Basia Belza, PhD, RN

By Laurie Fronek  |  7/17/07

Basia Belza, PhD, RN, is the Aljoya Endowed Professor in Aging at the University of Washington School of Nursing in Seattle. She is also a highly respected researcher who has focused extensively on health and fitness issues related to aging. She talked recently with On Call's Laurie Fronek about the role nursing plays in ensuring healthy aging.

Q. Can you tell us a little about your work in healthy aging?

A. Initially, I looked at different types of arthritis. In particular, I looked at the mechanisms and measurement of fatigue, and in the 1980s, I developed an instrument to measure fatigue. That instrument is still used by health professionals and pharmaceutical companies to better understand and measure fatigue across chronic illnesses and, actually, in well populations. In studying fatigue, I realized that deconditioning was a big problem among adults and older adults, so I moved into looking at exercise interventions to reduce deconditioning. Now my work is focused on taking evidence-based exercise programs into the community so they are more available for older adults.

Q. Do you think the fact that we have an expanding elderly population is going to have a big impact on the profession of nursing?

A. As nurses, we know we're going to be caring for more and more older adults, regardless of our clinical setting. Even someone who's working at a children's hospital will be working with aging parents and grandparents. That means all nurses need to be prepared to examine the care needs of older people and to think about strategies for disease prevention and health promotion. We also need to make a paradigm shift - that's actually taking place now - from focusing on acute conditions to really being able to work with individuals [who need] to manage chronic conditions.

Q. What are the most important issues involved in this shifting focus?

A. I think the health-promotion piece is really important. What that means is that we're not just treating diseases like diabetes and arthritis, but we're actually looking at how people can maintain their overall health - that means with exercise, with stress management, with nutrition, and it means intervening much earlier in one's life, not just when people are turning 70. Take physical activity. It has multiple benefits, and there are few adverse effects. No matter how much you do, it can benefit you in some way. It's beneficial across all ages and levels of frailty. People need to be active at whatever their capacity is.

Another important piece is to use all the strategies we can to keep older adults as independent as possible for as long as possible. This includes matching their environment to their level of competency. As long as they can stay independent, they need an environment that allows them to flourish, and then as their independence or competence decreases, they need an environment that's more supportive.

Q. So what you're saying is that in all kinds of clinical settings, nurses working with older adults should be asking themselves, "What can I be doing to help promote a patient's health and independence?"

A. Yes, exactly. And we all have a role in that. It's not just the nurse who sees someone in a retirement community. It's what happens when that person in the retirement community interfaces with their fitness trainer who comes in to help them, or interfaces with their physical therapist who’s helping rehabilitate them after a joint replacement. It's the front-desk person in the doctor’s office who alerts them to a swimming program that they just found out about. We all have a role in helping maintain that independence.

Q. As an educator, what kind of impact do you think all this will have on what happens in nursing schools?

A. There's a role for nursing faculty to play. As the population ages, we need more people to be able to take care of that population. So nursing faculty can create opportunities for students to have enriched contact with older adults. I think it’s these kinds of experiences, the experiences they have during their education that can encourage them to go into the field of gerontology.

For example, I co-teach an undergraduate gerontology class for 100 students. One of their assignments is to go out and involve themselves in a situation with older adults - a lecture, a health fair, something that will let them be engaged. One of the things I did was to invite students to volunteer at a fundraiser breakfast for ElderHealth Northwest, which provides adult day services in the Seattle area. The breakfast was at Safeco Field, where the Seattle Mariners play. Twelve students came. They got exposed to this organization, saw this wonderful videotape, heard very inspiring lectures about how people have benefited from the services of ElderHealth Northwest, and on top of that they all got their pictures taken with a former Mariner who was at the event. All of a sudden, they got excited about gerontology! I really feel that a number of them will continue that interest in gerontology, at least in part because of this particular experience.

Q. So events like this can help change people’s attitudes?

A. Yes. As nursing faculty, we’re responsible for creating these kinds of opportunities and engendering new images of healthy aging for our students. When we think "old," we tend to think "dreary, frail, decrepit." We need to address people’s stereotypical views of aging - basically, their ageism. Faculty have it, and students have it. But the more we can shift the way they think, the better care we'll be able to provide for older adults in the future.

Laurie Fronek is a freelance writer who lives in Seattle and a regular contributor to On Call. She has done the interviews for On Call for the past nine years.