The view from our third floor balcony
When Judy and I first retired, it felt like looking over a precipice. There was only a sketch of a plan and we wondered how it would all work out. But a few years down the road and opportunities have come along.
I have been thinking about retirement as a process this week, because a journal article just came out with me as lead author about a study that came about quite fortuitously. Around the time that we moved to Pittsburgh, I was asked to serve as a consultant at Presbyterian SeniorCare Network. We have written previously about Woodside Place, their outstanding dementia residence.
In my consultant role, I attended a meeting at one of the rehabilitation units run by Presbyterian SeniorCare. An occupational therapist, Chris Krause, who works for a computer company called iN2L (an acronym for “It’s Never too Late”) demonstrated the use of the computer platform that iN2L developed for engaging persons with dementia in rehabilitation activities. Presbyterian SeniorCare was thinking of purchasing some units for their rehabilitation programs. The presentation, which included video, showed that the iN2L had considerable promise in rehabilitation. Patients could be engaged in therapy activities by using music, video or other stimuli selected from the iN2L’s library. It wasn’t just any music or any video, but it was selected to match the interests of a particular patient. Although the system had been adopted in many rehabilitation programs, there was no research on it. So sitting there and feeling calm because I had no work demands to worry about, I blurted out, “It would be easy to do a study.” I was asked to develop a plan, and Presbyterian SeniorCare obtained a small grant to fund the study.
The idea for the study was to determine if the iN2L was effective in increasing engagement in the rehabilitation process for someone with dementia, and if increased engagement led to better outcomes. If the iN2L could do that, it meant that would be possible to help more persons with dementia regain functioning after an illness or injury. Remaining as independent as possible is very important in dementia. People then are able to remain active doing things they enjoy, and are less likely to become restless, bored or agitated.
To do the study, we compared patients with dementia at two rehabilitation facilities run by Presbyterian SeniorCare, one that was going to use the iN2L on a trial basis and another facility that was not getting the iN2L. The two facilities had similar policies, staffing and patient populations.
I had a great team to work with—supervisors and staff at the two rehabilitation units, and two research assistants who gathered the data. But the research was not without its stress. It took months to obtain human subjects approval from Penn State for the research and then from the State Department of Health. And then once the study was finally up and running, I found myself having all the worries I used to have when I was conducting a study. I would wake in the middle of the night worrying if we would get enough subjects to enroll in the study, whether we could get the data we wanted, what was the right way to do the data analysis, and would we find anything at all. It was a small-scale study (96 participants in the end) and it can be hard to show results with a small study.
So what happened? The iN2L worked. Persons with dementia at the rehabilitation unit that had the iN2L showed increased engagement in therapy and better rehabilitation outcomes than the comparison unit. The iN2L helped restore a bit more independence that usual care. You can link to the full study below, if you are interested. Access will be free in a couple of weeks.
This study was a path that unexpectedly opened up for me. Some retirement paths will take people in new directions. For this work, however, I got to use well-practiced skills, and apart from some sleepless nights, it was an enjoyable process, especially in light of the good people I worked with and the good outcome. The next path might take me in a different direction. It’s a matter of being open to the possibilities.
You can find the paper at:
It will be available soon through open access (free).