Oct 15, 2019
Embracing the therapeutic relationship: The joy of seniors’ care
Jennifer Baumbusch’s love affair with geriatric nursing began with her caregiving role to her grandmother, Ella Austrup, who moved into the family home when Baumbusch was 9 years old.
At the time, Austrup was 76, living in her own suite in the Baumbuschs’ Vancouver home. Young Jennifer spent part of every day with her grandmother, often watching television with her after school. When Baumbusch was 19, in her first year of earning a Bachelor of Applied Science degree at the University of British Columbia, Austrup had a severe stroke. The whole family pitched in as caregivers.
Baumbusch prepared her grandmother’s meals, sat with her while she ate to make sure she didn’t choke, and helped Austrup with medication. She took her to church and to visit friends. Most importantly, she provided her grandmother with companionship.
"It was just so important to live that intergenerational experience and to look after her as she became more frail," Baumbusch says. “It had a really big impact on my career."
After a rotation in obstetrics, which she expected to love, but did not, Baumbusch realized that her passion was building relationships with patients—difficult to do during the short period most women stay in hospital to give birth. Her rotation in a gerontology unit at a community hospital became her favourite placement. There, she really got to know patients.
"A lot of people don’t like geriatrics because it’s not fast-paced," Baumbusch says. "People avoid getting into therapeutic relationships with older people. I was different; that was the part I really embraced."
Teaching students to care for seniors
Now an associate professor at UBC’s School of Nursing, Baumbusch teaches seniors’ care in both the undergraduate program and the Master of Health Leadership and Policy in Seniors’ Care. She passes on the knowledge gained through 13 years of staff nursing, clinical care, and management in long-term care facilities.
Most of Baumbusch’s time, though, is spent in research. She investigates ways to improve care for older adults across the health care system.
"The reason I continued going to school was my frustration with the lack of movement on improving care for older adults across the health care system," Baumbusch says. "We have a very ageist culture, so nobody wants to think about getting old and becoming frail and dependent."
After completing her nursing degree and working in the field, Baumbusch earned a diploma in gerontology at Simon Fraser University, followed by a master’s degree at the University of Western Ontario (now Western University), and then her PhD at UBC.
While studying and working, Baumbusch was also raising a daughter, Ellanore, with her husband, Dean Lastoria. She spends a lot of time enjoying BC’s bounty of mountains and ocean, along with her two dogs. And when she’s not working or walking, she’s enjoying murder mysteries. Reading is a way to relax when she’s not advocating—either for patients or for Ellanore, who has a disability.
De-stigmatizing geriatric nursing
Her lived experience of advocacy is one of the reasons Baumbusch is convinced of the importance of empowering other families, by giving them the tools to intervene in case conferences and to ask for what they need for seniors. She’s also determined to tackle the stigma associated with geriatric nursing.
Ageism, pervasive in every aspect of society, spills over into health care and nursing—particularly in the allocation of resources to care for older people, she says.
"If you go into a hospital, the oldest, crummiest units are the ones where older people are—with the oldest, crummiest equipment," Baumbusch says. She strives to improve policy and resource allocation, and to improve nursing education in gerontology.
All nurses deal with older people because almost half the patients coming into any hospital are 65 or older, a percentage that will only increase in coming decades, she points out.
"We all need that specialized knowledge, and we need to grow capacity in this area," Baumbusch says.
One of the important changes Baumbusch has worked to secure in nursing education at UBC is that students no longer have their rotation in gerontology as their first placement, when they have the least experience. A new course in nursing care for older adults now comes midway through the curriculum, when students have more skills.
Warm, safe communities for seniors
Attitudes also need to change, Baumbusch says. Instead of viewing long-term care facilities as depressing places, she imbues her students and colleagues with her own vision of warm, safe communities of residents and caregivers. She also stresses the broad scope of practice required, given nurses’ autonomy in many facilities.
"We don’t have a lot of technology, so we have to develop keen assessment skills," she says. "We have to get our team together to do the interventions we need, keep people as well as they can be, and give them quality of life at the end of life."
Nurses require specialized knowledge to notice changes and care for older bodies, deal with complex medical issues, and be comfortable as leaders, because they may be the only regulated professional on site in a long-term care home. She recommends that students interested in the field take additional courses or become certified in gerontology by the Canadian Nurses Association, for example.
"One of the taglines I heard a long time ago was ‘low tech, high touch’—and that’s what it is," Baumbusch says. "A lot of people don’t see that as nursing, if they’re not constantly looking at a machine and pushing buttons."
Seniors’ care often involves listening to life stories and helping people cope with their losses—both physical and emotional.
"If you are uncomfortable with walking alongside people at the end of life, it’s not the place for you," she says. "It’s like a combination of health care and social care."