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Creating Better Doctors

Would-be physicians learn to care for older people by living with them

Gianna Petrone, 23, had a choice: spend the Fourth of July week with her boyfriend, go to a friend's annual cookout and watch fireworks, or celebrate the holiday in a wheelchair, in a memory care facility, seeing what it's like to be an 83-year-old with dementia. No Facebook, texting or Twitter.

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Student in wheelchair - Learning by Living program sends medical students into nursing homes to learn how older people live.

Medical student Kristen Murphy spent 10 days as a resident in a nursing home. — Photo by Nicole Bengiveno/The New York Times/Redux

The decision was an easy one for Petrone. "There will be other Fourth of Julys, but this is a valuable experience," says the soon-to-be second-year medical school student from the University of New England College of Osteopathic Medicine (UNE COM) in Biddeford, Maine. "No matter what field I choose, I will be dealing with older people and many will have dementia," she says on this midsummer day, speaking from her wheelchair at the Monarch Center memory care facility in Saco, Maine. "I had always hoped to be a compassionate doctor, but now I will have much more understanding of people with this disease, their families, and what it's like to actually live in long-term care."

A treatment plan

In the summer of 2011, Petrone and five other medical students are taking part in a program called Learning By Living. It is the brainchild of University of New England geriatrics professor Marilyn Gugliucci. Started in 2005, Learning By Living places volunteer medical students in nursing homes and assisted living settings for 10 days to two weeks so they can learn first-hand about geriatrics and the life of an older person. They receive no academic credit.

Since the program's inception, 28 people, including 26 medical students, have stayed in 14 facilities in Maine, Massachusetts, New York and Ohio. One of them has checked into three different nursing homes.

"When I was in architecture school, the big thing was green and energy efficiency," says Evan Carroll, 29, of Portland, Maine, who plans to "play" resident this fall so he can design better nursing homes. "I see aging and baby boomers as the new thing I need to know about to be competitive. Learning By Living is part of trying to educate myself. I want to see first-hand what is good about nursing homes and what residents don't like."

Gugliucci's goal is to create a national fellowship program where applicants vie for nursing home placements nationwide. The geriatrician already has a group of medical schools interested in the concept.

How it works

The nursing home staff gives the student a diagnosis — in Petrone's case, it's congestive heart failure and dementia, but it might be a stroke, pneumonia or other age-related conditions — and treats him or her like a regular resident.

Petrone is awakened by staff at 6 a.m. for medication (different colored M&Ms in her case), and has her 24/7 wheelchair and hospital bed on an alarm so they know if she tries to get up (a safety concern). The first few days she's fed pureed food for her "weakened state." Petrone is in a single room, but some "patients" in the program share rooms with residents.

Even alone in her room, she stays in her wheelchair. Other faux patients have had to cart around an oxygen tank (a tube is clasped to their nose, but without the tank turned on), use a special walker for people paralyzed on one side and have help with toileting.

"I expected people to be forgetful, but didn't realize how much they struggle every day with simple things we take for granted," says Petrone. "One resident had to be shown how to put one foot in front of the other to walk."

Next: Attracting medical students to the field of geriatrics. >>

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