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Dr. Jeremy Holloway, University of North Dakota
University of North Dakota
Dr. Jeremy Holloway, University of North Dakota

Show summary:

Dr. Jeremy Holloway, Director of Geriatrics Education at the University of North Dakota, delves into his geriatric specialty, highlighting the critical role of social bonds and educational advancements in elder care. He explores the hurdles within healthcare, the influences of culture and economy on aging, and how AI and cross-generational initiatives can significantly improve seniors' lives. ~~~ Meanwhile, with a third of U.S. podcast listeners (34%) tuning into true crime regularly, the genre's appeal is undeniable. Tony Tilton, organizer of the Fargo Crime Convention, discusses this intrigue with Prairie Public's Danielle Webster.

Summary of interview with Dr. Holloway:

In this interview with Dr. Jeremy Holloway, he discusses several key issues in the field of geriatrics and elder care. Here is a summary of the interview:

  1. Social Isolation and Loneliness Among Older Adults: Dr. Holloway emphasized the detrimental impact of social isolation on the elderly, particularly highlighted by the COVID-19 pandemic, and shared his motivation for creating an intergenerational program to address this issue.
  2. The Importance of an Age-Friendly Approach: He outlined the "four Ms" of the age-friendly approach (mobility, mentation, medication, and what matters) to geriatric care and stressed the importance of starting geriatric education early, advocating for a proactive stance on aging well.
  3. Challenges in Geriatric Healthcare Workforce: The discussion touched on the difficulties faced by healthcare workers in geriatric settings, including low pay, challenging working conditions, and understaffing, along with the importance of integrating social aspects into healthcare training.
  4. Educational Gaps in Geriatric Care: Dr. Holloway highlighted the gap in geriatric education among healthcare professionals and mentioned the Geriatric Workforce Enhancement Program aimed at bridging this gap, emphasizing the necessity of preparing all healthcare students with geriatric knowledge.
  5. Potential of AI in Enhancing Elder Care: The conversation concluded with a look at the future, particularly the role of artificial intelligence (AI) in revolutionizing elder care and the need for inclusive access to innovative technologies for all, regardless of economic status.

Full Interview Transcript:

Main Street

Welcome to Main Street on Prairie Public. I'm Craig Blumenshine, pleased to be joined by Dr. Jeremy Holloway. Dr. Holloway, welcome back to Main Street. It's good to be back. You are the Assistant Professor and Director of Geriatrics Education at the University of North Dakota and I'd like to focus on your work today. Tell me first though, give me the history of why wanting to study geriatrics became important to you.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Yes, I'd be happy to do that. I was finishing my dissertation and my dissertation was focused on helping underserved populations, specifically underrepresented students of certain maybe racial backgrounds or disadvantaged backgrounds and I defended my dissertation in February of 2020. Now, we probably know the context there.

In March 2020, the pandemic really hit pretty strong in the United States and I was attending church and there was a pastor there and he was a part-time pastor, still is, but full-time chaplain at a nursing home. Actually, it was a retirement community and he shared his experience there. He was sharing about how older adults were dying indirectly due to COVID-19 because of social isolation and loneliness.

They're literally coming up to him and saying, Pastor Dominic, why should I live on? Why? And Pastor Dominic is my friend to this day, Chaplain Dominic as well.

And he told them, well, why should I live on? And they said, well, because you're important. And he's, and you're not important.

You are important too. We need to see how, how are you, I need to see how you're living out the end of your days. And that hit me really strong.

I wanted to do something about that. I created an intergenerational program that got the attention of the Department of Geriatrics at the University of North Dakota and I became hired as geriatric professor at the University of North Dakota in November, 2020.

Main Street

Intergenerational to me means you're involving younger people, middle-aged folks and older folks together with a common mission. Tell me more.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Yeah, here's something that I think a lot of people, I would say, miss or need to understand more is that geriatrics should be something where we start with the end in mind and really start and give this geriatric type of training to folks in their twenties, because geriatrics is, should be at least the goal of a lot of folks, right? To go into older age and, and really live well and finish well. And to have their goal to age well.

And so how do you do that? The only way to do that is to be proactive and to begin with the end in mind. So here actually at the Department of Geriatrics, we focus on what's called the age-friendly approach.

