“My Heart is in the Community” A Q&A with Yuanjin Zhou

November 09, 2017

Research, Clinical Care, Dementia-Friendly Community, Q&A, ADRC News

Yuanjin Zhou, ’21, is working on a PhD in social welfare in the UW School of Social Work. She is passionate about practice-oriented research, that is, trying to integrate research into practice through collaboration with practitioners and community to solve problems together. Zhou grew up  in Chaohu, a city in the central Anhui Province of China, and attended college in Xiamen University in Xiamen, Fujian, a city on the southeast coast of China. There, she became interested in dementia care development, non-pharmaceutical interventions, and fall risk of older adults. During a recent internship with UW Memory and Brain Wellness Center, she studied and evaluated a community outreach program, part of the grassroots dementia-friendly community movement Momentia Seattle.

Yuanjin Zhou

How did you become interested in dementia as a research topic?

As a sociology graduate student at Xiamen University, I learned about the power of community education about dementia and non-pharmaceutical interventions, such as music therapy. My interest started when I joined a team of social workers and nurses who worked in a social services non-governmental organization (NGO). They had some funding from the local government to provide services for older adults with chronic diseases, such as stroke, diabetes, and dementia. The team ran a program for older adults with dementia using non-pharmaceutical interventions, such as music, exercise in nature, drawing, reading, and games, and they were having success.

In my research there, I evaluated this service model of non-pharmaceutical approach for dementia and helped the team achieve their goals. My aim was to figure out what these people with dementia need and the best ways to support them. Over a year, I followed up with the team after the community events, and helped them to develop assessment tools based on literature reviews. Then I worked on writing academic articles to help them organize their experience and develop their service model. One of my papers focused on integrating music therapy with social work interventions.

 

What did you learn in China from the team’s efforts in community education and non-pharmaceutical interventions for dementia?

The activities, such as music therapy, exercise in nature, and art benefited not only the individuals, but also the general public, community volunteers, and kids, who got the opportunity to spend time with people with dementia and realize they are not scary and they are very lovely people even they struggled with memory loss everyday.

An interesting thing I observed is a lack of knowledge about dementia in the general population. When our team conducted community education sessions about the different types of diseases that lead to dementia, I heard people say, “Oh, now I understand why my wife is like that!” Dementia makes more sense to people when they learn it is a medical condition.

 

Musical therapy for dementia sounds wonderful. How can this approach help, and what kind of music works best?

I think that music therapy is effective and makes sense on different levels—music makes people with dementia feel calm and happy, which also helps the caregivers to feel less stressed. So, we introduced the concept to the caregiver support group and volunteers. If care partners feel comfortable with music therapy, they will trust the effects of the music and use it at home.

The choice of songs depends on the individual’s taste in music, so the social worker first needs to ask about the person’s history or background, and watch his or her emotional reactions to a few songs. You can tell if they like the music. I found that people particularly enjoy songs from the 1990s. There is one client who was in the severe stage of dementia really loves the music by Lijun Deng, a very popular singer during the 1980s and 1990s in Asia, which was a time of political and economic reform in China. There were not many pop songs before then, making her very meaningful for many people.

Take a listen:

  

Now you’ve brought your interest and insights about dementia from Xiamen to Seattle. What is your focus here?

I am interested in the question of how to get people from different health care and social work disciplines to work together to solve a problem in dementia care, and how this research could help practitioners to integrate different services together . The problem I see is that the services in the health care system are very separate—social workers do what social workers do; nurses do what nurses do. Yet, peoples’ problems are connected. People with chronic illnesses have health needs, social needs, and emotional problems, and all these things influence each other and affect health outcomes.

For example, sometimes medications prescribed to dementia patients increase fall risk, and the physicians in the hospital might not know that. The social workers do know about the fall risk, but they don’t have the ability or medical training to change medication prescriptions  but they actually could encourage patients to talk to their doctor if they understand people’s health needs better.

I’m particularly interested in fall risk and fracture because when I spoke with caregivers for loved ones with dementia in China, I would ask, “What’s the thing that makes you the most stressed?” The biggest concern I heard was the risk of their loved one experiencing a fall and serious fracture. It’s so hard to rehabilitate and heal from a fracture, especially if a person is frail or doesn’t realize what has happened to them.

For my graduate research in social work, I want to understand how fall prevention and patient support after falls could be better integrated in the health care system in hospitals.

A person’s history of falling is a good predictor of falling in the future, so I feel that supporting people with dementia who fall or get injured from falls would be beneficial for preventing them from falling again. One idea would be to develop post-acute services and community outreach programs in hospitals.  However, this is really a complex issue that I want to explore more in the future.

 

The UW Memory and Brain Wellness Center was excited to have you as an intern for our community outreach and education programs and see you participate in Momentia Seattle. Tell us about your first experience with this local effort to create dementia-friendly communities?

Yuanjin at the Momentia in My Neighborhood- West Seattle event 'Rock the House'.

The idea of a grassroots movement to develop dementia-friendly communities resonated with me because I know how important community is to social work to address gaps in dementia care. At first, I wasn’t thinking about my social work research; I just wanted to learn about the community systems at work in Momentia because they are so different here, compared to the systems in China.

It took me a long time to understand how an initiative like Momentia becomes organized. I asked a lot of questions—how do people get together and just start doing things, such as taking time out of their busy lives and become so serious, without a centralized source of funding? The Momentia community even has a website and holds stakeholder meetings. So, it was a great opportunity to build my understanding.

For my internship, I worked with Marigrace Becker, the program manager of the Community Education and Impact at the UW Memory and Brain Wellness Center, who suggested I could create and conduct a program evaluation of a new community program called ‘Momentia in My Neighborhood,’ which took place in West Seattle. In this program, community members, local West Seattle organizations, and people with memory loss came together to create accessible programs to help people with dementia stay engaged in their own community.

I found that this first round of ‘Momentia in My Neighborhood’ succeeded in its goals of including and empowering people with memory loss and their perspective in the planning process, and building partnership between people with memory loss dementia and businesses and community services in West Seattle. I provided some recommendations for the next program according to my observation and evaluation process. Doing the evaluation also gave me a lot of practice in working as a researcher within a community.

 

Looking to the future, what do you hope comes out of your UW research and participation in Momentia?

My heart is in the community here—but my heart is also in China. Social work is a newly developed profession in China. I keep thinking about what I should learn to better support the researchers and practitioners in China as well. From all the study experience here at UW and participating in Momentia, I hope I can develop better research and practice skills that would be helpful for people here, and also people in China.