By Stephanie Grinnell
Staff Writer
    Two college students have been “Learning by Living” for the past two weeks — William Vogt at the Maine Veterans’ Home in Scarborough and Alice Li at St. Andre Healthcare Facility in Biddeford. The medical students spent their time at the nursing homes as patients, not caregivers, through the program, which was created by Dr. Marilyn Gugliucci, director of Geriatric Education and Research at the University of New England College of Osteopathic Medicine.
    Gugliucci said the idea for placing students in the shoes of their geriatric patients came to her “out of the blue” following a lecture in 2005 when a student said she wanted to learn how to speak with institutionalized elders. Her response to the student was to speak with older adults like they are human and suggested the student stay in a nursing home as a patient to better understand what it is like.
    “I don’t know where it came from, but it came out,” Gugliucci said.
    The student spent two weeks at Cedar Ridge Nursing Home in Skowhegan. The following year, Gugliucci had several more students interested in living in nursing homes and she created the program for them to follow. Students are required to write their preconceptions of nursing homes before they move in as well as journal daily in preparation for a final paper to be presented to incoming medical students.
    Gugliucci said the program did exactly what she hoped it would — help the students look beyond the disease to the patient.
    “That’s the part I was really hoping for, that they would look beyond the frailty and disease and create relationships,” she said.
    Several other issues have been revealed during the course of the program that have proved beneficial as well, Gugliucci said. She said nursing home staff have shared their experiences with her and said they changed the way they conduct patient care.
    Also, Gugliucci said she hoped to change the perception of nursing homes.
    “Nursing homes get such a bad rap and I wanted this to be positive,” she said.
    To date, the students have not reported any negative experiences with their nursing home stays and the only reason a nursing home refused students was due to space constraints. Gugliucci said she acts as the student’s power of attorney or daughter and speaks with or emails each student every day. The purpose of the contact is to assess the student’s mental condition, she said.
    This year marked the first year Maine Veterans’ Home participated in the program. Director Steve Garde said he thinks of the home as a teaching facility and said he was excited to have Vogt as a resident.
    Vogt, 27, a University of New England College of Osteopathic Medicine student, said he wanted to live as a resident to “get a better sense of what patients go through.” He said he has not determined if he will practice geriatric medicine, but said the experience at the nursing home could be applied elsewhere.
    “It’s incredible to try to come close to what they have to go through on a daily basis. It’s eye-opening,” he said. “No book or clinical experience can come close to describing it.”
    As part of his assigned diagnosis, Vogt was in a wheelchair and had to get used to propelling himself through the halls. Each morning he was awoken by nursing staff, who took his vital signs and dispensed his medication, which was specially prepared blister packs of candy rather than actual medication. 
    Vogt said he would recommend all medical students participate in similar programs.
    “It wakes you up to the humanity behind medical care,” he said. “In a short amount of time, this is a life altering experience.”
    Having a student as a patient was a new experience for staff as well. Certified Nursing Assistant (CNA) Michelle Southard and CNA and Medical Technician Jennifer Ogden cared for Vogt during his stay. They agreed it was an adjustment getting used to having a younger person to care for, but said after the first few days, Vogt was treated just like any other patient.
    “When he first came, we didn’t know what we were going to do,” Ogden said.
    After the initial adjustment, the staff, residents and Vogt settled in.
    “It really is like he is a resident,” Southard said.
    She said there have been nursing students at the facility, but never any who acted as patients.
    “If I was a student, I’d think it’s a great thing,” Southard said. “I think it’s an incredible opportunity.”
    Li, a 24-year-old student from Mount Sinai School of Medicine in New York City, is the first student outside of UNE to participate in the program. She said she has always had an interest in geriatric medicine, though some of her professors have tried to change her mind.
    “There’s not so much of an ‘oh yeah, geriatrics, that’s what I want to do, it’s so happening,’” she said.
    Li heard about “Learning by Living” during a December conference in Portland and said she hounded Gugliucci to allow her to participate.
    “This is such a great opportunity to learn what it’s like. I haven’t seen anywhere else this type of program,” she said.
    This year marked the third year St. Andre participated in the program, said St. Andre Social Worker Mary Danis.
    “It’s been a wonderful experience for us,” she said, adding changes have been made because of students.
    Danis said recommendations from students ranged from changes to toilet paper brand, lotion and bed sheets.
    Li said the initial transition was difficult. She said she started her day really excited about being admitted to St. Andre, then reality set in when Gugliucci pulled into the parking lot to drop her off. After two or three days her “initial shock” had passed.
    “You feel as though you’re part of this place pretty fast,” Li said.
    She said the other residents accepted her quickly.
    “They are kind and funny and outrageously awesome. I wish my friends were like them,” she said.
    Li used a walker and toted an oxygen tank during her stay. She said she noticed how things she used to take for granted, such as trips to the bathroom, were more difficult.
    “A lot of little things you don’t think about become things to think about,” she said.
    Another adjustment Li had to make was living with a roommate.
    “Just having the blinds up or the blinds down. We had to talk about it so you don’t step on anyone’s toes,” she said. 
    Li said she would recommend students and current doctors step into a patient’s shoes.
    “If nothing else, to learn about compassion,” she said. “Starting conversations and talking and getting to know people. That’s the inroad to everything else.”