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I met my husband at the [UNKNOWN] park.
It was the last Sunday in August in 1943.
That Sunday Which I didn't want to go anyway, but my sister talked me in to it.
Happened to be a group of men down there that I did some gymnastics with.
We were just really showing off, cuz everybody comes around and watches us like
your in a show, and I kinda had him picked out for my sister, cuz he was so tall.
And I'm so little, but didn't work out that way.
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Sherry's my daughter, and she came to live with me after my husband died.
The best part about my moving back here was that my
mother was able to maintain her independence, and she's very independent.
She may be 91, but she's sharp as a tack, and capable of doing just
about anything I can do except drive and things that take really good eye sight.
>> Ideally, as people live longer, they also live healthier.
And so, instead of being sick for 16 years and being kept alive by a bunch of
medicines and interventions, people would be living longer and being healthier.
>> The need to take care of an older population in a more efficient way.
In a way that brings greater value to care.
Is, is very important for the entire
society, cause we can't afford to do otherwise.
>> We've reached a point now where many
of the answers to the contemporary problems of
American health care are the very problems that
geriatricians have been working on for the last.
Three decades.
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From the seeds that [UNKNOWN] planted, the fruit has grown principally
on a unique campus, which has been the Johns Hopkins Baby Medical Center,
which not only houses the vast of the majority of the faculty in the
division of geriatric medicine but has aging expertise in surgery.
The orthopedic surgery in oncology, in psychiatry, in anesthesiology, and
we also are the home of the National Institute of
Aging on this very campus, so, in many respects, it's
the Silicon Valley of aging care and research, right here.
>> Where else can you be where you can be with
the Patients Safety Institute and collaborating with the Center on Aging.
And working with the School of Public Health, all three trying to
work together to find solutions to the problems that older adults face.
>> We have an infrastructure to promote this collaboration, we meet
every week for an hour and a half as a division.
The big scientists, the clinicians, the clinical researchers, the educators.
And we talk about.
Our challenges.
You can do research, you don't need to be in an academic medical center.
But being in one creates a more highly defined research question
and tempers your investigations to the realities of need.
>> I see my patients, I know what they are going through, I know what.
Diseases and what syndromes they are suffering from.
I see the whole picture.
It helps me also to focus my research question.
Helps me to think more carefully
about designing the intervention, about treatments.
>> I think as a fellow, the role of research here is unique.
Because you get to work with world renowned researchers
who go internationally to talk about their geriatrics research.
And yet, they all are so invested in their, in
their trainees that, you know, our mentors are always very hands-on.
They're always able to answer questions if we have them.
And so, I think that's something that we don't find in other places a lot.
I also feel like they do a lot of what I'm interested
in is more of the translation of bench research into bedside care.
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>> We have tried to figure out what the biology is that makes some older people
frail, and makes him more vulnerable to getting sick and to dying.
So in the [UNKNOWN] of healthy aging we're looking at
syndrome of frailty, what makes an older individual more frail.
Through the work of Dr. Jeremy Austin we have found that one of the cytokines, one
of the hormones in the body is the
driving force leading to that, to that frailty phenotype.
>> Mitochondria are the tiny intracellular components
that produce energy And what we have
found over the years is that these
mitochondria become more and more dis-regulated with aging.
>> And we think now there are ways to modulate it
with aging, where you improve that energy production in aging individuals.
>> Understanding that biology within the next decade, or maybe
two That we will be much better able to intervene.
In a way that allows us to maintain some of that
youthful resilience that we all have even into very old age.
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>> Another example is our Hospital at Home program.
Remember older people, extremely vulnerable.
Hospitals highly complex, highly technical environments.
So the concept we had, was well why don't we take the hospital out of the loop?
>> The two times I've been here, the main problem is the.
>> So by providing ongoing longitudinal care in the home,
you can really provide much better care at much lower costs.
Slowly but surely people are catching on
that understanding people in their own environments.
In the home visit is one of the best ways
to really get to know that patient as a person.
And knowing that patient is a person is one of the
most important ways of providing medical care for her or for him.
>> In geriatric medicine, we're caring for the
frailest and those with multiple active medical conditions.
And we manage them long term.
So it isn't a day or two of managing
a A bronchitis or week or two managing pneumonia.
