The Department of Social Work has received an Innovative Instruction Technology Grant (IITG) to develop a 3-tier learning environment. Students begin with web-based modules which introduce symptoms, common causes, assessment strategies, and evidence-based interventions for specific geriatric syndromes. These modules are being developed by an interdisciplinary team of faculty lead by Paul Gould, LCSW, PhD in the Department of Social Work and Shawn Berkowitz, MD, CMD, Co-Director Geriatric Education Theme at SUNY Upstate Medical. Students will be introduced to materials drawn from medicine, clinical social work, neurobiology, and public policy. Upon completion of the web-based modules, students will next have a simulated patient encounter. Actors will pose as patients in the simulation lab; students will conduct an assessment to differentially diagnose the patient's condition, and then identify an appropriate intervention strategy. The simulations are recorded and reviewed by an interdisciplinary team to provide feedback upon the students' application of specific skills. In the final tier of the learning environment, students will interact with actual patients in the community to conduct an assessment, develop an intervention plan, and apply evidence-based interventions to alleviate behavioral symptoms; similar to the simulations, these patient encounters will be recorded and reviewed by supervisors to evaluate students' performance. This 3-tier environment delivers a foundation of knowledge and introduces models of best practice, followed by structured experiences that allow students to practice essential skills while receiving critical feedback from professional supervisors.
This initiative is conducted in conjunction with SUNY Albany, Buffalo and Brockport, along with Syracuse University, and Roberts Wesleyan College. The project will educate and train Binghamton University MSW students in mental and behavioral health interventions with medically underserved populations. Two field placements are in underserved, poor rural communities with estimated family incomes significantly below the state average. The first placement is at UHS Primary Care Deposit with a focus on older patients. Deposit is a HRSA-designated health professional shortage area, and the poorest municipality in Broome County. The second placement is in Whitney Point Central School District with a focus on middle and high school students and their families. Whitney Point recently lost its health clinic and the nearest medical center is 12 miles away. The University of the State of New York Regents report of Designated Physician Shortage Areas (2009) notes that the two service areas of Deposit and Whitney Point within Broome County (out of 21 municipalities) are Primary Care Physician Shortage areas. In addition, the low-income community of Broome County is a designated mental health care health professional shortage area. MSW students will work as part of interdisciplinary care teams to provide direct mental and behavioral health services to medically underserved populations.
Persons with Dementia (PWDs) and their care-partners experience a complex and interrelated set of unique needs and interpersonal challenges as the disease progresses, resulting in increasing levels of stress upon the family system. Care-partners typically report deteriorating communication and quality time with their family member with dementia, an inability to manage problem behaviors, and feelings of frustration, resentment and grief. This leads to increased isolation for the care-partner, PWD, and increases risk for incidence of neglect and elder abuse. Services for care-partners and PWDs are generally provided separately, and address only a limited number of the family's needs – this compartmentalized approach fails to address the interdependent nature of the family system and complexity of care-giving for PWDs.
The Pathways Project will offer expressive arts groups to families in Broome and Tioga counties through regional community centers. A unique aspect of this project is that is pairs care-partners and PWDs in a therapeutic environment where they may engage in art-making and socialization with other families living with dementia. The project seeks to accomplish four basic goals:
Engage persons diagnosed with a dementia in artistic activities to stimulate cognitive processes and enhance quality of life. Identify activities caregivers may do at home with PWDs to enhance positive communication and "quality time".Provide a teaching environment where graduate students may develop competence in working with caregivers, families, and persons living with dementia.Develop a "Legacy Project" which preserves memories through artistic expressions constructed by the person with dementia.
Families participate in activities to create artistic expressions, including painting, drawing, sculpting, and collage. These activities are intended to stimulate various regions in both the right and left hemispheres of the brain through reminiscence, storytelling, and creating artwork. A series of themes will guide the development of artwork to assist PWDs with reminiscence and build a foundation for a Legacy Project to capture memories for families.
The project incorporates MSW students in the Hartford Partnership Program for Aging Education (HPPAE) in the development of the therapeutic groups, delivery of therapeutic services, and finally in the research evaluation. This provides students an opportunity to develop skills related to working with persons with cognitive impairments, families, and groups.
Diagnosis of Alzheimer's is very challenging, involving neuropsychological tests by trained technicians, brain imaging, and other tests. There is a need for a test with high sensitivity and specificity that is inexpensive, and as minimally burdensome as possible. In addition to early detection that can help families prepare, a more precise diagnostic may hasten the development of new therapeutics. Clinical trials of putative AD agents are greatly hampered by not having methods for recruiting precisely the types of patients most likely to benefit, thus diluting the statistical power of these trials.