And there's four Ms of that age-friendly approach. One is mobility. One is mentation.

Another one is medication. And the other one is what matters. And what matters is the foundation of the age-friendly approach, pursuing what matters.

That needs to be something that's educated to young people and help them to pursue what matters because it really does determine some health outcomes over time.

Main Street

I think of those who provide care for older folks in our country. I think of low pay. I think of very difficult working conditions.

I think of understaffing and the list can probably go on and on. Is that accurate?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

That is accurate. There are a lot of issues. I mean, there's a lot of issues in general with some healthcare systems and people know it.

People know that it's not exactly a proactive environment many times. Now I'm also going to say, of course, there are really bright lights where you see it. I mean, I'm from Ohio, so we're aware of the Cleveland Clinic.

One of the things that they do that I admire is they call every person that comes in the hospital and their clinic friend. That seems like a very small thing, right? But there's an intentional approach there.

And it also invites the social aspect of healthcare. And they've been doing that for a while. The social aspect of healthcare has been kind of, I'll say it this way, it's been paid attention to more of recent years.

And I'm really grateful for that. I'm so grateful because healthcare is a very, very socially engaging profession. Yet, a lot of our trainings only focus on the technical side of healthcare.

And that is something that I'm really motivated to influence.

Main Street

I don't know the exact demographics of the medical students at the University of North Dakota, but I'm guessing they come in and they're thinking, I'm going to practice family medicine. I'm going to be an orthopedic surgeon. I want to be an ER doc.

And maybe the list is much longer than that, but I'm guessing I'm going to help those who are aging and older is not at the top of the list.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

That is correct, Greg. You know, the interesting thing is my wife's a nurse. She's a nurse at Sanford.

And when she graduated with her nursing degree, guess the place where, the first place she worked at? It was a nursing home. So one of the things that I don't know why it's not communicated more, but one of the things that happens is, unless you're in pediatrics, when you graduate from any healthcare related field, 80% of your clientele are going to be 65 and up, especially with baby boomers, right?

That population is just growing and growing all the more. Yet there is this wide gap. And that's why the department of geriatrics received a grant called the Geriatric Workforce Enhancement Program, because it's recognized on a government level that there are really, really wide gaps between a lot of the education that students are receiving that are related to just the technical skills, but those that are more specifically targeted towards helping older adults really navigating through their older years.

Main Street

I'm guessing too that money might impact some decision making for some medical students. Am I going to be paid solely by Medicare my whole life? Or am I going to have other opportunities to perhaps make a lot more money?

Are those things that students are thinking about?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Students are, I don't know if they're thinking about all of those things, to be honest. I think a lot of students, especially our medical students, I've had an opportunity to meet with them. I mean, they are bombarded with exams.

They're just thinking about their exams and getting those things done. But as often as I try to, I try to ask them, why did you get into this? Why did you do this?

And a lot of them, they're inspired by maybe a family member or a parent. They're not thinking about Medicare. They're not thinking about some, and sometimes it's a positive thing.

They're trusting that their institution has their best interest in mind toward what they need to know. And that's why I'm an advocate. We're actually advocating for helping all healthcare students to get this geriatric knowledge.

And you're right, when you mentioned Medicare, that goes into social determinants of health. So we'll talk about that. But all those things, it's our responsibility to bring that, because students are coming in just trusting us that we're going to give them the knowledge that they need to know for their life.

Main Street

In your experience, are there some countries or maybe even parts of our country that do geriatric care better than perhaps another part of our country or maybe even here?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Culturally, yes, only because in some countries, and I'm only going to talk, I can't speak on all levels, but only from a cultural aspect, we have countries that embed the care of older adults within their culture. Older adults living with their children is something expected. And in some countries, I studied about the blue zones.

But- What are the blue zones? So blue zones are areas where you have a large population of individuals who live over the age of 100. And there's a lot of, some different factors that they found.

Some of the interesting ones are they stay socially connected. Older adults are socially connected, connected with family members. They might be living with their family members.

And we see that. There's a couple of, I won't name all of them, but there's a couple, like one in Japan, and there's a couple in North Dakota, in the United States as well. But some of the factors are they're socially connected.

They're socially connected. And education is also a factor that they're, because they're socially connected, they're communicating, learning new things, staying engaged. And those are factors that are very strong when it comes to aging well.

