Inside Duke Medicine

OGACHI leads Caribbean conference

The School of Nursing’s Office of Global and Community Health Initiatives (OGACHI) is preparing for an Oct. 13-15 conference on improving the health of elderly residents in Caribbean nations.

This year’s event in Antigua builds on important work on the issue begun last October at an OGACHI-led conference in Barbados.

The meeting will draw more than 150 people—more than two-thirds of them nurses—with the expertise to determine the most beneficial care strategies and the influence over public policy to make them a reality across the Caribbean, says Dorothy Powell, DUSON’s associate dean of global and community health initiatives.

“We’ll come out of it with a plan, models for the provision of evidence-based care for Caribbean elderly in community-based settings,” Powell says.

The conference will explore models for older people who need light, moderate or intensive assistance meeting daily needs. And it will develop the leadership skills that nurses, such as Caribbean countries’ chief nursing officers, need to accomplish change.

The cultural tradition in the Caribbean has been for women in families to care for elders at home. But with more Caribbean women entering the workforce full time or moving away from where their elders live, many elderly receive inadequate care. Powell notes that the hospital system is overburdened with elderly patients. The expensive setting is not tailored to meet many of elderly patients’ needs. Meanwhile, primary-care resources that could provide more effective care remain scarce.

So this year’s conference theme is “Community-based Prevention and Management of Cardiovascular and Other Chronic Diseases among Caribbean Elderly: A Focus on Nursing Leadership.” Participants will hear evidence-based strategies that have worked in other settings and decide which ones have relevance for the region.

Powell and her staff are organizing the conference in cooperation with:

• The Ministry of Health of Antigua and Barbuda.
• The Regional Nursing Body of the Caribbean Community.
• Pan American Health Organization-Office of Caribbean Program Coordination.
• The U.S. Centers for Disease Control and Prevention.

DUSON Dean Catherine Gilliss; assistant professors Kirsten Corazzini, Kathy Trotter and Cristina Hendrix; and Specialty Director, Geriatric Advanced Practice Nursing Ellie McConnell will speak at the conference.

Powell is excited about a unique element this year, a play called “Vesta” that will be performed by Caribbean actors on the second night of the conference. The play follows the struggles of one elderly woman and her family as she ages. The Duke Institute on Care at the End of Life often uses the play to open discussions of end-of-life issues and is helping to present the play at the conference.

“It causes folks to focus in on the humanity of these issues,” Powell says. “And the play gets at hospice care, acceptance of which requires a real cultural shift in the Caribbean.”

Powell envisions a third conference on Caribbean elder health next year, which will focus sharply on needed public policy and strategies to enact it.