Leo Tolstoy said that the biggest surprise in a man\u2019s life is old age. The surprise of old age \u2014 and its sometimes harsh reality \u2014 often is framed in stark relief for Judith A. Lucas, associate professor in Seton Hall\u2019s College of Nursing and a prominent authority on the long-term care of older adults.<\/p>\n
Lucas focuses her research on nursing-home care of geriatric patients with dementia. It is a timely subject as the Baby Boom generation and its successors gray. By 2060, it is estimated, 98 million Americans \u2014 nearly 25 percent of the population \u2014 will be over the age of 65, with close to 20 million of those 85 years of age or older.\u00a0 <\/span><\/p>\n \u201cAddressing the needs of older adults will be a dilemma and a huge public-health problem,\u201d Lucas says. \u201cRather than dealing with these issues at the end of life, we need to take preventive measures and focus on addressing the lifetime risk factors that contribute to dementia.\u201d<\/p>\n Nurses, she says, will be at the forefront of this effort. \u201cThey are more than simply caregivers; they are resources,\u201d Lucas says. It is an ethos she works hard to impart to her gerontological nursing students. \u201cSome students initially are afraid of working with the elderly,\u201d she says. \u201cI encourage them to be positive in their approach, and by the end of our class I think most of them are.\u201d<\/p>\n Lucas is particularly concerned about the use of psychoactive drugs for patients with dementia in nursing homes. She decries the tendency to prescribe medications \u201cin a way that treats everyone similarly.\u201d These powerful medications may be employed as a \u201cchemical restraint\u201d to quiet difficult patients, but their overuse can lead to destructive outcomes: injuries from falls, cardiac problems, strokes, pneumonia and even death.<\/p>\n In a clinical and academic career that spans more than 30 years, it has been Lucas\u2018 mission to conduct research and advance policy to rein in inappropriate use of such drugs. \u201cWe need to individualize care and change the culture in nursing homes,\u201d Lucas says.<\/p>\n Lucas was among a group of nursing experts who worked with the Centers for Medicare and Medicaid Services (CMS) to design an online \u201ctoolkit\u201d for nurses in long-term-care settings to promote non-pharmaceutical interventions for improved behavioral health. Her current research aims to assess the results of national elder-care policy. In July, she and a colleague at Miami University in Ohio published a study in the journal Health Affairs<\/i> evaluating CMS efforts to reduce the use of antipsychotic drugs in nursing homes.<\/p>\n The researchers found a \u201cmodest but significant reduction\u201d in the use of antipsychotic drugs, but at the same time, they noted that other psychoactive medications \u2014 some of them potential substitutes for antipsychotics \u2014 were being used in some cases.<\/p>\n \u201cContinuous monitoring and consistent enforcement are needed to ensure the continued decline in unnecessary use of antipsychotics and psychoactive medications in nursing homes,\u201d they concluded.<\/p>\n \u201cHer article in Health Affairs<\/i> is a tremendous contribution to elder-care policy \u2014 one of the first to deconstruct the impacts of the CMS initiative to reduce antipsychotic use in nursing homes,\u201d says Linda Simoni-Wastila, chair of geriatric pharmacotherapy and director of the Peter Lamy Center for Drug Therapy and Aging at the University of Maryland.<\/p>\n Lucas clearly has \u201cgreat research chops,\u201d Simoni-Wastila says, but more important is the depth of her clinical experience. \u201cShe has a remarkable ability to see the questions that need to be asked. There are a lot of health-services researchers,\u201d Simoni-Wastila says, \u201cbut few who are able to bring her level of clinical expertise to the table.\u201d<\/p>\n Margaret Huryk was on the Seton Hall nursing faculty when she first met Lucas in 2013, and Lucas later would chair Huryk\u2019s doctoral committee. Lucas\u2019 \u201cteaching has a lasting impression because she helps students have an understanding of aging and how the nurse can meet the needs of our older adults,\u201d says Huryk, an assistant professor of nursing. \u201cWhether you became geriatric-nurse certified or from time to time work with someone 65 or older, what you learn in Dr. Lucas\u2019 class stays with you.\u201d<\/p>\n Lucas\u2019 influence has helped to guide many students into geriatric nursing, adds Marie Foley, dean of the College of Nursing. \u201cMany of our undergraduate students who might not have thought that they would have a career in geriatric nursing have chosen to go in that direction,\u201d Foley says.<\/p>\n Lucas remains determined to see opportunities for delight, even in the twilight of one\u2019s life. Tacked to a bulletin board on the door of her office is a small poster with a photograph of Tao Porchon-Lynch, who, at age 99, is recognized as the world\u2019s oldest yoga instructor. Porchon-Lynch\u2019s accompanying quote is unambiguous: \u201cThe joy of living is inside you. Live it. Believe in it.\u201d<\/p>\n \u201cI put that on my door as a model for my students of healthy aging,\u201d Lucas says. \u201cWe can each celebrate our lives and be productive and keep connected to one another and share our special gifts throughout life. That,\u201d she says, <\/span>\u201cis a prescription for successful and healthy aging.\u201d<\/p>\n Written by David Greenwald<\/p>\n","protected":false},"excerpt":{"rendered":" Nursing professor Judith Lucas is a leading expert on the long-term care of older adults.<\/p>\n