Dr. Elise Eifert on the Intersections of Gerontology, Caregiving, and Society

Summary

Dr. Elise Eifert, a gerontologist, discusses the field of gerontology and its distinction from geriatrics. She explains that gerontology is the scientific study of aging, focusing on understanding older people, the network of organizations that serve them, and the policies that impact them. Geriatrics, on the other hand, is a medical science that focuses on the diseases and biology of aging. Dr. Eifert shares her personal journey into gerontology and her research on family caregiving and the utilization of support services. She emphasizes the importance of recognizing the positive aspects of caregiving and the need for novel solutions in gerontology to support family caregivers. Dr. Eifert also discusses the implications of an aging society and highlights the wisdom and strength of older adults.

Takeaways

  • Gerontology is the scientific study of aging, focusing on understanding older people, the network of organizations that serve them, and the policies that impact them.
  • Geriatrics is a medical science that focuses on the diseases and biology of aging.
  • Family caregivers often do not self-identify as caregivers, which can lead to underutilization of support services.
  • There is a need for novel solutions in gerontology to support family caregivers and promote positive aspects of caregiving.
  • An aging society has implications for economic growth, work patterns, family dynamics, and healthcare resources.
  • Older adults are often underestimated, and their abilities and contributions should be recognized and celebrated.

Chapters

00:00 Introduction to Gerontology
03:50 Discovering Gerontology
06:30 Focus of Research
10:16 The Invisible Second Patient
11:44 The Joys of Caregiving
13:50 Novel Solutions in Gerontology
16:04 Implications of an Aging Society
18:18 Wisdom and Life Lessons

Transcript

leah (00:01)
Today we have Dr. Elise Eifert on our podcast and I'm so excited to speak with her. Dr. Eifert earned her master's in health promotion and went on to work as an Alzheimer's disease and dementia educator for five years before returning to school to obtain her doctorate in public health education and a certificate in geriatricology. As faculty at UNC Greensboro, Dr. Eifert studies the dynamics of family caregiving and is interested in how these roles and community. Elise, thank you so much for being with us today.

elise_eifert (00:35)
Thank you for having me.

leah (00:37)
Yeah, to get us started, would you mind explaining just generally what is the field of gerontology and is it different from geriatrics? Why is that an important distinction?

elise_eifert (00:48)
Sure. So there are several different variations of the definition of gerontology in its simplest form. It's the scientific study of aging, but it does get a little bit more complicated than that if you look more closely. So I like to define gerontology as the science of specializing in understanding older people in the aging population, the network of businesses, organizations, and agencies that serve them.

And then the aging related policies that impact older adults. So there's three things there. It's people understanding people, understanding the structures that support them, and understanding the policies that impact them. Honestly, this definition is still evolving. Gerontology is a fairly new science because we've never had to think about getting older. Prior to, you know, around the mid 1900s, when our life expectancy rose by 30 years, now we can expect to live.

to our 70s and 80s and so we need to understand better what that means. When you compare gerontology to something like astronomy, astronomy is a 5,000 year old science while the first PhD program in gerontology began in the 1970s. So gerontology is really still in its infancy and that makes it really exciting because there's so much more to discover. In regards to

Second question about geriatrics. Gerontology is more of an applied non-clinical profession. So it's a social science that focuses on more of the psychological and social aspects of aging compared to geriatrics, which is more of a medical science or a healthcare specialty that focuses on the diseases and the biology of aging. So geriatrics and gerontology are kind of...

they get lumped together quite a bit because they're basically two sides of the same coin, however they're they're dramatically different sciences.

leah (02:58)
Yeah, thank you for those definitions and the distinction. Your description of gerontology as an ever-ever.

elise_eifert (03:01)
course. I get that question a lot because I sit on airplanes and when people tell me, oh, what do you do? And I say, I'm a gerontologist or I study gerontology, I get this real quizzical look. Lots of people don't know, so I'm glad to kind of be able to explain it.

leah (03:15)
No, it is bad.

Yeah, you described gerontology as an ever-evolving and relatively new field, which reminds me of the statistic, the description that the 2030s are supposed to be a transformative decade for, by the first time in US history, the number of people over the age of 65 should be greater than the number of people under age 18. And yeah, I think this is points to how large of a field this is growing into. And I'm curious. How did you?

elise_eifert (03:25)
Yeah.

Yes.

Thank you.

leah (03:50)
first discover the field of gerontology. What was your origin in it? How did it become something you were so passionate about?

elise_eifert (03:57)
Oh, great question. This is definitely a long winding road to where I am now. It really, I think, began with my dad. So my dad is a retired nursing home administrator. And so I grew up in this setting, right? And around older adults and around aging. And I consider myself really lucky. I didn't have just one or two grandmas. I had like dozens of grandmas. So it was a fun environment to be around. However, it was a limited,

perspective of aging. That's only one, you know, dimension of aging. And I didn't really want to go into the health care route and I didn't know that there were other options and other careers in aging. So when it came to college and picking a major, I went with education and I actually became a high school health teacher. That's where my adult career started. It didn't last long. I won't go into detail, but my first and only year of high school teaching didn't go

well and I left the profession. I went back to college, I got my master's degree in community health and my first job post-graduate education was as an Alzheimer's disease educator for a nonprofit dementia resource center in Florida and that I think is where the fire was lit, right? Like I really really loved that job. I loved the interactions that I had.

