Buddy programs link med students, Alzheimer’s patients
■ Four schools now offer a program designed to lead to better knowledge and empathy by students, and several more schools are coming on board.
Future physicians at a handful of medical schools are getting a firsthand opportunity to understand better what life is like for early-stage Alzheimer’s patients and their caregivers.
Through the Buddy Program developed at the Northwestern University Alzheimer’s Disease Center in Chicago 16 years ago, first-year medical students are paired with patients for a year. Buddies spend a minimum of four hours a month together to enjoy meals, stroll around the Art Institute of Chicago or experience other activities.
The program began as a way to empower Alzheimer’s patients, putting them in a position to help medical students. But a presentation at the Alzheimer’s Assn. International Conference 2013 in Boston in July shows that the medical students are gaining from the experience, too. It improves students’ knowledge and familiarity with Alzheimer’s, and it heightens their sensitivity and empathy toward people with the disease.
“It allows medical students to have a nonclinical experience. It allows them to get to know someone with an illness,” said Darby Morhardt, MSW, research associate professor in cognitive neurology at the Northwestern University Feinberg School of Medicine. “They see a person within a context, and they see that there is more to them than their disease.”
Students who went through the Buddy Program showed modest improvement on a dementia knowledge test that Morhardt and her colleagues created in 2000. And journals that students write in after each activity with a patient showed that the students changed their preconceived notions of dementia and had an increased recognition of the remaining strengths that Alzheimer’s patients have.
The program has matched 167 medical students and dementia patients over the years. One student wrote: “I feel like my interactions with [my mentor] are becoming more fluid as I begin to ask fewer complex questions and incorporate his viewpoint into my own speech. I also feel more comfortable ‘jumping in’ when [my mentor] struggles too long with a word or sentence without threatening his independence. I understand so much more about [my mentor’s] experience than I could even imagine before we met.”
Preparation for more cases
Health care leaders say programs that raise awareness and knowledge about Alzheimer’s are especially important for physicians as the population continues to live longer and need dementia care. More than 5 million Americans are living with Alzheimer’s, according to the Alzheimer’s Assn.’s 2013 Alzheimer’s Disease Facts and Figures report. By 2050, that number could nearly triple.
“We need that specialty care, but unfortunately [the number of] people specializing in geriatrics is declining,” said Dean M. Hartley, PhD, director of science initiatives at the Alzheimer’s Assn. “We know that as many as 50% of people with Alzheimer’s may not be diagnosed.”
According to the American Geriatrics Society, about 17,000 geriatricians are needed in the U.S. to care for today’s 12 million older Americans, but there are only about 7,500 certified geriatricians and fewer than 1,600 certified geriatric psychiatrists in the United States. And the AGS predicts that 30,000 geriatricians will be needed to meet demand by 2030.
DID YOU KNOW:
Up to 50% of Americans with Alzheimer’s may not be diagnosed.
On top of that, fewer medical school graduates are pursuing advanced geriatrics training, according to the AGS. In 2010, 75 internal medicine and family medicine residents went into geriatric medicine fellowship programs, down from 112 in 2005.
Hartley said a program like the one at Northwestern highlights the specialty and may inspire more students to get specialty training. He also noted that medical students who go through the Buddy Program and go into primary care will be more aware of Alzheimer’s.
“That can help in the early diagnosis, because primary care physicians are on the front line,” Hartley said.
Boston University, Dartmouth College in New Hampshire, and Washington University in St. Louis have replicated Northwestern’s Buddy Program. Each school has made modifications to best fit its needs. For example, Dartmouth’s TALES program (The Alzheimer’s Learning Experience for Students) started in 2010 and includes first- and second-year students, premed students and master of public health students. It also pairs two students with each person with Alzheimer’s, and the students generally visit with the person together.
“While our students typically enter the program with generally positive attitudes toward Alzheimer’s disease and those who have it, the experience of being in the program further improves their attitudes on nearly every dimension that we assess,” Robert B. Santulli, MD, associate professor of psychiatry at the Geisel School of Medicine at Dartmouth, said in a statement.
Morhardt said the University of Wisconsin and the University of Kansas will begin programs this fall. And the concept is going international. She said a program is being planned for the University of Bari in Italy, and geriatricians in Ontario, Canada, have expressed interest in starting a program there.