We're managing things like congestive heart failure that will be life long.
It's very rewarding for us, and very meaningful
and important to the older adults we serve.
>> I am now getting emails and calls, literally on a daily basis.
You know?
We're interested in this model that we talk about it.
We're interested in adopting this model.
Will you help us?
>> We've created a curriculum and published it.
So that other training institutions can do this same kind of thing if they want to.
>> And clearly it's going to be much cheaper for us as a society to
take care of them at home, rather than to wait until they get so sick.
That they come to the emergency room and they are admitted.
So the model of physician house call that
we've had on the Hopkins Bayview campus for
40 years really will be informing the way
healthcare will work in the United States going forward.
We're not recreating an old fashioned model.
We're showing the way forward.
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Ultimately patients need to be part of the healthcare team.
And they need to understand their illnesses.
>> About 15 years ago we came up with this Simple notion to utilize
interactive patient education to deliver them a tailored
information in an effective way which is guided by [INAUDIBLE].
>> So they're sitting in a hospital
bed, they've got a tablet device similar to
an iPad, where they're not only reading about
their illnesses, but they're being quizzed on it.
It allows people who have often very low health literacy to get educated,
about diseases and medications that are important for them to know about.
>> Another important objective is that healthcare is complicated for older
people especially people that have
eligibility Needs that our population does.
So they utilize a lot of health care.
So a lot of what we do is designed to preserve
autonomy for the older adult but also to control health care utilization.
Help keep health care costs down.
So the pace program gets involved and tries to.
Support those individuals so that they can
meet that personal goal of staying at home.
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>> The Shapera Center was founded about a year ago
to help improve the care of older adults through education.
So at our very core, we're really about making the experience
for older people and their families better in the health care system.
But using the method of educating the people who take care of them.
>> It's been a dream of mine and a dream of many of our faulty that
to be able to develop curriculum programs that
would actually translate what you've learned into physician's practices.
If you go out right now on the web and try
to find a foundation or a government entity that would fund
that kind of research You might be able to cobble together
some of it but you wouldn't be able to cover it all.
Through the generosity of of grateful
patients and families of patients, we've been
able to put together a program
like our Shapiro Geriatric Medical Education Center.
>> I don't think American medicine and American geriatric medicine would
be anywhere near the level it is now without philanthropy.
It's the ability to think outside the box.
It allows you to do something that's not traditional.
>> Philanthropic gifts are critical to our scientific mission.
Often times the new ideas are very
difficult to fund through normal NIH mechanisms.
So some of the gifts that we've received over the years have
really allowed us to begin doing research that otherwise wouldn't have been done.
>> Mason Lord is the real giant whose, shoulders we stand on.
Even though he died at age 39, I think his impact to us was powerful.
He really forecast the American medical scene in
a very present way that's remarkable to me.
It must have been his two primary values were respecting the dignity of the
individual as a patient and, and those
that were quite disabled and in, incapable.
Taking care of themselves, and empowering them.
And I believe that was unique, at least a unique
perspective at a time when,
disabled individuals were sometimes institutionalized.
>> Mason Lord is a mentor to me that I've never personally met.
But he's been valued on this campus as a leader.
A leader in society.
A leader is first a person, and a doctor second.
And he valued the care and, and help of the most vulnerable of Baltimoreans.
And that's what we do everyday here.
>> Mason Lord began to envision a different future.
And we're very proud of how we've built upon that legacy.
What I get most excited about is, is seeing that research
portfolio sort of take off and other people pick it up.
The junior investigators, other investigators from around the country and
around the world, and having them sort of take some of
our, our ideas and studies and really expand on them
and make a big difference in the lives of older adults.
That's the most exciting thing to me right now because
I think that's where we can make a really big difference.
Where just affecting the dozen people that
come through our primary care training every year.
Well they go out and work in a practice
and influence the way that that practice functions, or
they go out to another academic center and say,
hey why don't you guys do it this way?
So that's, that kind of dissemination through practice.
>> It's about trying to do things
better, trying do things in an exemplary way.
Trying to take care of a population that have enormous needs, in a way you'd
want to be taken care of, or our parents want to be taken care of.
And you gotta just start.
Baby steps at a time and do the right thing.
And if you have an institution that's behind
you, and nurturing you and supporting you It's possible.
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