Heather M. Young, PhD, RN, FAANPhoto courtesy of H. Young
Even as a young child, Dr. Young was passionate about providing care to older adults. As she followed her grandfather after he retired from his position in accounting to South Africa where he founded, and became President of, a non-profit organization that built retirement housing, Dr. Young knew that she wanted her life’s work to be in caring for older adults—she just was not clear on how her path would lead her there. Her path, and the legacy that she built from her grandfather’s organization, continues to evolve today and is exemplified by her past and current work in the field of gerontological nursing and her vision for how nurses need to impact the landscape of gerontological nursing for the future.
Interdisciplinary from the Beginning
Dr. Young began her college career with an interest in human development. Early in the course of her program, though, she found that the focus seemed to be “too much on young people” and only briefly touched on the unique characteristics of older adults, with the focus then primarily on death and dying. She quickly changed majors and graduated in 1981 with a bachelor’s degree in Dietetics. Throughout her undergraduate program, she had opportunities to review patients’ charts in her practicum experiences and found that she was intrigued with all aspects of patient care, not only on those that focused on nutrition. During one of her rotations, she followed nurses and was convinced that this was the path for her! Upon graduation, she immediately enrolled in the nursing program at Sacramento City College and completed her Associate Degree in Nursing, and then moved on to complete her Bachelor of Science in Nursing degree from Southern Oregon State College. Her education continued at the University of Washington, where she earned both a Doctor of Philosophy in Nursing Science, followed by a Master of Science in Nursing degree with a specialty in gerontology and certification as a Geriatric Nurse Practitioner, as she wanted to gain more clinical expertise in the care of older adults. As such, her clinical practice focused on community-based, long-term care for older adults and expanded to include a focus on the needs of older adults in rural settings, including those with cognitive decline, and how individuals and families interact with health systems to improve their health.
Always Look for Connections
Many scholars in gerontological nursing, including myself, think of Dr. Young as being a great sounding board for a variety of challenges that we all face. As such, Dr. Young has earned a reputation for being a premiere mentor. Thus, I asked Dr. Young what advice she would offer to nurses who are just beginning their careers in gerontological nursing, and she stated this: “You could not have picked a better field!” She believes that today’s gerontological nurses need to think broadly about their interests and that they need to make connections with other disciplines across the field of gerontology. She advises us all to be specialists in some aspect of gerontological nursing while being generalists in gerontology. In this way, we can connect what we know to health policy in broad ways. She offers that right now is a great time to be a gerontological nurse, as we have deep webs of connection within our discipline, and this is not typical of other fields. As such, she believes that we need to leverage our knowledge with other powerful people in our field—and that, through our National Hartford Centers of Gerontological Nursing Excellence, we have the opportunity to do so. She gives the example of the Change AGEnts initiatives through the National Hartford Centers of Gerontological Nursing Excellence as a means for nurses to positively affect change by working with other disciplines. Dr. Young credits other bold, courageous individuals, including gerontological nurses and other thought leaders, as being inspirations for her. She cites the work of Drs. Claire M. Fagin, Patricia Archbold, and Carroll Estes as being instrumental in shaping her beliefs about nursing, leadership, and policy to optimize care for older adults.
Focus on the Future
When asked what she believes are the greatest challenges for gerontological nurses, Dr. Young does not hesitate to answer: “Broaden the definition of gerontology and deploy new models of caring for older adults more quickly.” She believes that we as nurses need to extend our perspectives from our initial focus on the frailest of older adults to a broader focus on aging, with the need to re-envision how upstream processes affect health as we age. This broader focus includes the need for us to consider that aging begins in childhood and includes both the education and health policies that affect how we develop during childhood, and ultimately, how we age.
Given her research and clinical practice in health systems, Dr. Young knows well the need for new models of caring that offer solutions to best care of older adults that span across the entire health system and include family care settings, from emergency departments to oncology departments. She believes that we are not deploying these models quickly enough and that with the current climate of health care reform, the time to act is NOW! “We have a narrow window of opportunity to make a difference,” she says, “and nurses must step up and step out, now or never.” She further describes chronic disease management models that use “health coaches” and not nurses as examples of ways in which community-based care providers are trying to get by without nurses, and that we need to be active and enter all settings in meaningful ways where health care is provided. She goes on further to state that we cannot be intimidated by existing structures, and that we need to capitalize now on ways where we can, and should, be leaders in care for older adults, as we can take advantage of the flux in our current systems. The strength of her words and convictions are palpable.
Creating a Legacy
Dr. Young’s current position at the University of California, Davis, is the Associate Vice Chancellor for Nursing, founding Dean and Professor, Betty Irene Moore School of Nursing, and Dignity Health Dean’s Chair for Nursing Leadership. Previously, she directed the John A. Hartford Center for Geriatric Nursing Excellence at Oregon Health Sciences University. In her current role, as in her previous roles, she continues to focus on mentoring the next generation of nurse leaders and promoting health in older adults. As such, she serves as the primary investigator for a $2.1 million Patient-Centered Outcomes Research Institute study that seeks to improve health for individuals with diabetes by determining if innovative approaches, including mobile technology and nurse coaching, help participants better manage this chronic disease.
Dr. Young’s keen focus on the future needs of our aging population continues to build on her legacy of expert care for older adults. When asked what the secrets are to her success, she offers these insights. First, she is a deeply optimistic person, in that she sees opportunities where others see problems. Second, she has a tolerance for taking risks and living with ambiguity. Last, she possesses a “true North” sense in herself, and she believes that this internal compass guides her to her commitment for leaving the world in a better place than where we started. Given all of Dr. Young’s accomplishments and her steadfast determination to improve the care for all older adults, I believe that her compass is on point. Dr. Young, thank you for your steadfast leadership in gerontological nursing.