There are known aphasias associated with dementia, and some metrics have been devised in attempts to quantify them. Some neuropsychological tests key on them (e.g. category fluency). Advances in the technical domains of natural language processing (NLP, computer-based approaches to human language analysis), and speech processing (the signal processing of human speech, including speech-2-text), have reached levels where a concerted effort to combine the best approaches may well bring the dream of a speech-based diagnostic for dementia within reach.
This grant will support a pilot study in which speech samples are acquired from about 50 subjects with a diagnosis of probable Alzheimer's (i.e. where the diagnosis is not in question) and a matching cohort who are cognitively normal. In this study, we will begin to acquire insights into the best methods for each step in the chain: acquisition of the speech utterance, its digitization and extraction of dysfluencies (e.g. pauses, speech rate, um's ...), conversion to text, and NLP analyses of the text. With a suitable database, advanced bioinformatic pattern discovery algorithms will be applied to identify likely feature combinations that are diagnostic. The study design is cross sectional (i.e. only one sample from each subject) in order to get a quick test on the concept, although we believe a longitudinal design (periodic assessments across time) will finally be needed to account for individual differences and to achieve the sensitivities needed for early detection.
If results are positive, one or more papers will be published and serve as the basis for applications for external grant support to conduct a more extensive study with a longitudinal design.
Awards: Schaffer, JD (PI) and Berkowtiz, S. (Co-PI), Bronstein, L (Co-PI) and Zahorian, S (Co-PI) (2013-2014) Binghamton University and Upstate Medical University. $35,000. Awarded by the SUNY Research Foundation Research Collaboration Narrative
The following are awards made or ongoing since the center began in summer 2009:
Berkowtiz, S. (PI) and Bronstein, L (Co-PI) (2011-2012) Geriatric Consultation Clinic. $17,000. Awarded by the John A. Hartford Foundation to support development and evaluation of an interprofessional geriatric teaching clinic.
Bransford, C. (PI) and Gould, P. (2009-2010). Specialized Gerontology Program Grant (2009-2010). $10,000 funded by the John A. Hartford Foundation through the Council on Social Work Education.
Bransford, C. (lead); Choi, S.; Lee, Y.; and Bowne, H.(2009). Enhancing Quality of Life in Later Years. Awarded $6,000 from the Binghamton University Provost’s Inter/Multidisciplinary Symposia.
Bransford, C. (PI) and Pierce, C. (co-PI). Using Interpersonal Psychotherapy to Treat Depression and Anxiety in Home-Bound Seniors with Cognitive Impairment. Funded for $19,500 by the Binghamton University provost's office.
Bronstein, L. (PI) (2008-2010). Council on Social Work Education Gero-Ed Curriculum Development Institute. $5,000. Awarded for the infusion of content on gerontology into the curriculum.
Bronstein, L. (PI); Bunnell, K. (co-PI); Marshall, J. (co-PI); Gould, P. (project director); and Choi, S.(project eEvaluator). (2008-2011). Hartford Partnership Program for Aging Education. $75,000. Awarded from the New York Academy of Medicine and the John A. Hartford Foundation to support field placements for MSW students with older adults.
Choi, S. (PI) (2009-2011). Hartford Faculty Scholar. $100,000. Awarded by the John A. Hartford Foundation and Gerontological Society of America to conduct research in disparities in the out-of-pocket financial burden and total health care expenditures among recently arrived, older immigrants.
Gould, P. (PI) (2011-2013). Pathways Project: Building Connections in Families Living with Dementia. $27,000. Awarded through Binghamton University's Academic Program and Faculty Development Fund to implement a dual service learning and applied research project involving arts-based interventions with families living with dementia. This project will be executed in partnership with local Area Agencies on Aging (AAA).
Gould, P. (PI) and Bronstein, L. (Co-PI). (2012-2015). Hoyt Fellowships in Aging. $27,000. Awarded by the Stewart W. and Willma C. Hoyt Foundation to support stipends for MSW students working in community agencies with older adults.
Lee, Y. (2009). Binghamton University Individual Development Award. $500. Awarded for establishing community collaboration with the Korean Senior Center in Flushing, N.Y., and conducting qualitative research about Korean American dementia caregivers.
Last Updated: 9/24/13