Scholar Spotlight: Karl Cristie Figuracion

Karl Christie Figuracion

Karl Cristie Figuracion is a PhD in Nursing Science candidate and one of the de Tornyay Center’s 2022-2023 Healthy Aging Doctoral Scholars. Her project is “Environmental enrichment and cortical changes among brain tumor survivors”. Her faculty mentor is Dr. Hilaire Thompson.

Why did you choose nursing?

I chose the nursing profession, as I was really moved by the care that my grandmother received when she was sick, and seeing the nurses be involved by her bedside throughout the sickness, even toward the end of life.

It was all related to my clinical practice. I was seeing patients with brain tumors, and after treatment, I started noticing cognitive issues. I saw people who were physically engaged or socially engaged and able to return to work. They tend to do better. When I looked at the literature, there wasn’t really much research in terms of this patient population or this question. I went back to school with this premise of learning the methodology to ask these questions and to do this research to help patients with brain tumors.

What interested you about research?

What is your project with the de Tornyay Center?

Looking at environmental factors, specifically environmental enrichment, being physically active, social engagement or social network, and return to work, and how that influences healthy aging among cancer survivors after radiation.

Why is this project important to do?

I think about my patients after cancer diagnosis, and having to already undergo that treatment and having fought so hard and then they continue to experience cognitive issues, functional decline. Yet we still are lacking research as to what helps them after their treatment.

What sort of functional decline do you see after brain tumor treatment?

So after brain tumor diagnosis, they go through surgery. After surgery, sometimes they have neurological issues, whether that’s weakness on one side over the other, or whether it’s word-finding difficulty, whether it’s balance issues related to where the tumor was in the brain.

After treatment, some of our patients continue to have these, even if it’s mild. That’s the other thing that I wanted to see, how can we prevent this progressive neurological decline? They continue to have this, despite not having the disease itself.

Has there been anything that has surprised you while working on research projects during your PhD program?

One of the things that I probably enjoyed the most, and was surprised about, was how much enthusiasm my patients have in this type of research. We probably asked 39 patients and 37 agreed. As soon as I said, we’re working on this, it was just like, yes. I hadn’t even told them about the reimbursement.

What interests you about healthy aging?

It’s the fact that it’s so broad, and it truly applies to all populations, because we all age. So whether that is going through a chronic disease, whether that’s after treatment, whether that’s after a brain injury or a traumatic event. We go on and live our life. This research is about continuing to live your life, despite all of those challenges and all of those issues.

You mentioned your work with cancer patients. What’s your clinical background?

I have been a registered nurse since 2011, and I went back to school for my masters, to be a nurse practitioner in 2013, because I wanted to expand my role so that I could better advocate for my patients. As I was completing my master’s program, I was an outpatient oncology nurse.

I still work as a practitioner at the University of Washington Alvord Brain Tumor Center. I have two days of clinic, and am very involved in the quality improvement projects.

What’s it been like balancing being a practicing nurse and a PhD student?

I see both of them together, honestly. I’m currently leading the neuro-oncology survivorship program at the Alvord Brain Tumor Center. One of the core and foundational things about our program is research, and here I am learning the methodology of this research to better help our patients. So I see it hand in hand. There’s a lot of overlaps.

I think last quarter was probably one of the challenging quarters that I had, because I was working as a 50% nurse practitioner, and I also had the opportunity to teach the NCLIN 501 and 500. So that’s 50% and 50%, and then a full time student, trying to enroll my patients. It’s definitely put into perspective what our faculty go through trying to switch hats between being a clinician, being an instructor, and then being a researcher.

Scholar Spotlight: Tedra Hamel

Tedra Hamel

Tedra “Teddi” Hamel is an Accelerated Bachelor’s in Nursing Science student and the de Tornyay Center’s 2022-2023 Myrene C. McAninch Undergraduate Scholar. Her project is “Understanding Age-related Psychological Changes: A Secondary Data Analysis”. Her faculty mentor is Dr. Basia Belza.

Why did you choose nursing?

Coming from a background in outdoor education, I am used to working with a group of ten students for four or eight weeks. It’s a life changing experience for those students, but it’s a small population to work with. I wanted my next profession to be more accessible to more people. I hope to work in the ER at some point. The ER is a place where you serve anyone and everyone –people don’t have to be healthy enough to go on a backpacking trip. So it’s about giving my energy and resources to more people instead of just ten at a time.

What made you want to do research?

I come from a liberal arts background. My BA was in history and I had to do a thesis for graduation. I did a full year of research during my senior year of undergrad. I feel like doing research helps you delve into the issues of a field in a way that you might not fully get if you’re just working.

Could you briefly describe your project with the de Tornyay Center?

My project will be on the psychological changes that are self-identified in older adults, using the Engaging with Aging framework initially developed by Doris Carnevali.

The main framework of Engaging with Aging is identifying coping mechanisms and adaptations that older people are already using.

I’ll be analyzing the transcripts that have already been collected and looking for broad themes of psychological changes with the hope of identifying strategies and resources, that older adults already use themselves to get through those challenges and changes. Knowing these adaptations can be very helpful for those that work with older adults.

What sort of psychological changes are you looking for in the transcripts?

