A future doctor is learning about health care from the consumer’s perspective

PARIS – There have been no drastic changes at the Maine Veterans’ Home in the past week, but Steven Fosmire wouldn’t want it any other way.

The 27-year-old medical student, who is finishing up his first year at the University of New England College of Osteopathic Medicine in Biddeford, has been a resident at the home since May 29. He will be discharged today.

“They’re trying to immerse me as much as they can,” he said of the staff.

Fosmire said employees had been instructed to give him a diagnosis and treat him as they would any other incoming patient, to the extent that is possible. Instead of taking medication for his prescribed pneumonia ailment, for example, Fosmire has been given M&M’s. Fosmire has been staying in the home skilled care unit. The home has three units – one for residential care, one for skilled care and one for Alzheimer’s patients.

The immersion is designed to give medical students real-life experience on what it is like to live in an elder care facility. The project allows students to achieve a better understanding of residents’ needs.

“In medical school, you really don’t get that experience,” he said.

The program was pioneered by Dr. Marilyn Gugliucci, director of geriatric education and research at the university.

Gugliucci said she thought of the idea in 2005, when a student told her she wanted to “learn how to speak to institutionalized elders.”

She asked the student, “Would you live in a nursing home for two weeks?”

The student said she would.

Fosmire is the third student, and first male student, to take part in the project.

“I thought it was a very interesting idea,” he said.

He had a bit of a rough start, Fosmire said. As a new pneumonia patient, he could only have pureed food and thickened liquids. He was woken up around midnight for an examination of his lungs, and his sleep was further inhibited by check-ups on his roommate.

After speech, physical and occupational therapies, and an “overwhelming” amount of paperwork, Fosmire has been cleared as an independent resident.

“I still get my M&M drugs, morning and night,” he said.

He has been participating in the home’s activities, including morning exercises and bingo. Too much time lounging in his room, he said, “defeats the purpose of being here.”

Fosmire has nothing but praise for the facility, describing the staff as friendly and approachable. The home is not charging Fosmire for his stay; to show his gratitude, he bought the nursing staff six pounds of Dunkin’ Donuts coffee on Saturday during an outing with his wife.

“It was the least I could do,” he said.

He does not tell the residents why he is at the home unless they ask, Fosmire said. Some don’t even notice; he says one resident asked him not about his age, but what military branch he was from.

“They don’t think twice about me being here anymore,” he said.

Gugliucci says the assimilation process is one reason why students are asked to spend several days in a facility.

“It takes about three or four days for the environment to get desensitized to the student being there,” she said.

Despite the short time he’s been at the home, Fosmire has already forged some strong friendships. He met Roger St. Hilaire, a U.S. Air Force veteran of World War II, at breakfast one day.

“He’s a nice guy,” said St. Hilaire. “We hit it right off.”

Fosmire has been taking notes on a legal pad and a laptop during his stay. He said he and Gugliucci plan to publish his findings and speak on the experience at classes and conferences.

“It will be interesting to see if the outcomes for the male students are different from the female students,” Gugliucci said.

Gugliucci describes Fosmire as “more sophisticated” than the prior students who took part in the project, in that he is older, operating on an Air Force scholarship, and was raised by his grandparents.

The scholarship requires Fosmire to go on active duty in the Air Force, and he will most likely be in family practice, he said. He will be a typical medical practitioner during that time, treating everyone from children to elders, but figures he will go into veterans care after that.

The two students who participated in the project prior to Fosmire made similar conclusions regarding the necessity of eye contact and good communication in interacting with residents, Gugliucci said.

So far, Fosmire’s reflections are following suit.

He said he has tried to find out what a person’s interest is and work it into the conversation, increasing the comfort level and establishing a connection.

Sometimes, he said, that can be a difficult process, requiring earning the trust of a resident.

“I think the biggest thing is knowing how to communicate,” he said. “You have to know how to interact properly without making someone feel like less of a person.”

Overall, he follows a simple rule: he does not want to treat the residents any differently than he’d treat his own grandparents.

“They come from a period where they didn’t bother anyone with their own problems,” he said. Fosmire says this makes non-verbal cues as important as verbal ones.


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