During her 15 years in a Philadelphia SICU, Michelle McKay PhD, RN, CCRN recalls, “I noticed the trauma patients were increasingly older and were most often severely injured after experiencing a traumatic injury.That piqued my interest in understanding the difference in treatments and outcomes for geriatric trauma patients as compared to younger trauma patients, and how we can improve care of the older adult affected by traumatic injury throughout the continuum of care.”
Enjoying her interactions with nursing students in critical care, Dr. McKay started on the path at her alma mater, Villanova University’s Fitzpatrick College of Nursing, to becoming a nurse educator. She earned an MSN in Nursing Education and ultimately pursued her PhD to develop expertise as a teacher-scholar.She is now an assistant professor at Villanova.
“My dissertation work focused on and demonstrated associations among frailty, fear of falling and depression with the risk for falls and health-related quality of life in community-dwelling older adults,” Dr. McKay summarizes. These adults “met nursing home admission criteria but chose to live at home with the support of comprehensive health-care services. My study included primarily African-American adults 55 and older, since minorities are typically understudied, so having data related to the needs of this population is necessary,” she notes.
“One in three older adults falls every year, and falls are the leading cause of fatal and non-fatal injuries in this age group,”Dr. McKay says. “Treatment for fall-related injuries in older adults costs over $31 billion dollars annually.”
She has found that “Understanding how modifiable risk factors such as frailty, fear of falling and depression influence the risk for falls and health-related quality of life can assist in the development of assessment, intervention and prevention strategies.
”Following a traumatic injury, frailty increases the risk for poor outcomes, yet it is not routinely assessed in older adults.Depression is also frequently under-recognized and under-treated in this population. “Therefore,” says Dr. McKay, “if health-care providers, including primary care and trauma, consistently include frailty assessment and depression screening, then interventions and prevention strategies can be instituted earlier to decrease the risk for falls and improve quality of life for the older adult.”