What I’ve seen is that a lot of it is changes in emotional feelings, or how emotions are expressed, or all of a sudden they’re feeling a lot of sadness or feeling less emotion. So, how their psychological understanding of themselves and their feelings change over time.

Why is this research important to do?

I like this project based on the fact that we’re hearing older adults’ voices on how they are experiencing aging, instead of just applying blanket techniques, or band-aids, or what we think is right.

I know the Engaging with Aging research is informing providers on good ways to support older folks in their own self-identified strengths and adaptations versus just applying something outside of them.

What interests you about healthy aging?

I was young when three of my four grandparents died, but my mom’s mom lived until 2019. She had dementia for the last seven years of her life, and seeing her go through that and seeing my mom support her was eye opening. Our society doesn’t have good solutions or good structures in place for everyone that has to go through aging. I think that sparked my care and passion for it.

Then, the last few years I’ve been working in rural health in Eastern Washington as a medical assistant and also an EMT, and there’s so many people in the older population that just don’t have the resources. It’s really hard to live out there, and so the EMS system is used a lot to support them. If they fall at home, they’ll call 911 and then the EMTs get sent out there to help them get up.

There’s only 12 beds in the local assisted living facility and there’s always a year long wait list. So people tough it out at home, even though that area receives up to four feet of snow every winter. It was a really interesting place to get introduced to aging at home because a rural place is a totally different ball game than the city. So I got curious about how we help folks age gracefully in our society.

What are your plans after graduation?

I do want to get ER experience here in the city. I want to be a flight nurse at some point in the future. That environment really suits my skill set but that would allow for a lot of other work too. I could see myself being a clinical nurse in my small community in eastern Washington. That position is a really cool combination of nursing skills. You set up flu vaccine clinics at the local assisted living centers, as well as being the nurse at the local urgent care, etc. You end up working with the whole population. But mostly I’m planning to graduate, and probably work in a hospital for a few years to get experience.

Scholar Spotlight: Dariga Tugan

Dariga Tugan is an ABSN student and one of the de Tornyay Center’s 2022-2023 Healthy Aging Undergraduate Scholars. Her project is “A descriptive analysis of variability in exercise (VO2 Max) to address differences in physical function and alleviation of symptoms in older adults living with HIV”. Her faculty mentor is Dr. Allison Webel.

Why did you choose nursing?

I chose nursing because it’s an interesting blend of arts and sciences where you get to tailor your care to the patient’s needs. I wanted to master the art of spreading love during times of fear and uncertainty in people’s lives. Spreading joy, helping people heal, and understanding the human body with its interactions in medicine is beautiful to me.

What interested you about nursing research?

I absolutely love research. In my free time, I’d often print out articles from PubMed and just read through them. But the reason why I got interested in research was, unfortunately, health care is extremely racist. A lot of our research is catered to white males.

The way that our health care system works is the therapies, the medications, even the non-pharmacologic therapies are all based on research, which is primarily done on white males. So, entering the space where you can advocate for more diversity and bridge that huge lack of diversity in research, specifically with people of color, was a big interest to me.

What interested you about healthy aging?

I started off my nursing career in a nursing home around 2020. I became passionate about alleviating suffering for those during the final stages of their lives because oftentimes I was the last person that patients would see as they passed. The reason for this is our facility didn’t allow any visitors during the height of the pandemic, and I began to ask myself questions. How do I utilize my privilege of being the last person they see to ensure that they are suffering less? Is restricting access to seeing their family really benefiting or keeping older adults safe in the pandemic?

I would see how this nursing home specifically would charge patients fifteen thousand dollars a month for subpar care. I got really interested in brainstorming new ideas and solutions to address healthy aging and the gerontology populations. It was these ideas that drew me to join the honors route for the BSN program to better understand and create awareness around the need for quality nursing homes, especially for the people who can’t afford them.

Could you briefly describe your project?

It’s a descriptive analysis of variability and exercise to address differences in physical health, aka the VO2 max, in older adults living with HIV. VO2 Max is a measure of cardiovascular fitness and aerobic insurance based on the maximal oxygen consumption of individuals in a defined exercise protocol.

There’s a myriad of research surrounding VO2 Max in older adults, and it’s actually the strongest independent predictor of future life expectancy in both healthy and individuals with cardiorespiratory disease.

We have a lot of studies on VO2 Max and exercise in older adults, as well as exercise in older adults living with HIV, and VO2 Max and HIV specifically. But my study would be addressing the gaps in our knowledge. Specifically, the data will be surveyed using VO2 max at baseline and excelerometry at baseline between decades of people in their fifties, sixties, and seventies.

A lot of these studies also do not focus on older adults with HIV, so data that compares the age groups would be of utmost importance.

I did a literature review and there’s a call for action to have better definitions and studies on interventions that can improve physical function and VO2 Max in HIV-infected patients. I think that these data that I analyze can inform and empower older adults living with HIV to engage in strategies to improve their physical function.

What are your plans after graduation?

I plan on working in ICU, but I am dual enrolled in a post-bacc premed program right now, so I’m applying to medical school in October. I love pharmacology and pathophysiology. I think that becoming an ICU nurse and then going to medical school will allow me to study more pathophysiology, but also bring an interesting nursing perspective, which is holistic.

Is there anything else you want to share?

