At Penn State since 2004, Donna Fick has been renowned for her research in delirium, dementia, and improving cognitive health in older adults. As an Elouise Ross Eberly Endowed professor at the Ross and Carol Nese College of Nursing and director of the Tressa Nese and Helen Diskevich Center of Geriatric Nursing Excellence, Fick teaches gerontology, research, and public policy courses to students in both the graduate and undergraduate programs. She is also the editor of the Journal of Gerontological Nursing.
Currently on sabbatical, although she is not teaching, she is active in more than five federally funded research studies in hospitals, nursing homes, and the community that all focus on improving the care of older adults and their care partners.
Involving students in her projects, she hopes to improve the attitude and competencies of nursing and other health care professional students in working with older adults. Fick also focuses on supporting staff’s very difficult work and mental health needs in nursing homes and long-term care.
She just completed a five-year study with Ed Marcantonio, MD, at Harvard University related to delirium. In addition to developing quick and simple delirium screening, the team has tested individualized interventions for dementia and delirium. The team has also recently developed an app to detect delirium and is expanding to test it in hospitals across Pennsylvania and Massachusetts.
Fick earned a bachelor’s degree in nursing science at Berea College in Kentucky and a master’s degree in gerontological nursing from the University of Cincinnati. Subsequently, she completed a doctorate at the University of California, San Francisco.
Town&Gown founder Mimi Barash Coppersmith sat down with Fick via Zoom to discuss what inspired her to pursue her research in geriatrics and what is on the horizon for improving cognitive health in older adults.
Mimi: Well, I plan on starting this interview in a way that I’ve never done before. My readers will now learn that the interviewee fills out an information questionnaire before an interview, and I go from there directing my thoughts. Something that you said in this information questionnaire struck me as a wonderful way to start this interview.
You said, in November 2020, you received the Distinguished Educator in Gerontology Nursing Award from the National Hartford Center of Gerontological Nursing Excellence. What a recognition from one of the leading foundations that supports the kind of work you’re involved in.
In the next question, “Do you have any hobbies or play an instrument? Favorite sports?” You switch to loving music and nature. You try to support them locally and engage as a novice. [You said] “I believe the arts and environmental conservation are important to our community, and we all have a role in preserving and supporting them. Running brings me much joy and is my sport. Trail running in nature brings me closer to nature and myself. I have a running streak right now of about 1,403 days, consecutive days, running outside.”
I just thought that this was such a wonderful description of you.
Donna: Thank you.
Mimi: You are a great mother, a great professional, a modest woman, a perceptive and persistent woman with such a good nature that it’s hard for me to define it, as I know you. So, this will be a little bit of a different interview for me because I’m interviewing a close friend that I don’t see often enough, and I marvel at the juggling act that defines your life.
And I think it’s important to give the contrast of how you began. [You said], “For my undergraduate program in nursing, I attended a labor college where no student pays tuition. And you work for the college to pay your tuition and housing. This is still true today. The Washington Monthly recently named them the 2021 best college for the buck. It is a small liberal arts college founded by abolitionists — Berea College. This time in my life had a big impact on me. I grew up in a family of 11, and if not for Berea, I may not have been able to attend college and do the work.”
I believe that you are a person who has had the good fortune of rising to the top of your area of specialization. And you did it from seeds to great flowers. Along the way, you have had the special motivation to conquer the challenges of your life. What do you think is the part of you that motivated you to handle the hardest of struggles? I mean, working with the older adult marketplace and doing it with pleasure, professionalism, and progress. What was the thing that did that for you?
Donna: Well, that’s a that’s a wonderful question. When you’re a parent, you think about that all the time with your own kids. I was thinking about the first times that you and I were together; I remember that you were sharing a lot of your stories of hardships growing up. So, I think my motivation was really my parents and growing up in a big family, where you had to work really hard. And my parents were very much involved in the community. I also grew up Catholic.
My dad volunteered at a basketball league for ten years. We all were expected to be there. I had a job since the sixth grade picking strawberries and working in a garden. So, I think my motivation was growing up in this big family.
