Graduate Profile: Sarah Wu, MA, Gerontology
SFU Gerontology MA graduate Sarah Wu came to SFU with two bachelor degrees from York University: a BA in Health and Society and a Bachelors of Health Studies. She says her decision to pursue graduate work in gerontology came after her experiences working at Sunnybrook Research Institute in Toronto, Ontario with Dr. Jacques Lee, a physician-scientist in the emergency department (ED) who was conducting studies on delirium prevention. Wu helped develop a volunteer-based delirium prevention program for older ED patients which included training volunteers on delirium prevention and helping create an informational brochure on ED delirium for patient’s family, friends, and caregivers. “Working with his research team and the ED staff made me realize how incredibly complex and unique health care is for older adults, and how aspects of this care can go overlooked, especially in acute care settings.”
Wu says studying in SFU’s Gerontology program was one of the best academic experiences she’s ever had. With Dr. Habib Chaudhury as her senior supervisor and Dr. Andrew Sixsmith as her supervisor, Wu says she felt supported by the community of researchers, students and staff in the Department. She recounts that losing both her grandmothers in the first year of her program was “extremely difficult” but that the loss also strengthened and solidified her approach to her studies in gerontology. “My relationships with my grandmothers had much to do with my affinity for older adults and my area of research. There is a lot of talk about death and dying in gerontology (which I think is a healthy exercise), but the immediate and immense losses made me reflect on how my grandmothers lived their lives and how they’d want to be remembered.”
Valuing and respecting the lives of older adults is a principle that aligns with one of the central models of care Wu explored in her research for her master’s thesis, “Exploring Person-Centered Care and Mealtimes for Residents with Dementia in Specialized Care Units.” While she initially wanted to research technology and social support among community dwelling older adults, Wu says a small research project she undertook steered her in a different direction: “a nutritional anthropology class I took during my undergrad triggered the idea to pick the topic of mealtimes in long-term care. What I expected and what I observed did not align at all, and that was enough of a motivation for me to change my research topic.”
Even though her study focused on how staff delivered care in long-term care facilities, Wu says it was “critical” for her to “understand the complex social environment of those living in the selected facility.” Motivated by Tom Kitwood’s theories of personhood in dementia care, Wu says her “brain lit up” while reading an article Kitwood wrote with researcher Kathleen Bredin, “Towards a Theory of Dementia Care: Personhood and Well-being.” The last sentence of their article, she recounts, galvanized her approach to her research, as Kitwood and Bredin claim that caring for dementia doesn’t have to rely on “passive attendance upon a elderly man or woman’s psychological undoing,” but that caring can become “an exemplary model of interpersonal life, an epitome of how to be human.”
In her thesis introduction, Wu explains that person-centered care is an approach that prioritizes the personal needs and preferences of long-term care residents and can be seen as a “method of preserving the identity and honouring those persons with dementia through meaningful relationships and communication” (3). During her fieldwork, she observed and interviewed (both formally and informally) care staff and residents with dementia during mealtimes and her findings found that “while staff practices reflect several aspects of person-centred care, a biomedical undercurrent continues to hinder the evolution of dementia care”. For example, while care staff may do their best to give residents choice and ability to have food and mealtime preferences, meals and mealtimes may be rigidly planned and scheduled with little room for personal choice and preferences.
Wu says she met some “brilliant care staff who work very hard at trying to provide a loving and supportive environment, but who [also] often go home frustrated because they feel they couldn’t do enough for their residents that day.” The key message to come out of her research, she says, is this: “We are asking long-term care staff to provide a certain kind of dementia care within a context that does a good job of not supporting their efforts.” For this to change, she notes, some “very real and difficult changes need to be made to our health system if we are going to move forward and provide the kind of dementia care these residents deserve.”
Continuing this research on the experiences of food intake and mealtime among residents at Canadian long-term care facilities, Wu began her PhD in Kinesiology at the University of Waterloo’s Nutrition and Aging Lab in January 2016 and is involved in new projects concerning food and mealtimes for older adults. As her department research profile notes, she will be involved in the Making the Most of Mealtimes (M3) project with her supervisor, Dr. Heather Keller, and working with others to develop “complex interventions that target meal access, meal quality, and the mealtime experience of residents.” Wu says while she’s still immersed in course work, one of the “complex interventions” she’s started working on with Dr. Keller and the M3 Research Team relates to eating assistance in long term care settings. “There is so much that goes on during mealtimes – seating arrangements, serving food, medications, differing preferences and dietary restrictions, eating abilities, social interactions and relationships, staff availability, the physical dining environment – the list is long. At the moment we’re working to identify those critical variables and understand how they interact with one another at multiple levels within these environments so that we can build an acceptable and feasible intervention."