Lisa Ferretti, center, kicks off The Biggest Winner contest with community members in 2009.Over the past few weeks, we have begun introducing our new strategic funding areas, starting with our Leadership in Action and Linking Education to Practice grant portfolios. At the same time, we want to showcase real-life examples of geriatric care experts who already exemplify the kind of practice change work we hope to see in these program areas.
In a continuation of our Beyond the Boardroom video series, Rachael Watman interviews another superstar who is working to improve the health of older adults and who demonstrates many of the principles of the Education to Practice strategy. Lisa Ferretti, LMSW, participated in an internship supported by the Hartford Partnership Programs for Aging Education during her social work training and went on to become a Practice Change Fellow (now the Practice Change Leaders program). She currently co-leads the Center for Excellence in Aging and Community Wellness at the University at Albany, SUNY, where she continues to put geriatrics best practices into programs that are keeping older adults as healthy as possible in her community.
Here is a video clip of Rachael’s interview with Lisa. An edited transcript follows.
http://youtu.be/zrw1N_wsSNY
What got you interested in working with older adults and how has the Hartford Foundation influenced your development as a leader in the field of aging?
While working on my master’s degree in social work, I took a course in gerontology. When I took this class, a whole world opened up to me about all the things that you needed to know about aging. It wasn’t just about somebody’s health care, but it was also about their independence, their quality of life, their decision-making processes, and their financial future. There was so much to know, and it really spurred my interest.
I went from that into becoming a part of the Internships in Aging Project at the University of Albany, which is where I ultimately received my MSW. Then I got even more interested as I started working with the Office for Aging and learning about the policy environment and the services systems, etc. So from there, it snowballed into working at a translational research center, which is where I work now. I had the opportunity to apply for the Practice Change Fellows Program and was lucky enough to be chosen in the first cohort. Really, that even more so changed the way that I looked at geriatric care, because it expanded my view of the context of care. It also helped me to understand what real interdisciplinary work was all about.
Up to that point, I was very focused on the social work perspective, but after meeting with and spending lots of time with physicians and nurses and other leaders in geriatric care, I started to realize that the piece that I had to offer was really important, but it wasn’t the only piece. And I needed to be conscious of all the other pieces at the same time. So being a systems thinker gave me a new opportunity to look at and influence the field of aging, the field of community-based services and support, and geriatric care.
It’s wonderful to hear that you took one course in gerontology and it changed the course of your life. Did you have to take the gerontology class?
No. You know what? It was an elective that fit around my babysitter’s schedule. I thought, “Oh, well, let’s see what this is all about. How hard can this be? Old people aren’t that hard, right?” And it was fascinating and changed everything.
Tell us about your work to improve the health of older adults. Does that involve working with an interdisciplinary team?
Part of recognizing that we social workers deal with individual people in a context or in their environment means that we have to look at everybody in the environment, and that includes health care providers. It includes nurses, social workers, and it includes community-based service organizations. It includes the people themselves, their families, and other people in the community that have influence over people, which might be their faith-based community or a community group or even providers.
A lot of the work that I’ve done around the interdisciplinary piece is really focusing on how we have better communication and how we support what patients really need in their community setting. It’s addressing how we link back with community providers and clinical providers, so that they know that the things they want to happen are starting to happen, and they also understand the barriers to why they’re not happening. I think we end up with better patient interactions, better system interactions, and hopefully we end up with a better community-based effort around health care.
Can you give us an example of one of the success stories and outcomes of your work?
One of the things we did in the beginning stages of some of this interdisciplinary work was that we formed a community-based coalition, which had a primary care provider, a federally qualified health center, a hospital system, a number of community-based organizations, faith-based organizations, and also members of the community—which was probably the most critical piece. The group together decided that they wanted to make a public statement regarding a change that they wanted to see in the community around improving access to health care, access to places to be physically active in a safe way, access to healthier food and fresh food.
So we decided on something we called The Biggest Winner, which was sort of juxtaposed against The Biggest Loser (the TV weight-loss reality show). And that’s even a great story. In the coalition we talked about how we could have this Biggest-Loser-like thing, tell people to lose weight and be more physically active, and one of the members of the community said, “Listen. We’re tired of people calling us losers. This needs to be The Biggest Winner.” So even that small context change made a big difference in terms of what we did.
For six months, we gave people in the community access to opportunities to make changes in their behavior. They earned points for every time they were physically active, and if they went and got their regular health care checkups, and if they lowered their blood pressure, all these kinds of different measures, they could earn points. At the end, if you had enough points earned, you could qualify to be in a drawing for $5,000 donated by a local business.
Despite the fact that only one person won the $5,000, which was very exciting when we did the final event, we saw pretty significant changes in most of the people who ended up qualifying for that final prize. We had about 25 people out of about 200 that participated in some way that met enough of the criteria to qualify for the drawing. And those 25 people made significant changes, huge increases in physical activity. We had people joining dancing clubs and we had people walking with partners. We had a local high school supply their track for people to be able to walk on. We had people increase their healthy food intake, buying more fruits and vegetables, and we partnered with local grocery stores around that, to have people bring in their receipts and get credits for those.
We had one woman who, at the beginning of the six months, was a person with Type II diabetes, who was taking six different kinds of medication for the diabetes and for other conditions. By the end of the event, she had lost 30 pounds, was taking no medication at all, and was a totally changed woman. It was an amazing thing. But she’s not the only one. We actually had other people who had significant weight loss.
We had one woman who lost over 200 pounds, who had been suffering with depression for many, many, many years, who was untreated, who was now in a treatment program and getting the treatment that she needed for her depression, and who was engaged by the end of the event as well. So we had this huge life change.
Given the strategic shift in the direction of the foundation to support efforts like yours that want to make change in the practice environment, what can Hartford offer other leaders going forward?
Hartford has an opportunity in their strategic shift to provide opportunities for people in these fields to learn more about one another and to recognize that we need to bring more people to the table, not less. It’s not just about social workers, nurses, and physicians who are really the important pieces of this, but it’s also about other health care professionals. It’s also about community-based services and supports. It’s also about the people themselves and the changes they want to see. And I think the more people we get involved in that change, the more likely we’re going to see the change that we want to see.