News
May 2009
Influencing Quality of Life through Research: What Could Be Better?
Andrea Gilmore
"Estimates suggest that up to 80 percent of residents with chronic pain in long-term care facilities are insufficiently treated for pain; the prevalence may be even greater for people with dementia," says Barbara Bowers, PhD, RN, FAAN, associate dean for research and expert in long-term care at the University of Wisconsin–Madison School of Nursing.
Managing pain in residents with dementia in long-term care facilities describes the research of Andrea Gilmore, a student in the School of Nursing's Early-Entry PhD Option. "She possesses the compassion, commitment, and intellect to advance the care of older adults with dementia," says Bowers, her major advisor.
Specifically, Gilmore's research explores the possible causes of inadequately treated pain in older adults with dementia by looking at how nurses interpret the signs of pain and what factors influence their decisions to provide pain medication. "Margo McCaffery describes pain as 'whatever the person experiencing it says it is, occurring whenever the person experiencing it says it does,'" Gilmore explains. "Managing pain is complex; managing pain for residents with dementia adds a layer of complexity because those residents oftentimes experience limited reasoning, memory, recognition, and communication."
"Past studies have shown that long-term care residents with dementia who are in need of pain medication are treated much less aggressively than other residents," Gilmore says. "Research, however, hasn't done as thorough a job investigating why this is the case."
A huge challenge—one well-established in the research literature, Gilmore says—is communication. "If the resident with dementia has limited communication or is nonverbal, then it's difficult to understand what 'Ouch, that hurts,' or 'pain, pain, pain' means. It may be all the resident can say to describe any level of pain." To date, Gilmore has visited three long-term care facilities in Dane County to interview nursing staff and to collect data.
Gilmore was drawn to nursing through her love of science, specifically biology. "The scientific process of discovering new things, of learning how they work is just addicting to me," Gilmore says, "but I wanted to serve people as well." Nursing research—a fusion of science and service to the patient—seemed a logical career choice.
When applying to nursing school at the UW–Madison, Gilmore wanted to demonstrate a commitment to her chosen field. Guided by her mother's words—"You can say you want to help people, but you have to do it"—Gilmore became a certified nursing assistant (CNA) at a skilled nursing facility in Madison.
Gilmore's CNA role was typical: She bathed, groomed, and dressed patients as well as assisted them with the activities of daily living. It left her feeling anxious. "I felt guilty because I couldn't give residents the care and time they deserved," she says. "The pace of care for many physically dependent residents was rushed and counterproductive, it seemed, to quality care."
Once enrolled in the Early Entry PhD Option, Gilmore began reading some of Bowers's research on patient-centered care through organizational and cultural change. She became inspired to further her research interest in long-term care for the elderly.
As an early-entry doctoral student, Gilmore gets an early jump on earning her doctorate through immersion in intensive research activity with a mentor and a peer research team. "For a young researcher, IRB protocols and grant processes can be a bit daunting," says Gilmore. "Having my research colleagues and mentor there to give advice creates a very supportive learning environment."
Numerous scholarly awards suggest that Gilmore has profited from the support found at the UW–Madison, a place she calls her "intellectual home." She received UW–Madison's Hilldale Undergraduate Research Award/Fellowship in 2008. She was invited to present a research poster at the 2009 National Conference on Undergraduate Research at the UW–LaCrosse. She most recently received the Midwest Nursing Research Society's (MNRS's) Undergraduate Research Scholar's Award presented in March of 2009 at the MNRS annual conference in Minneapolis, Minnesota.
Gilmore's numerous awards reaffirm her career choice. "When considering a profession, you ask yourself, 'Are you going to like what you do?' " Gilmore says. "My answer when considering a career in nursing research was, 'How could I not like it. A nurse researcher has the opportunity to influence the patient's provision of care on a much broader level. What could be better?' "