March 28, 2007 -- When you’re a student in your early 20s, being 93 may seem a long way off —perhaps even unimaginable. The 28 nursing students in a fall nursing class learned first-hand what it means to be a healthy older adult when Grace O’Brien, who was just a few weeks shy of her 94th birthday, visited the class and regaled them with stories about her life, which was not without illness or hardship. As a child she had whooping cough and small pox. As an adult she survived numerous other diseases — some life threatening — including cancer, a detached retina, pneumonia, macular degeneration, osteoarthritis and just last year, an emergency major operation to remove an obstructive growth in her bowel.
"She was humorous and lively with many stories to tell. I think the younger generation has a different view of the older," said fourth-year nursing student Anna Christine Mapes. "Part of the interesting part of Ms. O'Brien's presentation is that she has been through [so much] and has had so many illnesses and yet remains active and optimistic. They represented great challenges in her life and yet, she has met them with determination and optimism and has not allowed them to affect the way she wanted to live her life. They have added to her strength, and this is one of the most amazing parts of her story."
Alert and engaging, O’Brien talked about surviving the loss of two husbands, the importance of her faith, as well as her determination to “age in place” in her home on a hill that she and her husband built and where she has lived since 1966. After the recent surgery, the only suggestion from the occupational therapist about changes at her home that she was willing to adopt was to add a grab bar in the shower. The scatter rugs remained as did the five steps leading up to the front door.
"Steps are good for you," O'Brien told the students.
"She's a risk taker and it has taken courage for her to remain independent," said nursing professor Anita Amelia Thompson-Heisterman, who invited O'Brien to be a guest in one of two sessions she was leading on aging and mental health in colleague Rebecca Harmon's semester-long psychiatric nursing class.
Thompson-Heisterman is a specialist in psychiatric mental health nursing and incorporates lessons in therapeutic communication skills in her class presentations.
The goal in inviting O'Brien to meet with the students was "to give a picture of a healthy older adult and dispel myths about aging," she said. "What better way to talk about what healthy aging looks like than to have Grace talk with the class."
Thompson-Heisterman affectionately refers to the class session as "Aging with Grace." It was so successful that she invited O'Brien again to the spring session of the class.
"Everyone ages at their own rate and we have control over how we live our lives and that can have an impact on the aging process," Thompson-Heisterman said.
O'Brien epitomizes how we all would like our lives to be in our 90s. She is feisty and funny and works at staying fit and alert. Although she had to give up driving a few years ago, that has not hindered her from getting around. She takes a JAUNT bus to appointments and meetings with friends to shop or share a meal. Exercise also is a regular part of her routine. She can be found twice a week at the gym where she does 40 laps around the track. One lady there calls her the "road runner," O'Brien said, although she herself described the walk as slow. She also spends 10 minutes on each of three weight-training machines.
Along with physical fitness, O'Brien works at her mental fitness. When she missed a call from Thompson-Heisterman to arrange the class visit, O'Brien remembered her cell phone number from an earlier call and quickly got back in touch to talk about the final arrangements. To prepare for the class, O'Brien described to the students how she thought about what she wanted to share with them and sat at the end of her bed and rehearsed aloud what she wanted to say.
"I have never done anything like this," O'Brien said.
There is continuity as you age, Thompson-Heisterman said. "You become more of who you are and do not necessarily withdraw from life. Grace certainly epitomizes that."
O'Brien's advice to the class was to make your own way, make friends and connect with people. Her practical advice for them as nurses was to be sure to smile when they go into a patient's room. "That's really important to those who are sick."
With all her activity O'Brien admitted that "everything is hard for me really. The only easy thing I can do is smile."
O'Brien's visit was the first of two sessions in Thompson-Heisterman's class on mental health and aging. "She was a perfect example of a mentally and physically healthy individual," said Thompson-Heisterman, who added that seeing healthy individuals as well as learning about mental infirmities in aging patients is important since the school does not offer a geriatric health class in the curriculum. Together, the two classes — the second discusses delirium, dementia and depression, and other mental illnesses that may present uniquely in older adults — provide an overview of geriatric mental health.
With the two class sessions Thompson-Heisterman aims to raise the students' consciousness about how they approach older patients — to avoid ageism-type language, allow more time when interacting, ask open-ended questions and speak in a low voice because the ability to hear higher pitch sounds diminishes first.
Mapes praised the opportunity to meet O'Brien and hear about life from her perspective. "She has made a definite impact on me and many of my classmates in a personal and professional way. I know that I will invest more in my elderly patients in the future in knowing that they have as many options available as they desire."
Thompson-Heisterman said, "The experience was not only good for the nursing students but good for Grace."