While most medical students learn about dementia in classrooms and clinical rotations, Kaylin Burton spent her first year at Michigan State University’s College of Human Medicine immersed in the lives of older adults who are living with these cognitive impairments, of which Alzheimer’s disease is the most common cause.
Burton participated in the Intergenerational Living Program, a new and first-in-the-nation partnership between MSU’s College of Human Medicine and the Dementia Institute that takes place not in a lab or lecture hall, but among residents of a senior living community, including those with dementia.
The goal of the program, which is guided by College of Human Medicine faculty, students and the Dementia Institute, is to shape empathetic, informed future physicians who understand and bring into action person-centered care. As America’s population ages, more than 7 million of its older adults are living with dementia.
Globally, 55 million individuals are affected. Researchers worldwide are working toward better treatments, but a cure remains elusive. At Michigan State University, various labs are advancing this research through neuroscientific inquiry and clinical trials focused on understanding the molecular and biochemical processes that drive neurodegeneration.
But the Intergenerational Living Program is a testament that, at MSU, different and sometimes parallel approaches are happening as well, which emphasize the community element that’s so crucial to caring for those experiencing dementia.
A first-in-the-nation program rooted in real life
Burton spent a lot of time with her grandparents growing up in Northern Michigan, which cultivated her interest in geriatrics, primary care and family medicine.
For the past year, Burton, the first medical student in the pilot program, has lived at Holland Home’s Raybrook Campus in Grand Rapids, Michigan, which encompasses independent and assisted living sections. As Burton continues her stay through her second year at medical school, the College of Human Medicine will look to recruit a new student during the fall.
While staying in a condo in the senior living community, she wore many hats: that of a busy medical student, an occasional caregiver and a friendly neighbor.
Beyond the structured activities, Burton also joined the Cook Unit, which is the home’s dementia care section, where she regularly showed up for morning coffee times and game nights. And she had unhurried, organic conversations with her neighbors in the hallways or when grabbing her mail.
“The experience was even better than I could have imagined,” she says. “I didn’t know if people would be hesitant or how they would feel about me moving in, but they were so welcoming. It almost feels like having lots of grandparents looking out for me instead!”
The residents, she says, “made me feel like a part of their community.”
For one memory care unit resident, that feeling was mutual. “I didn’t know what she would do,” says Patricia Burgett of Grand Rapids, “but it was a great thing that she had the time to fit this in.”
Meeting those with dementia where they are
A common misconception is that dementia is caused by aging. But even though the diseases that cause dementia — including Alzheimer’s — are strongly associated with older age, they are not considered a normal or inevitable part of simply growing old.
Caused by abnormal brain changes due to brain cell damage, dementia affects memory, language, problem-solving and other thinking abilities that start to interfere with daily life and independent function.
With no cure currently available, researchers and caregivers are increasingly focused on providing person-centered, tailored care. At Holland Home, Burton has been learning what that looks like in practice.
She shadowed geriatricians, designed activities for memory care residents and worked closely with Curt Gritters, director of the Dementia Institute. For example, Burton and the Dementia Institute are helping to test a new virtual screening tool that could make dementia screening more accessible, accurate and timely.
At MSU, Burton is mentored by Irving Vega, Red Cedar Distinguished Associate Professor in the Department of Translational Neuroscience in MSU’s College of Human Medicine. Vega sees the Intergenerational Living Program as a community-oriented complement that advances the evolving model of medical students’ traditional education. “Through this residential model, students develop a deeper understanding of aging, social context and patient-centered care,” he says.
In the Cook Unit, students interact with residents in a hands-on way that exemplifies MSU’s College of Human Medicine mission of learning through service, “fostering physicians who are both clinically skilled and deeply connected to the communities they serve.”
Central to the program’s mission to improve the standard of care for those living with dementia is what Burton describes as a “positive approach to care,” which recognizes that everyone is at a different stage. Assessing that stage and responding accordingly, with a holistic understanding of patient needs, is crucial to strengthening their skills and cultivating compassion.
“A lot of times, it’s really slowing down,” Burton says, “and meeting them where they’re at.”
This includes validating patients’ feelings rather than contradicting them. When a resident living with dementia insists something has been moved or taken, Burton explains, the tendency to correct them can cause distress. “Instead of saying, ‘No, I didn’t do that,’ we will agree with them and not try to correct things in the home.”
She also incorporates techniques such as combining visual and verbal cues when communicating and using the ‘hand-under-hand’ method to help get tasks done without taking away independence. “Instead of me brushing the resident’s teeth, I put their hand over mine while brushing.”
Intergenerational relationships that benefit everyone
Among older adults living in senior homes, loneliness is a well-known challenge. But the busy medical school schedule can also be isolating. The benefits of the Intergenerational Living Program, it seems, go both ways.
Burton has plenty of examples. Her neighbors in the independent section were “always dropping by treats or newspaper cutouts that they would think I’d find interesting,” she says.
One day in the dementia unit, a resident told Burton that she missed her mother. Burton’s own grandmother had recently passed away and after mentioning that to the resident, “all of a sudden it was she who was supporting me through my loss,” Burton recalls.
“It was really moving that we were both able to miss someone and be at a very different time in our lives but still feel this connection.”
For medical students, the Intergenerational Living Program is a valuable opportunity to get involved, become more comfortable caring for older adults through experience and embark on a career in geriatrics.
Through interactions with older adults, community leadership and staff and faculty, the program's student board has thoughtfully designed, evaluated and expanded the program in ways that support all older adults, those living with dementia and students simultaneously.
Beyond recruiting and supporting participants like Burton, the student board has gathered community feedback from residents, conducted and presented research on intergenerational living initiatives and has volunteered alongside Burton in the Memory Care Unit at Holland Home.
The program is one example of how MSU creates opportunities for students to learn through meaningful relationships across generations. Similarly, another MSU initiative connects social science students with Greater Lansing seniors to foster mutually beneficial friendships.
For Burton, the year spent at Holland Home fundamentally changed how she will practice medicine. As the Intergenerational Living Program hopes to expand to include more participating community partners in the future, Burton enters her second year of medical school with a frontline understanding of her future patients. The groundbreaking pilot program proves that the best way to learn how to treat a community is simply to become a part of it.
Alzheimer’s and Brain Awareness Month, happening each June, raises awareness about ways to take charge of brain health and recognize the signs of dementia.