Main Street

I noticed too, it seems to me, and I think the data might support this, that generally speaking, people of means can provide care for their loved ones differently than people who don't have resources in our country, for sure. What are your thoughts about that?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Yeah, this goes into the social determinants of health for me. So one of the social determinants is the economical condition. And that can be on a community level, or state, you know, nation, or individual, or family.

So yes, ones with the education, by the way, education is another category. And a lot of people don't share this, but these things interact with each other, right? But because of education, one may have a better income.

And then with that income, they may know and be aware of issues in the future that they need to prepare for. And so in that light, they may communicate with their parents that are older. And if their parents have an education, they're more inclined to listen to their kids.

Instead of saying, you're a kid, I'm not going to listen to you. Not that that ever happens, right? But, you know, and so with that type of environment, there can be better health-related outcomes for older adults and for the children.

And the children, when they become older adults, they can bestow that to their children. So it is a legacy. But these social determinants of health should be something that all students are, receive education for.

Main Street

In a previous interview, when you and I talked about Martin Luther King Day, you told me that, you know, there aren't manuals for being a parent. There aren't manuals for this and that. Well, there aren't manuals for growing old either.

And two things about that. First is, when my parents were aging, we found it surprisingly difficult to get basic information that we assumed would be available to everyone. And we dug pretty hard.

Why isn't that manual more clear? So I'm a curriculum and instruction guy.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

And I feel, I've taken it upon myself to look for areas in which there are, there is no curricula. I mean, there is no curriculum. And there are no curricula for certain things.

But that doesn't mean we shouldn't have something. And what happens a lot is that because we grew up in an environment where we went to school, I went to public school. And in that environment, we went to a certain school, eight hours a day, five days a week.

And so what often happens is after about 12 years of that education, you often tend to think that only the subjects that were in that school that was presented to me are the subjects that are important for my life.

Main Street

There's a lot that wasn't covered there. That's right.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

That is right. So a lot of times when the other subjects are brought up, like how to manage money or how to talk with family and connect with them, all these different things, we tend to feel a sense of, I don't know, there's a lot of words, shame or some may have a sense that they should know this already. I should just know this.

And so therefore, when the subject is brought up, there's this discomfort where, well, I should probably know this. So maybe we shouldn't even talk about this. And this makes me feel uncomfortable, all kinds of things.

And I want people to be more and more in environments where they feel OK talking about these things, navigating through these things, making mistakes as we talk through these things, because we all didn't have, well, a lot of us in this country didn't have those opportunities unless it was outside of school. So there needs to be environments where we do talk and discuss these things. And there's this sign on the wall that says it's OK to be wrong as you navigate through this because we're all learning this.

And so at least in environments where I am an instructor or facilitator, I do that. So when we talk about aging, when we talk about growing older, all these things, I do that. I am the sign that says we can talk about any.

I understand that. I understand the history. I know why you feel this way in this room.

And I'm saying it's OK to feel that way. And we're going to talk through and navigate through these subjects.

Main Street

I'm a parent whose kids now are also getting older. What are my responsibilities to share with them like you just alluded to today? How should I do that?

What's your advice? These are not easy topics. They are not easy topics.

What do you tell people that are like my age that have older kids? And you need to be really thinking about this. And here's maybe how you can do it.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

This is what I do. And this is what I really I'm passionate about doing. I'm not perfect at it.

I never graduate from it. But I create environments of freedom, environments where whether it be a child or a student or a person or an older adult feels, I want to say safe, but I also want to say brave enough to talk about these things because that's what they need the most. They need to trust their instincts because we all have instincts too that can are valid, are good.

You know, I think that, you know, I'm a metaphase, so I'm going to say it this way. You know, when God made us, we came with a lot of cool things like and my two-year-old knew when he wasn't getting treated the right way, right? And he would tell me and that's valid.

That doesn't go away. When you're 90, you still have that, right? And it's really cool, you know, and I think that we need to create environments where we honor those things.

When our children, I meet with my children, when they get older, I want to have an environment where we both respect each other's perspectives because that way we can really learn from each other and we can bring in the experiences we had in our upbringing. Both are valid. We just need to have an environment where both are respected so we can learn from each other and grow, if that makes sense.

