Residents teaching physicians. (Not-for-Profit Report).

Forgetful, frail, depressed, moody, and sedentary--unfortunately, this is too often a composite of the aged envisioned by the young. Although aging is a risky business, growing older can be a positive and healthy experience. And, whether infirm or hearty, older people need to have open communication with their physicians throughout life.

Regardless of a physician's medical specialty, older adults will continue to be a growing demographic in most medical practices. To provide the elderly with the best medical care possible, 21st-century doctors must learn to listen and communicate with seniors as individuals, because age is not a level playing field: Everyone's hearing doesn't diminish at age 70; not all vision is seriously impaired in later years; and, above all, not everyone over the age of 65 is destined to have catastrophic medical complications--but they all need good, basic medical care.

Statistics project that by 2011, there will be more than 45 million Americans 65 years of age or older. At present, most medical schools devote little curriculum to gerontology/geriatrics. To acquaint its medical students on the various aspects of aging, the University of Missouri-Kansas City (UMKC) School of Medicine has taken a three-pronged approach: Along with providing clinical exposure to the students in a hospital and nursing home setting, UMKC also has partnered with the independent-living residents of John Knox Village (JKV) in Lee's Summit, Missouri, to give the students--the doctors who will be caring for aging boomers--an idea of what healthy aging is about, pairing them with active, vital older adults. "By working one-on-one with future physicians, residents teach them how to communicate, listen, and respect older adults and their concerns," says Lisa Take, director of volunteers at JKV. "On the flip side," she adds, "residents gain an appreciation of the younger generation."

In an innovative six-year program, UMKC students earn their undergraduate and medical degrees concurrently. They begin their medical training right out of high school with a curriculum of academic and clinical courses scheduled across 11 months, with a one-month vacation period. Along with meeting their senior mentors, they spend eight weeks analyzing geriatric case studies under the guidance of docents (practicing physician volunteers), exploring how aging impacts on health issues such as nutrition, exercise, mental outlook, and socialization.

Harboring negative perceptions of older adults, many students initially grumbled about the requirement. "When the program began in 2001," says Take, "the students weren't really thrilled with the idea of spending time here. They were busy pursuing two degrees and felt that the project was too time-intensive, and they didn't necessarily want to mix with older people." Because the first sets of students and mentors were so suc-cessful in changing age biases, new students now look forward to the JKV experience.

To participate, a resident must be in an independent-living situation without any significant health problems. "Because some weaknesses are a normal part of aging," explains Take, "ambulating with the aid of a walker, low vision, or impaired hearing does not disqualify a resident." In fact, students can see firsthand that, although physical impairments might necessitate adaptations to lifestyle, they need not diminish quality of life.

Prior to meeting their students, volunteers are given an idea of what the students are learning. They are encouraged to respond to students' questions and discuss their answers with them. For example, after reviewing a case history on poor nutrition habits with his docent, the student can question the resident about his or her nutritional attitudes and how they might have changed with age. "Have you had a decrease in appetite?" "Has this happened to any of your friends?" "Do you take vitamins?" Through the resulting dialogue, students begin to understand the opinions, needs, and preferences of older adults.

Brook Nelson, now a third-year student, says she has been truly enriched by her experience. "Although I've completed that part of my education, my mentor Gail Van Horn and her husband Ralph continue to be an important part of my life. We still get together online, or I stop by to visit when I can. They are very supportive."

She adds, "For our joint project, Gail and I created a biographical scrapbook. I learned so much about her as we went through old photographs, captioned them, and placed them in the timeline of her life. Reliving the memories of her life really brought us close together. Working together, I learned to appreciate her life--where it has been and how positively she sees her future."

Meeting in the relaxed atmosphere of residents' homes, students and residents become more comfortable with each other, and genuine friendships and affection evolve. They take advantage of the various amenities the facility offers--often, students will participate in activities, and several of them have commented that they wouldn't mind living at JKV.

One of the most satisfying outcomes has been that because of the emphasis placed on the "whole" person, students now identify wellness as a part of aging and appreciate the role of the older adult in society. Attitudes on aging have changed. Students are grateful for the continuing support and encouragement of their mentors. Likewise, JKV resident volunteers discovered that by sharing and reliving their past experiences with these future physicians, they have gained a deeper appreciation of the lives they have led.

"It's been a wonderful experience for my husband and me to work with these young people. They help keep us young. I think we've gotten younger and they've become older," remarks Mrs. Van Horn. Her husband agrees: "How many people have a chance to help train their own doctors? This is a chance to have an impact on someone who at some point, other than a spouse or loved one, might be the most important person in your life."

For further information, phone Lisa Take, director of volunteers at John Knox Village, at [phone] or visit www.jkv.org. For more information about the UMKC School of Medicine, phone [phone] or visit www.med.umkc.edu. To comment on this article, please send e-mail to [e-mail].