But after three or four years, I started seeing some gaps and I had questions mostly regarding family caregivers and how they approached support services. And I realized that the only way I was going to get answers to these problems was if I went and did the research myself. And that's when I decided to get my PhD in community health education. And simultaneously, I got a graduate certificate in gerontology.

I think my true scientific training of gerontology was really through my PhD.

leah (06:05)
Wow, thank you for sharing. Sounds really incredible. I guess I can jump right in then to talking about your research specifically. It sounds like public health education has always been something central to your career, something even passionate about, and you transitioned to research during your time as a PhD candidate and now as faculty at UNCG. So would you mind describing to me a little bit about the focus of your research?

elise_eifert (06:19)
Mm-hmm.

Sure. My research predominantly focuses on family care partners and their use of home and community-based services. We know, or the literature really tells us, that home and community-based services are underutilized by care partners and there are dozens of reasons why that is.

I in particular look at care partner identity and I operate on the premise that many care partners don't self-identify as a family caregiver. Therefore they kind of ignore and don't utilize the support services that are meant to help caregivers specifically. So my research has been trying to understand the ways that influence and shape a caregiver identity.

my impact behavior. I started by developing an instrument called the Family Caregiver Identity Scale or FCIS and that measures caregiver identity and now I've shifted a little bit and now I'm using that and trying to understand the relationship between positive and negative conversations

caregiver identity. So negative aspects of caregiving like stress, burden, that type of stuff, that receives a ton of attention way more than the positive aspects of caregiving, which happened, if you look at the literature, happens just as frequently as negative experiences. So I'm exploring some of the work that I'm doing now is if we could frame caregiving in a more positive way, that more care partners might lean in.

and embrace that caregiver identity. And then hopefully they will use some of the caregiver services that are meant to support them and help them.

leah (08:35)
Yeah, absolutely. And I love your focus and attention to the positive aspects of caregiving week.

elise_eifert (08:41)
Yes, it's a huge area that just gets so ignored. Anytime you see the news, anytime you see interventions, they're always so focused on that negative stuff. And it's not that that's not important. That's really important. But all of this other stuff gets ignored. And there's like life, there's a balance, right? Good comes with bad, but we never ever emphasize that.

good stuff. And I often have the conversation of like, well, who wants the role of being a caregiver? If it's so bad, right? If all we ever talk about is bad stuff around caregiving, nobody's ever going to want to be a caregiver. So we have to start talking about it in a different way. And that's kind of what I'm interested in right now is how we can change people's perception

leah (09:28)
Great.

elise_eifert (09:41)
get drama or attention and emphasize some of those positive aspects.

leah (09:47)
Yeah, to help our listeners understand the dual nature, the highs and the lows of caregiving, specifically family caregiving, can we start by discussing the term, the invisible second patient? That's something that I've heard in family caregiving settings from various academics who use that to describe the caregiver burden. And I don't wanna focus solely on the caregiver burden, but to start us out, can you kind of explain what that term means and how it can apply

caregiving settings.

elise_eifert (10:18)
Sure, I'll do my best. I will say that I'm not very familiar with that term. I mean, I think I kind of get the idea of, I believe what when people are saying this invisible second patient is really that so much stress and burden does occur. Like we know that caregiving negatively impacts the health and wellbeing of the caregiver. But the person who is most vulnerable

or the person that gets the most attention is often the patient or the care recipient. And that caregiver, the care partner, often their needs get ignored. And so they're kind of the secondary patient where their needs are actually increasing, their health is declining, and their attention, they're becoming more vulnerable. And so we have to not just look at the care recipient.

focusing on their care partners, typically, a spouse, an adult child, something along those lines.

leah (11:26)
Yeah, I think this just emphasizes the importance of caring for not just the individual you're caring for, but also making sure we're paying attention to the people caring for them. Yeah, so on the flip side, what are some of the highs that you see family caregivers experiencing? What are some of the joys that you get to witness every day?

elise_eifert (11:33)
Yeah, 100%.

Right, yeah. I think what a lot of people have told me, I've never been a full-time family caregiver, but looking at the literature and just talking with family caregivers, they often speak to their strength and how it has grown, that they were challenged in ways that they didn't know that they could do or they could accomplish. But you also hear things about joy and the relationship

the people that they cared for, that they got to see their mother in a different light, or they got to see their husband in a different way, that maybe he was dependent all the time and never, ever asked her for anything, and then all of a sudden he's not well and maybe can't take care of himself, and he's asking his wife to do something, and that often brings them closer together and bonds them and kind of strengthens their relationship.

