclusivity in aging education in a global context and asks how do we build upon our international roots? Our second presenter shares a proposed framework for a rights-based approach to gerontology education. The third presentation explores an example of a rights-based training program. We conclude with a lively discussion focusing on how to take action through education.

Medical/Pharmacy Students Interprofessional Older Adult Medication Interactions/Contraindications Project

The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentors [GEM] program, established in 2014, pairs UNECOM students with older community living adults. GEM assignments focus on health review, medical humanities, and geriatrics training. Each year approximately 90 older adults participate in GEMs. In 2019, the GEM program was expanded with Geriatrics Workforce Enhancement Program (GWEP) grant funding to: include first year medical students, include 2 additional assignments (4 assignments over 10 months to 6 assignments over 18 months), and to create interprofessional student collaboration. In the new GEM Assignment 4: Medication Interactions/Contraindications, UNECOM students with their GEM compiled details on the GEM’s medication list (prescriptions, herbal, OTC); one of 4 Ms of Age Friendly Health Care. UNECOM students (84 pairs) were then assigned to UNE School of Pharmacy (SOP) students (42 SOP students had 2 UNECOM pairs) to conduct a “Lexicomp” (App) medication interactions and Beers Criteria review. UNECOM students documented findings with the SOP student partner; discussed the processes of review with their GEM and the resultant findings; documented the GEM’s questions and how the UNECOM student answered those questions; and discussed next steps for the GEM regarding options for different medications - especially follow up with their prescribing physician(s) for any noted interactions/contraindications. For GEMs with few medications, a mock medication list was assigned to ensure student experiences with medication reviews and GEM discussion. Although time intensive preparation is required, UNECOM & SOP students attained significant learning as did the GEM mentors.

Clark Tibbitts Award and Hiram J. Friedsam Mentorship Award Lectures

The Clark Tibbitts Award lecture will feature an address by Debra Dobbs, PhD, FGSA in memory of the 2021 award recipient, Kathryn Hyer, PhD, FGSA. AGHE's Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education. The Hiram J. Friedsam Award lecture will feature an address by the 2021 award recipient, Pamela Elfenbein, MSW, PhD, FAGHE, HS-BCP. Hiram J. Friedsam was the professor, co-founder, and director of the Center for Studies in Aging and dean of the School of Community Service at the University of Northern Texas. Dr. Friedsam was an outstanding teacher, researcher, colleague, and mentor to students, faculty, and administrators, as well as a past president of AGHE. The purpose of this award is to recognize those who emulate Dr. Friedsam's excellence in mentorship.

The Development of a Stakeholder Member Organization to Advocate for Geriatrics Education

The National Association of Geriatric Education Centers organization was established in 1990, to promote interdisciplinary geriatric education and to provide a unified voice for Geriatric Education Centers (GECs). In 2005, the GECs voted to form two non-profit organizations due to restrictions related to lobbying activities. An umbrella organization was created, the National Association for Geriatric Education, that includes all geriatric related education programs, and maintain a lobbyist in Washington DC to protect the GECs interests. It was a pivotal time, as we had a year (2006) without federal funding that summarily dismantled the DHHS-HRSA geriatrics programs, including the entire GEC network, the geriatric fellowship program, and Geriatric Academic Career Awards. This resulted in a GEC-wide and national geriatrics movement that succeeded in restoring the geriatrics line item in the President’s budget. Our advocacy efforts not only had the line item restored, but obtained an increase in funding for geriatrics.

Development of Dementia Best Care Practices in Long-Term Care Settings Online Modules

One arm of the Utah Geriatrics Education Consortium focuses on providing Alzheimer’s disease and related dementias (ADRD) education to formal and informal caregivers. An interdisciplinary group of faculty developed a 3-hour online training program focused on best care practices, recommended by the National Alzheimer’s Association, for persons with ADRD residing in long-term care settings. Topic include: 1) Overview of Dementia (e.g., What are types of dementia and the associated symptoms?), 2) Understanding Behaviors and Your Approach (e.g., What are the best methods for recognizing and reporting behavior change?), 3) Effective Communication within Long-Term Care (e.g., What are the best strategies to enact effective team meetings?), and 4) Communication and Responding to Behaviors (e.g., What are methods for reducing patient agitation?). Throughout the four modules a case study follows “Mrs. Jones” to demonstrate the skills and techniques raised in each module. Pre- and post-evaluation questions are embedded in the training program.

Clark Tibbitts Award Lecture

The Clark Tibbitts Award lecture will feature an address by the 2020 award recipient, Jan Abusharkrah, PhD, FAGHE. AGHE’s Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education.

Medical Students' Longitudinal Learning With Older Adults: Geriatrics Education Mentor Program

The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentor (GEM) Program is in its sixth year. It's a joint project between older community living adults and 2nd year medical students within the Osteopathic Clinical Skills course. The GEM program goal is to foster understanding and importance of the person/patient-provider relationship. Pairs of osteopathic medical students (N=87 +/- 5) were assigned to an older adult GEM (mentor) volunteer (N=87 +/-5) living within a 50 mile radius of UNECOM. Snowball sampling was used to recruit the GEMs; student participation is required. Four (4) home visits were conducted over 9 months with an assigned GEM; each visit included a new assignment. Students observed, summarized, and recorded experiences communicated by the GEM for each cumulative assignment. Data from assignments were “graded” and content analyses of open ended evaluation/summary questions were conducted. This program is UNE IRB approved. Student pairs completed all assignments. Assignments analysis on Blackboard revealed that students developed respect and awareness of life and medical experiences of the GEM; expressed understanding of the GEM’s life experiences and goals for what “matters most”. Relationships with older adults were established while students maintained professionalism and succeeded in competent and confident interactions. Documentation review from the 4 assignments aided in building students’ geriatrics knowledge, attitudes and skills. Pre-clinical medical education tends to be episodic; providing an opportunity to establish longitudinal assignments over the course of the academic year with the same older adult augments relationship skills and learning in geriatrics.

Current and Future Geriatrics Education Policy Initiatives

Current and future NAGE policy-related activities will be the focus of this presentation. The Geriatric Academic Career Awards (GACAs), which support the career development of junior faculty clinician educators in geriatrics, were reinstituted by HRSA in 2019 after a 13-year absence. We will discuss the role of this award in the broader context of geriatrics education and GWEPs, how GACA awardees have been integrated into NAGE, and the need for expansion of the GACA program to support both the GWEP and geriatric education pipelines. Areas for future NAGE engagement will be focused on advocacy efforts to support: permanent GWEP reauthorization by Congress; expanding current level of $40.737 million to $51 million to enable HRSA to increase the number of GWEPS to further extend their reach; increasing funding for GACA awardees; and strengthening the synergies between the GACA and GWEP programs to support development of future GWEP leadership.