I’m an immigrant from Almaty, Kazakhstan, and not many people know what Kazakhstan is. But it is the ninth biggest country in the world. It was a part of the Soviet Union, so they speak Russian there. It has a huge Russian culture. A lot of the background is also Muslim. So you have the Muslim culture, the Russian culture, and our own Kazak culture, which is a nomadic culture, which is beautiful because you have such an intersection of so many different personalities and viewpoints.

It’s allowed me to be diverse in my own thinking and the way I approach people and solutions. My own family is Christian. Balancing my relatives being Muslim and then my own Christian family, it’s all balanced like the yin and yang of life. I love being an immigrant, and I like being from Kazakhstan.

(Article correction: The original article mentioned a lack of women in research before 1976, which has been removed, as there were clinical trials before that date which included women).

Ageism Interview: Harriet Adhiambo

Harriet Adhiambo is a PhD Nursing Science student at the University of Washington with experience in clinical and implementation science research. Her work has mainly focused on improving maternal, child, and adolescent health outcomes using innovative strategies including mHealth and improving retention and viral load suppression among patients living with HIV/AIDs in Western Kenya. She is currently working at the Webel Research Lab as a Graduate Research Student Assistant in the High Intensity Exercise to Attenuate Limitations and Train Habits in Older Adults with HIV study (HEALTH).

This interview is a part of a series on ageism, completed by de Tornyay Center predoctoral scholar, Sarah McKiddy (sm256@uw.edu). Read her article on ageism here, and find more interviews on ageism here.

What are two to three action items that we could do on an individual, practical level to redirect ageist remarks by others?

We first need to speak with individuals who feel they are now old and cannot perform certain tasks and do not want to take the time to think through things because they feel or fear they’re too old for them. Some older adults feel like they can’t go out and dance. But who said that? Talking to individuals could help create a different mind shift. Everyone will grow old, but it does not mean being old you’re incapacitated – mentally, emotionally, or physically. Do what you can as a person. If you love dancing, dance. If you love music, listen to music or participate in music. Keep yourself active because idleness and not engaging yourself very much leads to thoughts of no longer being valuable. Talk to them and give them even examples. You could also form groups or clubs for people to meet and engage them in exciting activities and encourage them to do the work if they have the strength.

The fact that someone is incapacitated, or has some illnesses, should not push them down. They should still seek treatment but continue doing what they can. In Kenya, there is an expression we call “old age syndrome”, in which you start complaining of headaches, stomach aches, and all these symptoms. For the family, it is most helpful to be supportive.

I’ve observed in the U.S. that when people get older, they’re taken to adult family homes because they need someone to take care of them. Sometimes, the environment may not be as conducive because they’re going to an environment with people who are not familiar to them. You need a social support system. Those who are still working probably feel they don’t have the time to take care of their parents, so they move them to other community homes. What are the alternatives? Can a caregiver take care of a relative in their home environment?

Ageism is a global challenge, but there are unique variances in the ways that different countries, cultures, and communities discuss aging. How can we make this a collective global effort?

It will involve stakeholder engagement not just within the U.S. – globally. Engage all global leaders in this discussion. For example, In Kenya, if you want to engage in such, we can involve the people at the community level because, in Kenya, most people stay within the communities or the rural places. We need to engage as many community members who are considered older adults — or, as we say in Kenya, simply “old people” — as possible. Ask them what they want to see because if you get their opinion, you’ll be able to better advance in terms of the interventions you want to offer to them. And then these interventions will have a better chance of improving their lives so they can live fulfilling lives. With elders, global leaders, and stakeholders, you need their perspectives on aging and the particulars unique to each community. We need to bring all those ideas together and ask ourselves what our priorities are and what is achievable now – short-term, mid-term, and long-term.

Scholar Spotlight: Priscilla Carmiol-Rodriguez

Priscilla Carmiol-Rodriguez is a PhD in Nursing Science student and a de Tornyay Center for Healthy Aging Pre-doctoral Scholar. Carmiol-Rodriguez’s research interests include sleep and health inequities.

Why did you choose nursing?

I wanted to be in a profession or discipline working more closely with people throughout the entire lifespan. Nursing has broadened my perspective of what this profession can do for people’s health and well-being. Particularly, I’m interested in the scope nursing has on inequities. In my undergrad program, health inequities were central to our curriculum. It’s crucial for us to be aware of it and how it impacts health outcomes.

What areas of research are you interested in?

After the COVID lockdown, I started seeing many people with sleep problems. I was also affected by that. I began to look for information on what we could do to improve the situation. I started learning about the health inequities related to sleep health. I saw how this affected people of all ages, particularly older adults, and how it was detrimental to their health.

Where did you see these sleep problems? Were you seeing these sleep problems initially as a practicing nurse or somewhere else?

In people of all ages, teenagers, younger adults, and older adults. It affected a lot of people. Sometimes we consider poor sleep part of our daily life, and that it’s normal to have these kinds of problems. But it’s not.

When I was a practicing nurse, I started seeing people — because I worked in a hospital setting — that because of the changes in the environment, it was impacting their health. They might complain about, “I cannot sleep”, “I’m tired all day”, or “I’m sleeping during the day because over the night I cannot sleep because I’m not in my home”, or because of the all the noise that comes with the hospital.