So those are some of the examples just off the top of my head that there are opportunities for laughter, there are opportunities for closeness and for relationship growth and that maybe never would have happened if a caregiving context didn't occur.

leah (13:04)
That's wonderful to hear. And it sounds like these joys, this growth for relationship building and experiences can be wonderful accompaniments to caregiving. I can also imagine that these joys don't necessarily come easily. They don't come when one person tries to take on full responsibilities all on their own. It takes a community, and it takes support resources and structures that can help.

caregiving process to make it a positive experience. So in your opinion, what are things where novel solutions are needed in gerontology? Where are their promising developments and hope for a more positive future for family caregivers?

elise_eifert (13:50)
Oh man, I wish there was a simple answer to this question. I don't think there are areas in gerontology that would not benefit from novel solutions. We have policies in place that have been around since the 1960s. Our long-term care structure has been the same for 30 years. There haven't been new advances in Alzheimer's treatments in 20 years. So, so much of how we operate is based on ideas

outdated and have proven to be ineffective, but they're still in place. It's time for change and there are people and organizations out there who see these opportunities and are taking advantage of it. And not to do a plug, but Kariyaya is a great example. It's a simple innovative solution to a long-standing problem and that's the cost of care.

leah (14:35)
Thank you so much.

elise_eifert (14:49)
more risk takers, more creative types who are kind of willing to think outside of the box and to try something new. There's really lots of reasons to be hopeful that the way my parents are aging is not going to be the same for me when I'm their age.

leah (15:09)
Right, yeah, and to circle back to your work, caregiving and caring for aging individuals can be a very positive and joyful experience, but in order for it to be that, we need to be supporting these family caregivers through novel solutions like Kariya and other, you know, tech forums and yeah.

elise_eifert (15:24)
Right, right. We're in a longevity revolution, right? Like we have to think of a long game. We have to start planning now. We can't wait until 2060 when 25% of our population is going to be over 65 years of age. We need to be coming up with things right now and we need to be making plans and changes now so that our society is built for success.

leah (15:52)
Yeah, what types of challenges do you foresee as you described, have a rapidly aging society? What sort of implications does this mean to have a rapidly aging society?

elise_eifert (16:03)
Sure. Right, well, I'm gonna change your language just a little bit. I love that you said implications. I don't wanna say challenges because I think an aging society has a lot of positive things as well. So it's not just challenges. Older adults are not just bringing challenges to us. They're bringing lots of good things too. So I'll just make that point. I'll get off my soapbox. There's lots of different implications. I mean, nothing about our society

touched by our changing demographics. Societal aging will impact economic growth. It's going to impact patterns of work and retirement. You mentioned families, it's gonna change the way our families function. The ability of our governments and communities to kind of provide resources is gonna be interesting to see. And then of course, the prevalence of chronic disease and disability,

who's going to care for these individuals who may be dependent or vulnerable. So there's lots of implications. We should really be looking at some of our other countries around the world. Countries like Japan and South Korea, I mean, they've been dealing what's going to happen to us in probably about 15, 20 years. They've started, you know, to see.

They're starting to try to come up with things that they can do to prepare for that aging society And we could be learning a lot from what these other countries are doing What's working what's not working that type of thing?

leah (17:48)
Absolutely. Yes, thank you so much for clarifying implications. I definitely agree that we as a society can do a much better job of focusing on the positives that, you know, an aging society will bring and sure there will be challenges. There is also a time for growth. So to wrap us up, do you have any kind of wisdom or life lessons you've learned about aging from your experience

elise_eifert (18:04)
All the wisdom, it's good.

leah (18:18)
like to share.

elise_eifert (18:19)
Yeah, absolutely. The biggest thing for me that I've learned about aging is that we underestimate older adults all the time. My idea of what it means to be 70, 80, 90, even 100 has continually and repetitively just been shattered through the people I've met over the years.

getting older is just wrong. Age is just a number and there are older adults who are living these amazing full lives and we don't talk about it enough. And so I think what I've just learned in interactions and talking with more and more older adults is that they're incredible, that they're doing really impressive things across their life course and you know,

It's another 25, 30 years of great living and learning and growth. And I think elderhood is just a really exciting time.

leah (19:30)
Thank you so much, Elise, for being on our podcast. I personally feel more optimistic about aging in the future after talking with you. So hopefully I will stay as well as well. Yes, thank you so much.

elise_eifert (19:39)
Yes, we need it. Gerontology is such a fun field. I wish more people would come to it and explore it because the opportunity and growth is really, it's really endless.

leah (19:55)
most definitely. Thank you for sharing your expertise with us. It was wonderful speaking with you.

elise_eifert (19:57)
Yeah, of course.

Thank you.

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