The other thing is maybe a little bit religious. It was the idea that we have a purpose for being here, and you never have just a job. It’s a vocation. I feel lucky to have a job that has given back to me in incredible ways.
Mimi: You have to feel good about the research that you’ve done in the past and the research you’re doing now on the aging population.
Donna: The thing is, it brings me so much joy. I ran with my girlfriends this morning. I did vaccine clinic yesterday. Lewistown has a federally qualified health care center for low-income people. Some of us are volunteering to work in their vaccine clinic.
Mimi: God bless you. It’s a measurable contribution to society. You’ve got to feel like a giant on some days of your life, with the research you’re doing and the mission and commitment you’ve made to making life better for people in the aging process, and you’re their missionary.
Donna: Thank you. It’s a team effort. With our geriatric center, it’s really a team. I’m the director, but Janice Whitaker is the administrator doing the day-to-day hard work, and we have three associate directors. I know very few people in geriatrics who don’t love what they do because they wouldn’t stay in it. The other thing I see is the field of caring for older adults is universal because if we’re lucky enough, we all get to age, right?
Mimi: Yeah, I’m 88 and proud of it.
Donna: Exactly. You are my hero in terms of aging. It’s like you’re an ageless self. Things that were important to you in your book, Eat First, Cry Later, when you were 30 and 40 are still important.
There is a book written by a sociologist who interviewed 60 older adults. It’s by Sharon Kaufman and called The Ageless Self. Knowing you reminds me of that because she says that people, as they get older, don’t necessarily say, “Well, I’m old now.” Things that were important to their lives, whether family or work or spirituality, continued to be important. Does that resonate with you?
Mimi: A lot of things you do resonate with me.
I’ll share with you and our readers that today I made arrangements to have a brain scan because my memory worries me, and when I get worried, I get afraid of life. Like everybody else, it throws me off balance, and the aging population needs to learn. I’m one of those students. If you get some clues that might provide some information that can be helpful to you, do something about it. And I did that today. I feel very proud about it.
Donna: That’s good because we’ve put so much of a stigma around the fear of memory loss, but we should not. Your brain is an organ, just like your lungs and your heart, and yet we wouldn’t think twice about taking care of our heart. We’re afraid to say to people, “I’m having memory problems.”
Mimi: The pity of it all is I couldn’t get an appointment until January, but I know I have an appointment now. You are the mother of a special needs child who leads a beautiful life because you’re his mother. How did you manage that along the way?
Donna: There have been sleepless nights, but again, so much joy. Like any mother, when William was born with Down syndrome, I grieved. I cried. But not for long. My parents, at one time, said, “I’m so sorry you are going through this.” And I said, “You know, why not us?”
So, when he was born, it wasn’t like, “Oh, this is going to be hard.” It’s like, this is what life is supposed to be. Sometimes it’s hard, and then in those difficulties, you find joy. He brings me so much joy.
Mimi: Where do you think your strength comes from? Is it from your religion? Is it from just your attitude? How do you manage to be the positive person you have always been and always looking to discover new answers to tough questions? Can you define that motivation?
Donna: I think it’s definitely a sense of family. Not so much organized religion for me, but spirituality. It’s a connection to nature. It’s a sense of what are we here for? Can I read something to you? Because, you know, I’m an editor. I had to write an editorial this month, and it was the last minute, and sometimes those are some of my most powerful ones. The name of this one is: “How will we spend our days and hours to improve the care of older adults.” I started with a quote by Annie Dillard, who won the Pulitzer Prize for her writing: “What shall I do this morning. Of course, how we spend our days is how we spend our lives. What we do with this hour, and that one, is what we are doing.” It’s not religious, but it’s definitely spiritual. This is what we’re here for.
Mimi: This is now, not then.
Donna: This is why we’re here. I don’t know how you can be strong in life without a sense of purpose and meaning. I feel incredibly grateful that I’ve been at Penn State for 17 years. I work with wonderful people.