Then I started seeing my co-workers, friends, and people who talk about how they’re facing the lockdown, say, I cannot sleep, or I sleep, and I don’t rest enough. During the lockdown, it was more evident how this impacts people.

You mentioned health inequities and sleep hygiene. What kind of inequities exist?

Lower-income people have a higher risk of insomnia, and sometimes if you don’t have money to pay for health care, you don’t have access to sleep healthcare to help you. Maybe you have other priorities, where to live, what to eat, so you don’t worry about your sleep.

What made you realize that you wanted to transition into doing research?

I have always been interested in research. I did some higher education research. However, it was important to me to do nursing research. Moreover, I want to be able to help other younger nursing generations to become nurse researchers. If you don’t research, you cannot teach others to do it. You have to be hands-on.

Have you done any healthy aging work in the past?

I worked in healthcare simulation for about ten years. I spent most of my professional career as an educator. So I did not work directly in healthy aging, but I used to work with a gerontological nursing course. We tried to develop educational interventions for students so they could provide education to older people. The main objective was to be aware of the stereotypes or biases you have when working with older adults because most of them are not right. We were trying for them to be more aware of that.

Additionally, I worked closely with older adults, facilitating a simulated participant training program for older adults. They were vital part of members of the simulation team back in my previous work, as they served as consultants in the simulation design and actively participated in the simulation-based learning events. Their contribution to our student’s education is so valuable.

What interests you about healthy aging?

As we age and our life expectancy grows, we should be able to be autonomous and have the best life that we can have, no matter how old we are. It’s not only for older people, but for everyone, because everyone is aging. Healthy aging, for me, is a framework to help our patients or communities to have better lives across their lifespan

I am interested in sleep because if we have better sleep quality, we will have a better quality of life. We will have more energy. Our cognitive function is going to be better. Therefore, we will have more possibilities to engage with our communities, and reach our individual goals as we age.

Scholar Spotlight: Emily Ahrens

Emily Ahrens is a second year PhD in Nursing Science Student, who received funding from the NTI Joan Culp funds and de Tornyay Center for the 2022 AACN’s National Teaching Institute & Critical Care Exposition (NTI) conference.

Why did you choose nursing?

I’ve always found the human body and helping people to be fascinating and compelling. Nursing specifically came to me after my close friend in college got in a severe car accident and I went and visited her while she was intubated and had several chest tubes. The ICU nurses made us feel less scared about what happened to her and what was going on. It made me feel like that was important, to be able to help people through some of these really serious, scary events.

At the same time, I had been on a trajectory to do a physical therapy type of program. I was talking to my next door neighbor, who was a critical care nurse, and she let me job shadow her. I was like, this is definitely where I want to be. I really enjoyed the critical thinking aspect. I really enjoyed the camaraderie of the ICU team. It felt very meaningful to me.

What made you want to go into research?

I wanted to impact more people than I could physically take care of. I wanted to contribute to developing new research that produces better outcomes for people. I looked into the DNP, and the PhD, and a master’s course, and a PhD seemed very interesting. Now that I’m in it, I feel like I’m definitely in the right spot. I think my brain has been a research brain this whole time.

What are your areas of research interest?

I’m a critical care nurse, and I have been for 10 years. My area of interest is ICU delirium, specifically focusing on patients with limited English proficiency. I have a theory that they experienced more ICU delirium than patients who speak English. There’s a big research gap in that area.

ICU delirium, if you don’t know, it’s a somewhat common but very consequential sequela of being critically ill, where you enter this altered state of consciousness fluctuating between hyperactivity and hypoactivity. It’s independently associated with PTSD and neuro cognitive deficits that are part of post intensive care syndrome. If someone has ICU delirium it can be devastating for their long term quality of life as a critical care survivor.

I think certainly older people are at high risk for it but also patients who don’t speak English, in my personal bedside experience, are at a higher risk for it than English speakers. So I’m hoping to do more research in that area to get down to the bottom of that problem.

What about ICU delirium made you want to study this area?

As a bedside nurse it’s really difficult to manage. Especially when they’re hypoactive, you can’t do rehab with them easily because you can’t get them to do much and that really limits their healing and their ability to gain strength. Then when they’re hyperactive it’s like you’re in a wrestling match just trying to keep your patient in bed and from pulling their lines out, even when you restrain them and restraints make it worse. A lot of hospitals, regardless of your patient having delirium, will pair you with another patient, so you have to try to maintain this person’s safety while taking care of someone else. It’s really, really stressful and difficult.

Then I learned about post intensive care syndrome and how much it correlates with more severe post intensive care syndrome symptoms, like neurocognitive deficits and PTSD and decreased strength from ICU acquired weakness. Some people can have it for years. It was devastating to me. It made me want to do more for people while they’re critically ill to try to set them up better.

Is there anything known about how to reduce ICU delirium?

It’s very, very researched. There’s probably tens of thousands of articles on ICU delirium. There’s multiple reasons why people get it, that both are and are not preventable. The sicker you are, the more severe illnesses, people get medically sedated, that all contributes. Then you’re in a hospital environment where you don’t get your circadian rhythm acknowledged, there’s continuous interruption in your sleep, and you’re in pain, and there’s so many things that contribute to that. It can be really difficult to prevent, which is why so many people get it. The most recent numbers that I have seen in research was that if you’re not mechanically ventilated it’s somewhere between 20 to 40%, and then, if you are mechanically ventilated, it’s between 60 to 80% of patients. That’s after 20 years of research.

