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Research: GeriatricThe Center on Aging, Health & Humanities
at The George Washington University Medical Center
Research and Priority Areas: The Geriatric Landscape
The new Landscape for Aging in America and the Geriatric Landscape are terms introduced by the Center Director, Dr. Gene Cohen, to describe the growing number of sites where older persons both reside and receive treatment. A generation ago it was common to think that residential options for older persons represented a choice typically only between home and nursing home. Today, choices vary considerably and are growing—representing a new phenomenon in need of more research, innovative approaches to on site services, and better information for policy deliberations.
In addition to home and nursing home, the new Landscape for Aging includes settings like congregate housing, assisted living facilities, life or continuing care communities, senior hotels, foster care, group homes, day care, respite care, and others, not to mention the growing diversity of retirement homes and communities.
To a large extent these new options have been developed in response to the perceived problems of nursing homes as being the only major alternative to one’s home as a setting for home life where help, as necessary, is also available. As the saying went before nursing home reform, “nursing homes had two major problems: they too often provided neither good nursing nor good home”. At one level, the evolving Landscape for Aging represents a constellation of new approaches to dealing with issues of nursing and home for older adults at a growing number and diversity of sites (including nursing homes). Depending on which specific setting, within the broader landscape of different sites, the balance between attention to elements of nursing and elements of home vary.
To address the nursing side is to draw upon knowledge from the field of health care; to address the home side is to draw upon knowledge from the humanities. Moreover, these two elements obviously intersect—at times being additive in their effects, at other times synergistic. In a related sense, the nursing or health care focus can benefit from medical center involvement; the home or humanities focus can benefit from university involvement outside the medical center. Together, the nursing-and-home/health-and-humanities focus represent a challenge and opportunity for a combined medical center/university involvement to foster, through research, new approaches aimed at a better synchrony if not synergism of linkages between these core elements.
In summary, the Landscape for Aging (or the Geriatric Landscape) is a construct within which to examine the depth and breadth of human experience in later life. A health and humanities focus across this landscape offers a design for dealing with not just the problems but also the potentials that can occur in later life—a way of approaching both limitations that accompany disability as well as opportunities for new creative expression with growing old. The Landscape for Aging with its health and humanities orientation is a construct designed to promote new thinking in the areas of research, practice, and policy relevant to creative aging and intergenerational interchange.