Mimi: What is on the horizon? Is there a breakthrough or particular problem that we can have some input about how we’re progressing?
Donna: I feel like we’re at a really important time in aging. We need breakthrough ideas and innovation, especially in dementia. I believe that we still don’t understand the underlying neuropathophysiology. There’s a lot of people that believe that. We need a breakthrough to understand. I think the brain is the next frontier. We need to understand non-drug approaches better. For instance, we know that watching the medications you take helps your memory, and it actually helps prevent Alzheimer’s disease. We know that by addressing modifiable risks for dementia like hearing loss and inactivity we can prevent many cases of dementia. We have many things that we know help, but instead, we value drugs. We want quick fix procedures instead of a public health approach.
I know people want quick answers, but I would tell older adults to minimize the number of medications they’re on. The number one thing that we know that helps memory is physical activity. So, staying physically and mentally active. There’s lots and lots of evidence for exercise. One way to do this, is having a daily mobility goal, every single day. It doesn’t have to be a run streak like mine. It can be chair exercises, yoga, tai chi, or walking.
Mimi: Did I read that you were involved in important research on delirium?
Donna: Delirium is really common, and people don’t realize how common and preventable it is. It was a presenting symptom of COVID-19 for older adults, and so many things can cause delirium, but some examples are things like a urinary tract or lung infection. Dehydration is a very common and preventable cause. Just being acutely sick can cause delirium. Hitting your head can cause delirium. Having low blood sugar or low sodium or having your electrolytes off can cause delirium. Preventing delirium is also part of preventing dementia. In our College and Center we do a lot of work that is related to delirium but also aging and dementia. We are part of a national project called “Creating an Age-Friendly Health System.” It focuses on four things that all start with the letter “M”: Telling your health care provider What Matters, Mentation, Avoiding high-risk Medications, and Mobility. This work is very meaningful to me.
Mimi: So, you got a lot of work to do.
Donna: Yeah, and look how excited I am about it. I’m lucky that there’s always something new in geriatrics, but here’s the tough part here. We just recently did an older adult health fair. All the nursing students are standing around. So, of course, I walked over, and I said, “Does this make you excited about entering the field of gerontology and caring for older adults?” Guess what they said?
Mimi: No.
Donna: Nobody wants to do that. Still, here we are, trying to get them excited. So, I spent 10 minutes telling them how much I love doing what I’m doing and how I get to travel all over the world. I’ve been to Germany, Copenhagen, and all these places. I was an ICU nurse, and older people are in intensive care. They’re in the emergency room. They’re in-home care. They’re everywhere, but society still believes that it’s not what they want to do. One of the biggest things I struggle with is how I can go into the classroom with them and what we can show them that would make them understand how wonderful it is to be in this field, to change their attitudes.
Mimi: What’s your best story you can tell them?
Donna: That’s a good question. I’m probably telling them the wrong stories because of what I study, which is delirium, depression, and dementia. Even middle-aged people and older adults don’t want to talk about that because they’re fearful maybe. But we have to talk about it.
Mimi: Now, I feel pretty proud that I did get a brain scan. I hope it turns out all right.
Donna: Don’t take those brain scans too seriously, by the way. What is as important as scans and diagnoses is how you are functioning and what matters to you. Most nursing students don’t necessarily know 88-year-olds who are still working, driving, and vibrant too. So, those with a grandparent or someone they connect with, regardless of ability, are more likely to go into the field. It doesn’t matter if it’s in a nursing home or the community but where they have a positive experience bonding with an older adult like you makes a difference.
Mimi: So, my last question. What’s your favorite part about living in State College?
Donna: The sense of community. I’ve been here 17 years, and probably for the first 10 years I was too busy with work and raising three children to appreciate that. I really appreciate that now.
Mimi: And we’ve been connected for all 17 years, I believe. Well, I believe we’ve covered a lot, and my greatest hope is that our readers learn something from each interview. This one has a lot of good messages in it.