The Society of Critical Care Medicine has a campaign that they call the ICU liberation campaign. It’s to use the A, B, C D E, F bundle to try to reduce the occurrence of delirium and post intensive care syndrome. Which is to try to get people off ventilation as soon as possible to minimize the amount of sedation that they get if anything at all. To mobilize them, even while they’re on the ventilator to reduce the weakness, to keep their brain engaged. To involve their family, which helps them stay calm and more oriented. Trying to mimic the day night cycle to protect the patients circadian rhythm as much as possible, and treating pain first instead of providing sedation when someone looks like they’re uncomfortable. But to do that bundle properly, it takes a very large culture shift in the way that critical care is done now. Part of the reason why it’s continues to persist at such high rates is that culture is incredibly difficult to change.

I know you attended AACN’s National Teaching Institute & Critical Care Exposition (NTI) conference. Could you share a little bit about that?

I wanted to go because I’ve never been. It’s our national conference. Now that I’m more research-oriented and I’ve been taking more leadership type of roles at work, I wanted to see what is new out there and what other people are doing. I went as both a PhD student and a clinician, in that I couldn’t help but be involved in the clinician stuff, learning about the best way to intubate someone or what does this medication do. It’s fascinating to see people putting research into place and how that’s working for them. Talking to some of the other PhD nurses was helpful to look to some examples of what you can do with a career in PhD, as well as some networking.

Is there anything you want to share?

I am doing a symposium presentation at the Council for the Advancement of Nursing Science (CANS) in September in Washington DC. It’s a concept analysis of effective communication with patients who are linguistically diverse. It’s an evolving concept, because the only real thing that’s out there is to use accurate interpretation. I’m excited to present on it because it’s the backbone of all of my research, which is that the reason I think patients have more difficulty with delirium in ICU, is because we can’t communicate with them as well when they’re intubated. Once we establish what effective communication looks like we can start to improve that health disparity.

Ageism Interview: Victor Yampolsky

Esteemed teacher, conductor and violinist Victor Yampolsky served as Carol F. and Arthur L. Rice Jr. University Professor in Music Performance at the Northwestern University Bienen School of Music; Music Director of the Peninsula Music Festival in Door County, Wisconsin; Music Director Emeritus of the Omaha Symphony, as well as the Honorary Director of the Scotia Festival of Music in Halifax, Nova Scotia, Canada.

Born in the Soviet Union in 1942, Victor Yampolsky – the son of the great pianist Vladimir Yampolsky – studied violin with renowned pedagogue Michail Garlitsky (1949-1961) at Central Music School in Moscow, the legendary David Oistrakh at the Moscow Conservatory (1961-1966) and conducting with Nikolai Rabinovich at the Leningrad Conservatory (1968-1973). He was a member of the Moscow Philharmonic as both violinist and assistant conductor, under the direction of the renowned Kirill Kondrashin.

Could you share a bit about your background and perhaps any differences in the cultures you have experienced regarding views on aging?

Humans in many ways are the same. All of us are born, live our life, and pass away – it doesn’t matter which language we speak. At some point we realize we use different amounts of energy to overcome obstacles as we get older; that’s a very normal thing in daily living. How we treat one another throughout the world differs, however. What is a norm here is not necessarily a norm somewhere else in the world. The United States of America is a very, very young country. As a society, it is less than 300 years old. I brought my country’s tradition, which was the Soviet Union.

My thinking has always been about tomorrow: what is tomorrow? There was always a full plate of activities for tomorrow: mental labor, physical labor, reflection, meditation, physical exercise, speaking on the phone, traveling. From my profession as a teacher, I met individuals from various cultures across the globe. I managed to see a kaleidoscope of human experiences.

When do we start feeling that something is different, that we are aging? The answer is: we don’t. I don’t feel it, and it’s something that has bothered me because in conversations we talk about people who are “old.” My wife and I recently heard the recital of a pianist and my sister-in-law said there were a lot of “old people” present. But I did not think that I was one of them, despite the fact that I am just one month away from being 80 years old.

Conducting as a field may be an anomaly in that conductors are commonly seen as being able to offer more insights, creativity, and knowledge and continue to actively conduct beyond the typical ages of retirement when compared with other professions. These are the very values and sources of growth that sometimes get lost in our narratives about aging. Would you agree with this observation? Or do you want to add anything?

Obviously, there are unmistakable changes in the body, but there were changes throughout my entire life. One of my old colleagues, whom I admire very much, was the world-famous cellist and conductor Mstislav Rostropovich. The last time I saw him was at the end of his life, when he was already close to 80 years old. Shortly after, he passed away, and I saw his burial stone across in a cemetery in Moscow. When I saw his grave, the last things he told me in Russian language were: (Translated) Old man, never slow down! Obviously, I remembered this almost daily since I have been a teacher until a month ago when I retired. I always remind my students: Never slow down!

