KINGSTON, R.I. — November 10, 2020 — An older adult named Daureen told of the difficulties she has with otherwise simple tasks like cooking because of the arthritis in her hands. She detailed the medicines she takes, expressed concerns about falling, scheduled follow-up physical therapy appointments, and even got a quick mental health checkup, all in a single virtual meeting with a group of University of Rhode Island students from the colleges of the Academic Health Collaborative.
The annual Senior Day is a health and wellness program for older adults in the community organized by the Colleges of Health Sciences, Nursing and Pharmacy. About 30 seniors meet with teams of URI graduate and undergraduate students for a comprehensive assessment of their health — diet, vital signs, sleep habits, medications, mobility, strength, balance. Ordinarily an in-person event held on a single day in Independence Square, this year’s program took place over a series of virtual sessions due to the ongoing COVID-19 pandemic.
About 150 students in physical therapy, nutrition, pharmacy, nursing, communicative disorders, psychology and human development and family studies, as well as students from Johnson & Wales University’s occupational therapy program, broke into teams to meet with individual clients via Zoom, provide comprehensive health screenings and write recommendations for each client, sometimes referring them to additional services, including the physical therapy clinic at URI.
“It’s been good to have all sorts of different health professionals come and work together,” said Kaley Ahern, a second-year grad student in URI’s doctor of physical therapy program who headed up Daureen’s session recently. “It’s a good chance for us to get to meet different health studies professionals and work together to see how everyone works, because in the real world, that’s how it is. So it’s nice to have exposure to that while in school.”
The program started nearly a decade ago with about 14 volunteers and physical therapy students, according to Janice Hulme, clinical professor of physical therapy and an event organizer. In recent years, it has expanded to include other disciplines, giving the students a chance to work closely with peers in other health fields.
The team aims to conduct an overall health check — physical and mental — on each client. Nutrition students consult with clients on the healthiest diets for them; communicative disorders students work on any communication issues, if any; and psychology and human development and family studies students check in on their mental health and family life, among other check-ups.
Pharmacy student Alicia Ademi went over the medications Daureen takes to manage her diabetes and the pain of arthritis. She asked the client about her adherence to the medication schedule and any side effects she had experienced. She explained alternatives to medication, including therapeutic supplements like CBD cream for her arthritis, but given Daureen’s satisfaction with her medication schedule, they agreed she should stay with her current plan.
“For physical therapy, we’re looking to see where they are with their fall risk, look at their medical history – maybe there’s some medication they are on that puts them at risk of a fall,” Ahern said, noting the group scheduled a follow-up program with URI’s Physical Therapy Clinic for Daureen. “What are their activities and exercises? Are they generally an active, healthy person? Are they hearing right? Are they able to see properly? Are there any interventions that we could recommend or education we can provide them to help them if they are at risk? We’re learning how to express questions to them and how to get a good history and ask the right questions for their evaluation.”
That education for students is as much a part of the program as is the wellness check for the senior volunteers. The students learn from their clients and from each other while providing a benefit to the clients.
“I learned a lot about what the other majors did. For instance, the HDF student asked a lot of personal questions about depression and social aspects of life,” Ahern said. “I feel like sometimes as a PT student, I know we should ask those questions, but that topic can be more uncomfortable to discuss. So it was really nice to see how well and how fluent she was with asking those personal questions, so it gave me good insight for the future. This is something I’m happy I had the opportunity to do; it’s so unique to be able to work with the different health practitioners. It’s good practice for our future.”
Handling the complications imposed by the COVID-19 pandemic adds another layer of education for the students and clients, who have all gotten a lesson in telehealth and Zoom appointments.
“It’s been really challenging with COVID just doing this all remotely, so I’ve really enhanced my communication skills being able to work as a team when we can’t physically see each other,” Ahern said. “And we need to work with a patient when we’re not physically there to pick up on some cues or be there to support them. So that added another whole layer that made it kind of challenging.”
The students have been able to power through the challenges, Hulme said, and continue to provide important advice to their senior clients. The challenges have actually presented opportunities to learn, both for the students and the clients.
“Delivering the program virtually actually improved the team aspect and prepared students for the challenges of telehealth,” Hulme said. “The program was very successful, and there was one unanticipated benefit that came with the changes. Because of the additional number of visits, seniors learning Zoom, and doing the ‘visits’ while the seniors were at home, many groups formed bonds in ways we did not expect.”
The students have formed bonds with each other and their clients.
“My senior has given me so much great information from her own life, like telling me she walks backwards down stairs because it puts less pressure on her knees,” Ahern said. “Just by having a conversation with her I’m getting ideas of things I can suggest to patients in the future. The seniors realize it’s for our educational purposes and our practice, and I think they enjoy being able to be teachers with us and communicate with us. It’s a really unique opportunity to be able to talk to someone different.”