Photo Courtesy of Duke University School of Nursing
Editor’s Note.I first met Jody Clipp in 1991, when I was a Visiting Professor at the Duke University School of Nursing and she was a Professor in the School of Medicine there. We bonded, both professionally and personally, almost immediately and were able to maintain a relationship of mutual admiration and affection over the next 16 years, despite the distance between North Carolina and Iowa. Jody’s untimely death saddened me immeasurably—not only for the loss of an incredible colleague, as detailed in this tribute to her life and work, but also for the lost opportunities to discuss everything from the personal challenge of caring for aging parents to the future of geriatric nursing. A strong yet elegant woman of grace and substance, she will be sorely missed.
~Kathleen C. Buckwalter, PhD, RN, FAAN
Elizabeth “Jody” Clipp, PhD, RN, FAAN, The Bessie Baker Distinguished Professor of Nursing at Duke University and a nationally recognized researcher in the field of gerontology, died on August 5, 2007.
Dr. Clipp’s research addressed trajectories of health across the life course (veterans’ health and aging), health consequences of providing informal care for individuals with chronic illnesses and health promotion in chronic illness (cancer), and care at the end of life. Her scientific work led to a significant body of published works and scientific presentations. As a research scientist and aging expert, she published more than 100 papers on aspects of aging, work that was influential to revisions of care-related policies with the Veterans Administration system for individuals with chronic illnesses.
In addition to her own research program, Dr. Clipp was noted for her talents in building research capacity and mentoring others. Using her understanding of trajectories of health and illness in an innovative manner, she established two nationally recognized research centers: the Trajectories of Aging and Care Center, funded by the National Institutes of Health, and the Geriatric Interdisciplinary Research Center at Duke University, supported by the John A. Hartford Foundation. The scientific activity in these centers laid the foundation for the doctoral program at Duke University School of Nursing, a program focused on the preparation of nurse scientists with rigorous training in longitudinal methods and analyses. Dr. Clipp mentored many scientists from nursing and related disciplines, including gerontology, medicine, psychology, public health, sociology, and pharmacy. As a result, the nation’s capacity for understanding patterns of health, illness, and care over time continues to expand.
Dr. Clipp earned her undergraduate and master’s degrees in nursing at the University of Maryland and completed her doctoral studies in psychology at Cornell University. A postdoctoral fellowship in aging research brought her to Duke in 1984, where she joined the faculty in 1985. Concurrently, she was appointed as a core investigator in the Geriatric Research, Education and Clinical Center (GRECC) at the Durham Veterans Affairs Medical Center. In 2001, she joined the faculty of the Duke University School of Nursing.
Dr. Clipp served as the Associate Dean for Research Affairs for the Duke University School of Nursing until July 2007, when she resigned due to illness. In addition to her role in the School of Nursing, she held the rank of Professor of Medicine, Geriatrics Division, within the Duke University School of Medicine and was a Senior Fellow within the Duke Center for the Study of Aging and Human Development. She also served as Associate Director for Research for the GRECC.
Dr. Clipp’s research was characterized by the creative, rigorous application of social science methods (both qualitative and quantitative) to important problems in nursing. Her earliest work focused on describing a typology of trajectories of health and illness among veterans who had survived combat during World War II, demonstrating empirically that multiple trajectories (positive and negative, linear and nonlinear) ensued (Clipp, Pavalko, & Elder, 1992). Later, with support from the Nursing Research Initiative of the Department of Veterans Affairs, she conducted the largest national, longitudinal survey of informal caregivers of patients with dementia ever conducted. The National Longitudinal Caregivers Study provides an unusually broad perspective, over time, of the stressors and health responses of informal caregivers in a nationally representative sample and, thus, has laid the groundwork for the design of effective caregiver support interventions (Clipp, George, & Doyle, 1999; Clipp, Moore, & George, 1996). The study has generated a series of secondary analyses that are ongoing by scientists in economics, health policy, medicine, nursing, and pharmacy (Sleath, Thorpe, Landerman, Doyle, & Clipp, 2005; Van Houtven, Wilson, & Clipp, 2005; Moore, Zhu, & Clipp, 2001).