In the profession of conducting, there are interesting ingredients: conductors work standing up, which has its health benefits; conductors are always using physical gestures with the upper body and involve a degree of cardio, which is related to longevity; conducting requires the constant work of your brain, which is like a constant exercise of the brain: directing the orchestra, adjusting to sounds, and remembering musical text. In these ways, conducting is conducive to living a longer life and staying mentally and physically active. Of course, I also want to recognize the privilege of these experiences I am sharing.

Generally speaking, aging is misinterpreted in a way because I think there is a big difference in looking at the number and internalizing it. We invented this word: aging. We invented another word: retirement. All these milestones are made by us for either economic or political reasons. They are not really “natural” reasons. Growing up in the Soviet Union, there was a retirement age of 60 for males and 65 for females, which had nothing to do with physical or mental abilities. It had something to do with the notion that the Soviet Union, as the most progressive country in the world, did not have any unemployment. By sending millions of men to retirement at 60, they provided jobs for younger men, and there was no unemployment. This sends a message that at a certain age, you are done. This can affect the way people view themselves, and they self-limit their activities. Psychologically, it has nothing to do with human nature, but rather self-perception. In the US, I remember learning from my colleagues that I would reach my retirement age of 65 in eight months: I guess I missed it by over ten years.

When I look at myself, I think of my mother: she lived every day like a duty. Going back now to the culture of Ashkenazi Jews, most practice Judaism as a religion. I was told a long time ago: Don’t try to save the world; try to save one person. The Jewish religion is built upon the idea of a ‘mitzvah,’ which means, “You must do good things every day.” Jewish people are to perform up to 600 mitzvahs throughout their lives. I was told by rabbis in my past that you don’t need to count 600 mitzvahs; just try to do one or two every day. And not for yourself, but for others. In the philosophy of the Jewish people, there is no room for ego. In music, we are largely not performing individually with our instruments or voices. We play music that was created for a group of people: choir, band, orchestra, or various combinations. We are servants of the composer, so there is no place for ego, only our shared human experience.

Ageism Interview: Mark Johnson

Mark Johnson is currently involved with the University of Washington Retirement Association. Mark graduated from Edmonds High School and retired in 2013 after working as a maintenance painter at the UWMC for 30 years.

Intergenerational activities are one way we can increase age diversity throughout the community. What do you think would be meaningful intergenerational activities?

In the retirement association, there was an organization called Encore.org about giving back and taking your expertise and getting involved with younger people with activities like tutoring and mentoring.

Classic involvement would involve grandparents acting in caregiver roles and passing on knowledge. The logistics of getting people together can be tough but finding things of common interest and including everybody would garner compassion, and we need to give and receive more compassion in this world.

One of the programs in the retirement association is called ‘Member to Member.’ We recently gathered a few people who are retired authors who just published a book. We also have a mediator and then they discuss the processes of writing and publication. We also had artists discuss their work and the art community. Everything is recorded on Zoom. In the past, it was live, but we have adjusted to hybrid events and are able to reach wider audiences now.

Ageism is considered one of the unchallenged isms and is defined as discrimination based on age. How would you define it? Where do you see it?

I’m involved in aging in another aspect in that my mother just turned 99 last week and she’s in assisted living now but I am pretty much the primary care person for her. That gives me quite a perspective of what my future could look like. What my mother needs most from me is my presence and reassuring touch.

Part of the issues surrounding ageism is cultural. On a societal level, we need to look at how the family and the community deal with and take care of older adults. I know in other cultures that older adults remain close to the family and at home, but that’s even rapidly changing in modern times. There’s a detachment there. There’s not this obvious obligation or commitment to older adults. I’m really my mom’s advocate, and I see all the other residents there, and I am by far the huge exception to the rest of the people. Staff and movers were blown away that our family was there to help move my mom in. So, it’s kind of the way our society has gotten, and it has become an out-of-mind, out-of-sight phenomenon.

Sometimes you feel like with increasing age, you are slipping off the radar. It used to be retirement at 65 and then the “golden years.” Dealing with stigmas is a major obstacle. We don’t want to talk about older age, and we don’t want to “see” the institutionalized systems for older adults. When I retired at 62, my mother was 92, so I thought about how I had a whole new career and life ahead of me. There’s a lot of aspects that I need to accomplish to make the most out of that, and it’s not how long I can live; it’s how well I can live.

Ageism Interview: Aaron Rosser

Aaron Rosser is a recent graduate from the University of Washington holding a dual degree in Psychology and Philosophy. During his time there, he worked with the School of Nursing DPEN Team to develop an evidence-based intervention for informal caregivers and volunteered his time on the board of the non-profit Circle of Friends for Mental Health. Now, he works at the Hendrickson Lab in the Seattle VA Hospital researching PTSD and its comorbid conditions.

This interview is a part of a series on ageism, completed by de Tornyay Center predoctoral scholar, Sarah McKiddy. Read her article on ageism here, and find more interviews on ageism here.

Despite the fact that we all age and share a cumulative experience with successive ages throughout the course of our lives, aging still seems to be viewed and experienced as a mechanism for division. What contributes toward this disconnect?

There are differences in values and beliefs between different age groups perhaps because every generation has certain expectations about how they think the world is and how the world should be, and these ideas are ultimately crafted by experiences and the historical context of that time. It’s only human nature to experience nostalgia and romanticize the “good old days.” Generations differ from one another and do not necessarily have the same frame of reference on which to build viewpoints. Additionally, the status, positions, and varying amounts of wealth that often come with age offer a certain privilege and sense of self.

