TCOM medical students have hands-on geriatrics education
Posted Sep 06 2011 8:47am
Within a few minutes, it becomes clear that what 102-year-old Beauregard Hale needs most is someone to talk with.
Second-year medical student Luis Gilbert is happy to provide that as he makes a house call to check on the elderly man’s health. Gilbert spends most of the visit listening to Hale’s story of a recent trip to New York City and Washington, D.C., before checking the Fort Worth man’s vital signs. “He comes over here to take my blood pressure to find out if I’m still living,” Hale jokes. “If anything were seriously wrong, he’d catch it, but there’s nothing much wrong with me.”
As one of 272 seniors participating in UNT Health Science Center’s Seniors Assisting in Geriatric Education, or SAGE, Hale is teaching Gilbert a lesson that’s not so much about illness as aging well.
“Mr. Hale, he’s such a healthy person,” Gilbert said. “He’s an amazing man.”
At least four times a year, Gilbert and another medical student from the Texas College of Osteopathic Medicine come by to check Hale’s vital signs and monitor his medication. Most of all, they listen.
“We’re learning how to better communicate with patients and understand how they feel about the medical process, their doctors and their own health,” Gilbert said.
Since it began in 2009 the SAGE program has served 412 area seniors, almost 40 percent of them over age 81. Most were selected through their participation in Meals On Wheels. The rest were chosen from senior centers, the UNT Patient Care Center and the community.
Students are required to participate in the program, which is funded by a $2 million grant from the Donald W. Reynolds Foundation and matching funds from UNTHSC. The grant ends next year, but school officials hope to continue the program.
By spending time in elderly patients’ homes, students develop an understanding of how best to care for the elderly. They also gain insight into the many issues faced by older people.
Gilbert discovered early on how important independence was to Hale, who still drives, follows the stock market and travels. Before a fall last year, he walked a mile a day.
The first time Gilbert arrived at Hale’s Fort Worth home, the elderly man was leery.
“He didn’t want to go to a nursing home and he thought that’s why we were there,” Gilbert said. “But we could see he has a better quality of life at home. Once he realized that, our relationship got a whole lot better.”
Since then, their relationship has deepened.
“I love talking to elderly people and feel like they have so much wisdom to give,” Gilbert said. “I look into his eyes and I just wonder how many different things he has seen over his lifetime.”
For a generation that had little contact with their grandparents or other seniors while growing up, this is a chance to develop relationships and learn how to really appreciate older adults, said Dr. Janice Knebl, a geriatrician and professor of internal medicine at UNT Health Science Center.“These are their first patients,” she said. “Some of these students have never touched a person like this before.”
During the visits, the medical students see what they’ve read about in their textbooks, from the thinner skin that comes with aging to changes in a person’s heartbeat.
“As we get older, our heart gets a little more musical,” Knebl said. “Doctors need to recognize sounds that are benign and sounds that are not. They need to know whether it is normal or disease.”
Typically, medical students don’t get many opportunities to see how humans age.
“I think when you can attach something to real life, you remember more as opposed to reading a book,” Knebl said. “Our hope is that if we expose students to this early on, they will embrace the care of older adults.”
It’s a population that doctors need to be prepared for. By 2030, about 20 percent of the population will be over 65, according to the census.“The medical education system hasn’t kept up with this population,” Knebl said. “But every doctor needs to know how to take care of every patient as he or she ages.”
Students have learned that and more.
“They’ve installed grab bars in bathtubs, provided locks and arranged transportation,” Knebl said. “One group of students arranged for a hole to be fixed in an elderly patient’s home.”
A few have faced experiences that they did not expect; some seniors have died or moved to hospice.
“Some of these students have never lost anyone before,” Knebl said.
Over the past year, Gilbert said Hale has shared personal experiences with him as well as his secret for longevity, which he attributes to good genes, low stress and luck.
“I have learned a whole lot from him,” Gilbert said. “Not just about medicine, but about life.”