Main Street

We're enjoying our conversation with Dr. Jeremy Holloway. He's an assistant professor and director of geriatrics education at the University of North Dakota. You talked about how important it is for all of us, but specifically older folks, to be socially connected.

And I'm guessing there are some people listening today that's easy for him to say, I can't hardly get out of the house or I don't feel comfortable even walking to the store anymore. How can we do that better?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Yeah, it's interesting because we can't do it alone. And here's the issue, because I study social isolation and loneliness of older adults, but also just in general as well. One of the things that I found is that social isolation and loneliness can affect one's self-esteem and self-efficacy.

So they may more and more start feeling like maybe I'm not someone valuable enough to have these things that better my life. And so when they experience hardship, they also don't feel inclined to do something about it because they've already felt like, well, I don't matter. And I create an intergenerational program that connects university students in healthcare fields with older adults who may feel socially isolated and alone.

And at the end of the program, we give the older adults a book called a legacy book that summarizes the stories they shared to reinforce their lives do matter, their story matters, and their story is one to be told. And so one older adult started a session with a student and said, I don't really have much to share. But after some time, and we train the students to reinforce the values, value of the stories of the older adult.

After some time of that, the older adult had, you couldn't, you know, the sessions went on and on because they subconsciously, they said, oh, wow, this person does care about what I have to say. I actually had a lot to say, but I didn't, I didn't think that person cared about what mattered to me. And pursuing what matters is the number one thing that all healthcare students and staff need to reinforce because it'll be, it'll come in handy when an older adult is alone, yet they feel like, no, I'm a person worthy of having social connection.

And if someone's listening to me right now, I just want to put a chunk of encouragement to say, you are a person worthy of social connection, no matter where you are. And there are resources, believe that there are resources and look online and, or ask someone to help. And even my program to legacy T E L L E G A C Y.

That one is an opportunity to have some social connection.

Main Street

How might technology in my future help with some of the issues that we've talked about today? What's coming down the road?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Oh man, I got two letters for you. A I. A I.

I mean, oh my goodness. Some, some have said, it's, I believe it's pretty much true that it's going to be one of those revolutions similar to like electricity. So, but if people do it smart, and when I say people, I mean, those that are kind of spearheading AI, if they do it in a smart way, it's going to be presented in a seamless way that should be easy to navigate.

That is the, I think that that's the essence, I think of business. And so hopefully it will be done right. Now, most older adults, when they're having issues related to health, unfortunately have access to a lot of things related to now, and I love not-for-profits, but the, one of the innovations that we really need to, someone needs to approach and challenge is the fact that not-for-profits and anything government funded don't have a lot of people who feel like they're owners of something.

And that's a lot of, that's an issue. That is, will take up the whole rest of our time, right? But that said, the innovations, it's almost like, unfortunately you get like a hand-me-down of an innovative approach, and they're frustrating to navigate through.

And anybody that's gotten any resources that were government funded, unfortunately that's happened. And I'm government funded. I'm thankful for government funds, but I'm saying that because we need to really collaborate with other entities, other, you know, commercial, and there are folks that are collaborating, but we need to understand those things, acknowledge those things, and provide people that are hurting and that don't have access to these premium quality AI products.

We need to find a way for them to have premium quality, even though they might not have the funds for it.

Main Street

I remember when my brother and I tried to teach my father how to generate an email, something he had never done before, on a slow antiquated computer and how frustrating it was for him. And fast forward to what it is you're talking about, send an email to my son that says X, Y, and Z, thank you. And it would be done by maybe AI.

Dr. Holloway, it's a pleasure. For someone who needs more information, where should they go?

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

Yes, you can contact me at Or you can even Google me, Jeremy Holloway, UND, and I will come up. And my phone number is there, everything. Please contact me.

I really believe in social connection. I really want you to contact me and just say, hey, what's up? How's it going?

Main Street

Best wishes to you and your work. Thank you so much. Dr. Jeremy Holloway, he's an assistant professor and director of geriatrics education at the University of North Dakota. Thanks for joining us on Main Street.

Dr. Jeremy Holloway, UND Dir. of Geriatrics Education

It's an honor.

NOTE: This transcript was generated with AI tools. The audio of the show is the official record.