Different generations who obviously have had very different experiences and possess diverging beliefs about the world may at times inevitably clash in terms of overgeneralizing traits like idealism and pragmaticism. There is a tendency for bias against older adults that they are set in their ways and unable to change when that’s not true at all. It might just be that in some cases, individuals choose not to change. The disconnect in expectations among generations is exacerbated by our biases, and it is easy to limit generational labels to a certain ideology.

In our Western culture, generational labels like baby boomer, millennial, and Gen Z are widely used and accepted. One problem with this categorization is that it attempts to represent a snapshot in time and characterize someone based on an archetype, thus assigning traits. What are your thoughts on the use of generational labels?

It is difficult not to use the term “generation” when describing different ages; however, when you think about how individuals are born every single second, it does not make sense to utilize such a definite term for a phenomenon that exists within a broad spectrum. Still, it can be a useful construct when defining groups of people who are defined by their common, usually historical, experiences, which shape their beliefs and concerns. Younger generations may sometimes build resentment about various issues, like inaction surrounding climate change, income inequality, employment opportunities, and housing. The varying structures of power and resulting economic disparities contrast from one generation to another, and this creates tension.

Ageism is an unproductive divisor with undercurrents of blame when it comes to institutional-levied issues like wage gaps and diminishing labor protections, which ultimately play a much larger role than age in creating socioeconomic barriers. Casting blame on age distracts by saying that differences ultimately lie in age rather than excess wealth or individuals’ overdue amount of influence within institutions as the cause of these inequities while simultaneously overgeneralizing older generations.

In reflecting on your studies and experiences, are there any philosophers or researchers that come to mind who challenged the current concepts surrounding aging?

Much of philosophy is focused on existentialism and abstract ideas of death more than the progression of life itself. Marcus Aurelius, in Meditations, discusses aging and frames some of his discussions around the inevitability of aging and urges us to embrace the time and capabilities we have while we possess them. Notably, Simone de Beauvoir, a seminal figure in the philosophy of the 20th century in existentialism and second-wave feminism, wrote a compelling book, La vieillesse, translated in the US as The Coming of Age, about the growth and richness of experiences that accumulate with age and the distance humans seek from aging and death. Beauvoir also emphasized the need for recognizing other ways to communicate with individuals when traditional linguistics are no longer possible, like individuals living with advanced dementia or experiencing aphasia. Beauvoir reminds us of our shared humanity and cautions against neglecting the voices of elders, or as Beauvoir refers to as the “conspiracy of silence.”

Ageism Interview: Tracey Gendron

Dr. Tracey Gendron serves as Chair for the Virginia Commonwealth University Department of Gerontology, as Director for the Virginia Center on Aging and is the author of the book Ageism Unmasked: Exploring Age Bias and How to End It. With over 25 years of experience as a grant- funded researcher and nationally recognized speaker, Tracey is dedicated to raising awareness and ending ageism through education. Tracey has a Master’s degree in Gerontology, a Master’s degree in Psychology, and a Ph.D. in Developmental Psychology.

Since you started your work in ageism, how has your definition or concept of ageism changed?

I think we’re just starting to have these conversations on age. It’s starting to crack through more mainstream consciousness. There’s still a long way to go but there’s more movement than there ever has been. You can Google ‘ageism’ and see more articles about it — more studies and more information than there ever has been. I know my concept of ageism continues to evolve the more I dig into it.

I’ve been studying ageism now for over 10 years, and it started for a variety of reasons. It was a part of my dissertation in which I was looking at aging anxiety. When I was first examining and understanding ageism, I had more of a unidirectional framework with it and looked at it more exclusively towards older people. The vast majority of research is looking at those negative attitudes towards older people – towards our own aging – and the detrimental consequences of that.

In more recent years, I started to explore the omnidirectional nature of ageism and not only how it is directed towards older people but how it’s directed toward younger people.

Another area ageism evolved for me is the concept of generations and how generational labels and stereotypes perpetuate ageism. I see them as a form of ageism; labels are another layer because those have become so normalized that we just refer to people as boomers and millennials, which have now become catch-all terms.

Now there’s a push to disentangle ageism from ableism and figure out not only how they work together but how they also need to be pulled apart. For a long time, and I write about this in the book, when we talked about successful aging, we were really fighting ageism by saying, “No, not all older people are frail. In fact, only 4% live in long term care and the vast majority live in the community.” And that’s fine, but we did enter that slippery slope of then perpetuating ableism at the risk of fighting ageism. That’s a newer thought in my mind of how we talk about it but in a way that doesn’t stigmatize disability or frailty. Rather, we need to value people in all abilities, stages, and ages.

In thinking about the ‘OK, boomer’ trend, was this a contributing factor to the idea of age groups as monoliths? What is the benefit, if any, to sustaining generational labeling?

If you look at it from a demographer’s perspective, I understand the value of lumping groups of people together in order to understand behavior. The problem when we do that with generations is that it’s leading to this idea of a monolith and that everybody within this group has the same values – the same likes and dislikes and preferences – which isn’t true. It’s capturing what’s happening at this point in our history, but it’s not capturing the nuances of how people who were boomers felt when they were millennials’ ages.