In addition to her focus on caregivers of older adults with chronic illness, Dr. Clipp contributed important insights into the understanding of behavioral approaches to prevention and treatment of individuals with cancer (Demark-Wahnefried, Peterson, McBride, Lipkus, & Clipp, 2000; McBride, Clipp, Peterson, Lipkus, & Demark-Wahnefried, 2000). As the nurse investigator on multidisciplinary teams studying lifestyle modification in cancer survivors, she helped develop and test novel interventions to allow older adults to benefit from diet and exercise interventions. In addition, she showed how psychosocial trajectories of cancer patients differ from their physiological trajectories (Clipp et al., 2004; Clipp, Hollis, & Cohen, 2001) and developed new methods of interdisciplinary assessment for older cancer patients (Ingram et al., 2002).
Dr. Clipp’s research broadened to include issues of death, dying, and quality of life at the end of life. Her impetus to assess quality of life in medical studies of patients with terminal illnesses stemmed from an abiding concern for vulnerable older adults and their rights as patients to be acknowledged as whole, autonomous individuals. For several years, Dr. Clipp worked in an interdisciplinary team to develop increased understanding of what dying patients, their families, and health care providers value at the end of life.
Her contributions to this work included a clinical nursing perspective on dying trajectories, focus on the family as the unit of analysis, and methodological approaches to studying patients with chronic illnesses and their caregivers. A qualitative groundwork for conceptualizing quality of life at the end of life was published in the Journal of the American Medical Association (Steinhauser et al., 2000) and the Journal of Pain and Symptom Management (Steinhauser et al., 2001).
From this initial work, she and her colleagues developed instruments that would measure quality of life at the end of life. The end result was the development of the QUAL-E (Steinhauser et al., 2002, 2004a, 2004b). The QUAL-E is recognized as a reliable and valid instrument to measure quality of life at the end of life and is now being used by researchers internationally.
According to Harvey J. Cohen, MD, director of Duke University’s Center for Study of Aging and Human Development, Dr. Clipp’s ability to bring together doctors, nurses, and other medical professionals to address an area of research was unique: “She was a fabulous collaborator on multidisciplinary work. She was a tremendous talent. She was also a great mentor to both nursing and medical trainees. She was a pleasure to work with and to know.”
According to Peter Lange, PhD, Provost of Duke University, “Jody was a creative, inspirational leader and a joy to work with. When the School of Nursing was developing its PhD program, Jody understood the importance of drawing from and building upon other parts of the University. As a result, one of the distinctive strengths of the program is its interdisciplinary nature. Jody was a great advocate for nursing and nursing education and a true citizen of the University. Her passing is very sad for us all.”
Mary Champagne, PhD, RN, FAAN, Professor and former Dean at Duke University School of Nursing, remembers Dr. Clipp as an incredible force who joined the School of Nursing faculty and filled a leadership role just as a doctoral program was needed. “Spectacular is a word that comes to mind. She radiated energy,” said Dr. Champagne. “When she walked in a room, you were almost overwhelmed by this intelligent person with her engaging smile and flaming red hair. She had a keen understanding of science, and the importance of nurse scientists and interdisciplinary research teams in improving the health of people. She excelled here, and we were lucky to have her.”
Catherine Gilliss, DNSc, RN, FAAN, Dean of the Duke University School of Nursing and Vice Chancellor of Nursing Affairs said, “Dr. Clipp has made substantial contributions to our understanding of health and aging. She was a nationally respected researcher and educator. As a leader within our school, she helped build a research enterprise and launch a doctoral program. We will miss her dynamic personality, her enormous talent, and the generosity of her spirit.”
In April 2007, Dr. Clipp received the Distinguished Contributions to Nursing Science Award from Duke University School of Nursing for her accomplishments as a nurse scientist, and in May 2007, the building that houses the School of Nursing research faculty was formally renamed the Elizabeth C. Clipp Research Building in her honor. Dr. Clipp was recognized across disciplines as a scholar and is noted for her work with interdisciplinary teams.
Dr. Clipp is also remembered as a woman who loved her family. Jody’s family was the anchor in her life. She is survived by her husband, Steven, and her three children; her son Stephen is an undergraduate student at Cornell University and her daughters Elizabeth and Celeste are undergraduate students at Duke University.
Ruth Anderson, PhD, RN, FAAN
Professor and Chair, Doctoral
Duke University School of Nursing
Durham, North Carolina
Eleanor McConnell, PhD, APRN,
Associate Professor and Director,
Gerontological Nursing Specialty
Duke University School of Nursing
Clinical Nurse Specialist
Durham VAMC Geriatric Research
Education and Clinical Center
Durham, North Carolina
Catherine Gilliss, DNSc, RN,
Dean and Vice Chancellor, Nursing
Duke University School of Nursing
Durham, North Carolina
- Clipp, E, George, LK & Doyle, MA. 1999. National Longitudinal Study of Informal Cost and Quality of Life among Caregivers of Elderly Individuals with Dementia. The Gerontologist, 39, 65.
