Lee-Ling Chen is one of the de Tornyay Center for Healthy Aging’s 2023-2024 Healthy Aging Doctoral Scholars, and a UW School of Nursing Adult Gerontology Primary Care Nurse Practitioner Doctor of Nursing Practice student. Her project is on “Fall Prevention and Management for Older Adults in Assisted Living Service Programs within Retirement Communities”. Her faculty mentor is Jonathan Auld, PhD, MAT, RN.
Why did you choose nursing?
My interest in nursing dates back to when I was about 10 years old. My grandmother was hospitalized with a post-hip replacement infection. One of my aunts insisted on giving her more nutritional support in hopes of keeping her alive. However, her body was declining and unable to absorb the nutrition and fluids. I felt that there was no purpose in prolonging her suffering. Eventually, she passed away after a few days. This experience profoundly impacted me and shaped my future aspirations. I realized the importance of providing the best care to patients based on their wishes and desires. Letting the loved one go is uneasy, but nursing guides us in listening and providing support for patients and their families.
Nursing is a rewarding career because it allows me to help people and make a positive difference in their lives. Additionally, the knowledge I gain can also be used to care for my own family. That’s why I chose nursing.
What made you interested in this topic for your DNP project?
For my DNP project, I am focusing on fall prevention and management in a retirement community, specifically targeting older adults who receive assisted living services. My interest in this topic is deeply personal. My dad has Parkinson’s disease and now also has dementia, which significantly affects his daily activities and balance. He has fallen multiple times, resulting in various injuries and fractures.
Through this project, I hope to develop strategies that will help older adults in assisted living programs prevent falls. Observing my father’s struggles made me realize that there are ways we can improve fall prevention and support the residents in these facilities. That’s why I chose to work on this topic.
Why is this research project important to do?
Fall prevention is a significant topic that has been discussed for a long time, but there is not much research focusing on older adults in assisted living services. Furthermore, the senior retirement community that I worked with was seeking recommendations on updating their fall prevention and management policies, which have remained unchanged since 2013. Effective fall prevention measures have markedly decreased falls, leading to cost savings and reduced mortality and morbidity.
For this project, I utilized the Ottawa Model as the framework, focusing on the Assessment phase, which includes innovation, potential adopters, and the practice environment. This approach helped identify barriers and informed project planning, aiming to bridge the gap between current practices and evidence-based recommendations. The findings from my project included comparing recent guidelines with Era Living’s policy and conducting an assessment of staff and residents via interviews. These interviews focused on awareness, attitudes, knowledge, and experiences related to fall prevention and management.
Has there been anything that surprised you while working on the project so far?
I was surprised that I didn’t find much evidence specifically focusing on fall prevention in assisted living. There’s limited information available on this area, possibly because I restricted my research to recent years. To address this, I used similar research on fall prevention and gathered related evidence that could be applied to residents in assisted living.
Another surprising finding was the reliance on community health nurses in retirement communities to identify individual risk factors and the confinement of fall risk assessment. According to the AHRQ’s Safety Program for Nursing Homes, an effective policy should incorporate interdisciplinary input on resident fall risk. This highlighted the importance of interdisciplinary input in creating comprehensive and effective fall prevention strategies. It made me realize how crucial it is to involve various healthcare professionals, residents, and families in assessing and managing fall risks to improve older adults’ overall safety and well-being.
What interests you about healthy aging and gerontology?
What fascinates me about gerontology is how our bodies change as we age. The presentation of symptoms in older adults can be atypical compared to younger individuals, which requires a specialized understanding of their unique needs. Older adults are a vulnerable population, and my interest in gerontology arises from my desire to help them navigate available resources and avoid unnecessary medications through deprescribing.
By focusing on healthy aging, I aim to improve the quality of life for older adults and support them in maintaining their independence and well-being. Everyone will get old. We’re aging every day, but the key is how to age healthily.
Did you have any past experience working with older adults in your career before you came to the DNP program?
I worked in the orthopedics unit and primary care settings before I came to the DNP program. At the hospital, I cared for many older adults who needed knee and hip replacements, as well as those with fractures and amputations. I loved interacting with them and learning about their lives, which provided me with invaluable insights into the challenges they face.
In my career, I also learned a lot from older nurses in the primary care setting. They have shared invaluable life lessons and knowledge with me, enriching my professional growth and understanding of geriatric care. Their mentorship has been instrumental in shaping my approach to nursing.
Additionally, I have always been the one taking care of my grandparents and now my parents because I have a nursing background. I truly appreciate the time spent with them and being able to utilize my nursing skills in caring for them.