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Release: Feb. 6, 2002

Kathleen Buckwalter, noted geriatric nursing researcher, to deliver UI Presidential Lecture

Addressing the needs of older Iowans with impaired mental faculties will be the subject of this year's Presidential Lecture, to be presented at 3:30 p.m. Sunday, Feb. 24, at the Levitt Center for University Advancement on the University of Iowa campus. The event is free and open to the public.

Kathleen C. Buckwalter, Ph.D., professor of nursing and UI associate provost for health sciences, will deliver the talk, titled, "Who Will Care? Research and Service on Behalf of Iowa's Impaired Elders."

Buckwalter, a registered nurse, is a prolific researcher of issues affecting older adults, with particular emphasis on geriatric mental health. She has written and consulted extensively on both the needs of older individuals with mental and cognitive impairments and on the needs of their caregivers, be they family members or health professionals. In her talk, Buckwalter will outline the demographic trends that will strain health care resources in the coming decades. She will also challenge policy makers and health care providers to apply knowledge that already exists about how to improve services for elders, especially those with mental health needs.

"We already know a great deal about how to improve the delivery of needed services in ways that can save money in the long run," Buckwalter said. "But most importantly, we also know we can do this in ways that are compassionate and allow elders and their families to receive the care and services they need in the settings they prefer -- that is, in their own homes and communities.

"Our challenge as health providers and researchers is to see that this knowledge is put into practice every day throughout the state."

The 2000 census showed that Iowa ranks as one of the oldest states. Nearly one in five Iowans -- 18.8 percent -- is 60 or older, with those 85 and older making up 2.2 percent of the population. Almost 30 percent of Iowans 65 and older live alone, and a quarter of Iowa households have individuals 65 and older living in them. Depression is common among older Iowans, often related to retirement, the loss of a spouse or physical impairment. Any of these life events may leave the older individual feeling isolated and unable to adjust, which can lead to depression. Other common mental problems include dementia brought on by Alzheimer's disease and similar disorders and acute confusion related to factors such as dehydration, medications or pain.

Buckwalter has been instrumental in efforts to improve services for mentally impaired elders and those who provide care for them. She led a project to design and test an outreach program to identify and provide mental health services to elderly rural Iowans, who typically fell through the cracks of the existing system. The project integrated a variety of health, mental health and human service agencies in the planning and delivery of services, and trained hundreds of so-called "gatekeepers" -- rural mail carriers, veterinarians, grain and farm equipment dealers, and others who might have day-to-day contact with older community members -- to recognize signs of mental impairment and make appropriate referrals to qualified service providers. The project, which was independently evaluated, succeeded in identifying clients who otherwise might not have come to the attention of the local social service network; interviews with a sample of clients suggested significant improvements in depression and other psychiatric symptoms.

Another way to improve mental health services for elders is to provide more training to staff in nursing homes, where up to 70 percent of residents over age 65 experience mental health or behavioral problems. Buckwalter and a team of specialists at the UI and the Abbe Center for Community Mental Health in Cedar Rapids developed an interactive, statewide train-the-trainers program for nurses at about 100 long-term care facilities in Iowa. The nurses learned how to train other workers, most of them nursing assistants, to better meet the mental health needs of residents. In all, more than 1,500 Iowa nursing home staff benefited from the program. The program was replicated in rural Virginia with minority staff members to ensure the cultural competence of the training materials.

Buckwalter has also turned her attention to the needs of professional and family caregivers. Her funded research and consultation includes projects to assess the effects of institutionalization of persons with Alzheimer's disease on family members who had cared for them at home, and to integrate family members into care plans for institutionalized elders. She has written on elder abuse by family members and long-term care facility staff as well.

In addition to her place on the UI College of Nursing faculty, where she is UI Foundation distinguished professor, Buckwalter has appointments in the UI Departments of Psychiatry and Internal Medicine in the College of Medicine; she also is co-director of the UI Center on Aging, associate director of the Gerontological Nursing Interventions Research Center and co-principal investigator of the Hartford Center of Geriatric Nursing Excellence at the UI. Buckwalter's contributions to nursing science and practice are nationally recognized, earning her membership in the National Academy of Science's Institute of Medicine and the American Academy of Nursing, as well as numerous awards and honors.