- Clipp, EC, Carver, EH, Pollak, KI, Puleo, E, Emmons, KM & Onken, J et al. . 2004. Age-related vulnerabilities of older adults with colon adenomas: Evidence from Project Prevent. Cancer, 100, 1085–1094. doi:10.1002/cncr.20082 [CrossRef]
- Clipp, EC, Hollis, D & Cohen, HJ. 2001. Considerations of psychosocial illness phase in cancer survival. PsychoOncology, 10, 166–178. doi:10.1002/pon.506 [CrossRef]
- Clipp, EC, Moore, MJ & George, LK. 1996. The content and properties of the Caregiver Activities Time Survey (CATS): An outcome measure for use in clinical trials of Alzheimer’s disease. American Journal of Alzheimer’s Disease and Other Dementias, 116, 3–9. doi:10.1177/153331759601100602 [CrossRef]
- Clipp, EC, Pavalko, EK & Elder, GH. 1992. Trajectories of health: In concept and empirical pattern. Behavior, Health, and Aging, 2, 159–179.
- Demark-Wahnefried, W, Peterson, B, McBride, C, Lipkus, I & Clipp, E. 2000. Current health behavior and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer, 88, 674–684. doi:10.1002/(SICI)1097-0142(20000201)88:3<674::AID-CNCR26>3.0.CO;2-R [CrossRef]
- Ingram, SS, Seo, PH, Martell, RE, Clipp, EC, Doyle, ME & Montana, GS et al. . 2002. Comprehensive assessment of the elderly cancer patient: The feasibility of self-report methodology. Journal of Clinical Oncology, 20, 770–775. doi:10.1200/JCO.20.3.770 [CrossRef]
- McBride, CM, Clipp, E, Peterson, B, Lipkus, I & Demark-Wahnefried, W. 2000. Psychological impact of diagnosis and risk reduction among cancer survivors. Psycho-Oncology, 9, 418–427. doi:10.1002/1099-1611(200009/10)9:5<418::AID-PON474>3.0.CO;2-E [CrossRef]
- Moore, MJ, Zhu, CW & Clipp, EC. 2001. Informal costs of dementia care: Estimates from the National Longitudinal Caregiver Study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 56, S219–S228.
- Sleath, B, Thorpe, J, Landerman, LR, Doyle, ME & Clipp, EC. 2005. African American and White caregivers of older adults with dementia: Differences in depressive symptomatology and psychotropic drug use. Journal of the American Geriatrics Society, 53, 397–404. doi:10.1111/j.1532-5415.2005.53155.x [CrossRef]
- Steinhauser, KE, Bosworth, HB, Clipp, EC, McNeilly, M, Christakis, NA & Parker, J et al. . 2002. An initial assessment of a new instrument to measure quality at the end of life. Journal of Palliative Medicine, 5, 829–841. doi:10.1089/10966210260499014 [CrossRef]
- Steinhauser, KE, Christakis, NA, Clipp, EC, McNeilly, M, Grambow, S & Parker, J et al. . 2001. Preparing for the end of life: Preferences of patients, families, physicians and other care providers. Journal of Pain and Symptom Management, 22, 727–737. doi:10.1016/S0885-3924(01)00334-7 [CrossRef]
- Steinhauser, KE, Christakis, NA, Clipp, EC, McNeilly, MD, McIntyre, L & Tulsky, JA. 2000. Factors considered important at the end of life by patients, family, physicians, and other care providers. Journal of the American Medical Association, 284, 2476–2482. doi:10.1001/jama.284.19.2476 [CrossRef]
- Steinhauser, KE, Clipp, EC, Bosworth, HB, McNeilly, M, Christakis, NA & Voils, CI et al. . 2004a. Measuring quality of life at the end of life: Validation of the QUAL-E. Journal of Palliative and Supportive Care, 2, 3–14.
- Steinhauser, KE, Clipp, EC, Bosworth, HB, McNeilly, M, Christakis, NA & Voils, CI et al. . 2004b, June. Validation of the QUAL-E. Paper presented at the research forum of the European Association for Palliative Care. , Stresa, Italy. .
- Van Houtven, CH, Wilson, MR & Clipp, EC. 2005, February. Informal caregiver intensity and caregiver drug utilization. Paper presented at the annual Veterans Affairs Health Service Research meeting. , Washington, DC. .