I don’t think we’re going to move away from it. I think it’s sticky, but I think the more we talk about the way it doesn’t make sense, the closer we will get to people questioning its validity. We’ve been building on the idea of generational labels since the book on generational theory came out in the ‘90s. We’ve even built a whole series of workforce trainings on how to manage generations in the workplace and how to change your culture so that ‘Generation Z will stay. We’ve built these bricks, and we’ve created this wall, and now it’s time to deconstruct that and take that apart.

I think a lot of people don’t really recognize that ‘OK, boomer’ came out of one millennial’s frustration with being dismissed for being young. This was an ageist response to ageism, but we shouldn’t dismiss the origin of ‘OK, boomer’ with a simple notion that it is wrong. We must look at what it represents, which is a pushback against ageism. That’s important because then people of all ages can come together and recognize that when you stereotype a so-called “millennial” and say, “You don’t know what you’re talking about because XYZ,” you’re contributing to ageism. Ageism is a distraction technique because blaming a generation distracts us from the real issue. It’s easy, lazy, and convenient.

Regarding generational labels or terms like dementia, are there any terms or phrases that you think we could continue to pursue alternative language or nomenclature for?

It’s interesting – everybody wants to know what to call older people. The issue is that there’s never going to be a term that fits until we destigmatize what it means to be old. Any term that we have is not going to cut it because we’re still dreading what it means to be old. We still don’t want to be identified as a member of that group.

The most innocuous is to use ’older people,’ but I hope one day we can embrace ‘elder,’ and the reason I like it is because when you think about it, we do have all these stages of development in life, and when someone is in childhood, we call them a child. When someone is in adulthood, we call them an adult. We don’t push back against that because there’s no stigma associated with it. Someone who is in elderhood referred to as an elder just makes sense, but people don’t like the label because they think it implies frailty or will be judged in some way. No labels can work when stigmas remain. We need to stop lifting up what it means to be young. Young should not have value judgment just like old should not have a value judgment; it just is. That’s the work that needs to be done first and then maybe the language can come next.

Dementia is the perfect example of the intersection between ageism and ableism. It’s a double whammy to talk about someone suffering from dementia or calling someone a demented person. This person is just living with dementia. Why does dementia have to be the thing that defines them? That also goes to other kinds of forms of mental illness, and now we use that as a label to describe someone instead of recognizing that this is a part of their life experience.

What can we do on an individual, daily, practical level to redirect or eradicate ageism?

Eradicating ageism starts with the self. The first step is breaking down the barriers and recognizing we are all aging. It is important to recognize that the actual real definition of aging is not a sole process of decline. Aging is a process of biopsychosocial, spiritual change over time. It’s multidimensional and multidirectional, meaning we experience some decline, but we also experience simultaneous growth. If we start to see aging for what it really is, then it becomes a lot easier to say that you’re aging and it’s not this ‘us versus them’ barrier. I truly think step one is shifting our mindset and embracing the fact that aging is life, aging is change. It has both good and bad aspects.

We also need to take the blinders off. It’s one of the reasons I called the book Ageism Unmasked since we are so blinded by the normalization of ageism. It’s everywhere. We no longer see it and we just accept it. Taking the blinders off means we finally start to see the shame-based, fear-based messages and marketing that teaches us to be afraid of aging and to disassociate from it. Once you see it and recognize yourself as someone who is aging, you can find your motivation for change.

The next step is asking yourself – why does this matter to me? It matters for your health, your longevity, your happiness. It also matters for businesses and for workplaces. We lose millions of dollars and many years of potential contribution and productivity of people. It causes inequity. Finding your ‘why’ matters, and then you can get down to the nitty gritty of paying attention to the language that you use. Then you can ask yourself why you think you’re too old to start something new or why you make a judgement against somebody that’s younger that they’re too young to understand something. We need to recognize just as we do when it comes to racism, sexism, homophobia, and other forms of discrimination. We’ve had to practice, work on, and really recognize that certain things are offensive and can really hurt someone.

It takes years to plant ideas. It’s important to meet people where they are, and if they’re not ready, then they’re not going to hear it. You could give one small thing for someone to think about. If someone says something ageist, it could be helpful to ask a question back: Why do you think that about aging or older people? Where did that come from? How did you learn about aging? Who are your role models?

This is all to get to a dialogue about what is underneath the beliefs while recognizing this is not just one conversation that will immediately cause change. I found a 1959 issue of Ladies’ Home Journal with the headline: Look 20 years younger. Older people have been socialized with this and it has gone largely unquestioned their entire lives, so it’s deep and invisible. One conversation isn’t going to change it, but every conversation helps, and you never know how a conversation you have today could sprout something years from now.

After you recognize ageism, you can think about developing skills for disrupting social situations. It’s hard because it is uncomfortable, and it depends on the situation you’re in and who you talk to. We shouldn’t blame or shame ourselves or others because you don’t know what you don’t know. The point is to do better once you know better and to be aware. How we take the conversation in a different direction and give someone feedback when they’ve said something offensive related to age – how we redirect – there’s no single answer for that. Nonetheless, I think these are the steps that we need to start to take because that will create social change. It’s going to take a movement, but a movement takes each one of us.