A creative way to expand the geriatrics workforce

June 11, 2020

Geriatrics is the field of health care focused on care for older adults. Experts suggest that our current geriatrics workforce needs better preparation to care for the 5.7 million people living with dementia in this country. To help meet this challenge, the Institute of Medicine has called for enhancing educational and training programs for improving the competence of the workforce, and to ensure that our workforce reaches the level needed to serve the growing population of older adults with dementia.

Despite these ongoing efforts, the shortage of geriatricians makes it difficult to meet these urgent educational needs. For this study, a team of researchers looked "outside the box" to learn more about whether creative solutions could offer valuable opportunities for addressing these issues. In this new study, the researchers outlined the results and outcomes of an undergraduate service-learning course that used music and filmmaking to teach person-centered approaches to dementia.

The course, which included music, filmmaking, and reflective writing components, focused on service at local dementia care settings and was conducted in collaboration with Music & Memory, a non-profit organization dedicated to bringing personalized music playlists to people living with dementia or other serious medical challenges.

The three-credit undergraduate service-learning course was developed and taught by a music professor over three consecutive semesters with 16 to 18 students each term.

The students worked in pairs at one of two dementia care settings. Students received initial classroom training on dementia, ethnomusicology (music anthropology), ethnographic fieldwork methods (the technical term for expert research based on studying people and culture), filmmaking basics, and creative aging.

A gerontologist social worker was invited to offer guest lectures each semester to train students in the basics of dementia care and dementia communication. Students also attended an initial orientation visit to their field site before filming. Over five to eight weeks, students completed six or seven three-hour visits to the dementia care settings, either assisted living facilities or adult day health centers. Their tasks for the semester were to create personalized music playlists for participating older adults and to document these experiences through short films.

During these visits, students worked with people living with dementia who had consented by proxy to participate. At the end of the semester, playlists developed for these participants were loaded onto iPods and given to the people with dementia to use with the help of staff and family members. The students took turns interacting with the people and filming the process.

Throughout the course, students wrote multiple essays, workshopped their films, and discussed their experiences as a group. At the end of the course, students shared their films with the people with dementia and their families, the dementia care facilities, and the local community through public and private screenings. If given permission by families, student films were also shared online. As their final assignment, each student wrote a reflective essay about the film and their experiences in the course.

Three major themes and one unexpected finding emerged in this study:

1. Music helps students connect with people with dementia in meaningful ways.

2. Filmmaking offers students the opportunity to share unique, person-centered stories about dementia and music that empowers the voices of people with dementia.

3. Reflective writing enables students to process new experiences and lessons learned.

According to the researchers, one way to build a larger geriatrics workforce could involve using resources found outside the realm of geriatrics and health sciences education. For example, arts and humanities approaches to the study of dementia have the potential to humanize the condition for potential geriatric trainees.

"By teaching students to view aging through creative, intercultural and interdisciplinary frames, we have the opportunity to shape a new generation of health care professionals, artists, and community members who will be motivated to collaboratively work towards addressing the needs of our rapidly aging populations," said lead author Jennie Gubner, PhD, from the University of Arizona and the Global Brain Health Institute. "Whether studying classical guitar, nursing, anthropology, public health, or business and marketing, everyone has something to offer to conversations about brain health and aging."

As one student put it: "I wish I could meet everyone by learning their favorite songs because it tells you so much about a person, more than any conversation ever will. I also realized how many misconceptions I had about those living with dementia. It does not define them, it is just a piece of who they are, just as we are all made of different pieces."
This summary is from "Transforming undergraduate student perceptions of dementia through music and filmmaking." It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Jennie Gubner, PhD; Alexander K. Smith, MD, MS, MPH; and Theresa A. Allison MD, PhD.

American Geriatrics Society

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