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Papers by Marilyn R. Gugliucci

Innovation in Aging, Jun 30, 2017

IAGG 2017 World Congress programs is not straightforward, because decision-making involves a comp... more IAGG 2017 World Congress programs is not straightforward, because decision-making involves a complex interplay of factors. Having demonstrated in a clinical trial that antibiotic prescribing can be reduced by over 25% through comprehensive antibiotic stewardship efforts, our research team implemented a dissemination research study in 28 typical community-based NHs to determine change in prescribing and the factors most critical to success in antibiotic stewardship. After one year of implementation, antibiotic prescribing decreased from 12.39 to 10.95 prescriptions/resident day, with most decrease evident for presumed urinary and respiratory tract infections. The session will also discuss the role of nursing home administration, medical staff leadership, staff and provider attitudes, and intervention activities in achieving and maintaining changes in antibiotic prescribing.

The Journal of the American Osteopathic Association, 2020

A collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine... more A collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine (AACOM) to recruit, peer review, publish, and distribute research and other scholarly articles related to osteopathic medical education.

International Journal of Clinical Medicine, 2015

The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project ... more The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were "admitted" into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or "culture" (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: "What it is like FOR ME to live in the Hospice Home?" The results focus on the students' common themes that include 1) Unknown Territory; 2) Support; 3) Role of Staff; 4) Role of Immersion Learning in Palliative and End of Life Care; 5) Facing Death and Dying; and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch; 2) significance of communication at the end of life for the patient, family, and staff; 3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring; 4) connection with and awareness of the person (rather than their terminal illness) and their family; and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.

Gerontology & Geriatrics Education, 2020

International Journal of Clinical Medicine, 2019

The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused... more The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused plan of care for nursing home residents diagnosed with dementia; and 2) maximizing and maintaining older adults' contentment, peace, and happiness while living in dementia care environments. There are three essential components within the FCM: 1) Person/Family Centered Care; 2) Slow Medicine; and 3) Team Care Management. The principles of "Person/Family-Centered Care" are coupled with the philosophy of "Slow Medicine," and neither can exist without the engagement of "Team Care Management." In short, the FCM maximizes the older adult's potential functioning in activities of daily living, cognition, gross and fine motor skills, communication, and physical well-being, while maintaining the highest possible level of contentment, peace, and happiness. This is accomplished through dynamically utilized professional modalities adapted to the changing needs of the older adult resident-pharmacologic, physical and occupational therapies, family education and involvement, dietary, spiritual, stimulating activities, as well as any individualized modality. The lead for operationalizing the Functional Contentment Model is the nursing home medical director, whose key role is assuring a team approach to care including the older adult resident, the family, and all staff (dietary, housekeeping maintenance as well as care and administrative staff). The FCM is a culture change model that has implications in practice and policy for each nursing home.

Gerontology & Geriatrics Education, 2001

... This is supported by the curriculum designed according to progressive and confluent ideologie... more ... This is supported by the curriculum designed according to progressive and confluent ideologies (Dewey, 1938; Tanner & Tanner, 1980; McNeil, 1990;). The Aging in Rurality CD-ROM ISM stimulates both cognition and emotions. ...

Family medicine, 2005

OBJECTIVE This study's objective was to prove or disprove four hypotheses, three addressing p... more OBJECTIVE This study's objective was to prove or disprove four hypotheses, three addressing physical function and a subjective measure of self-perceived well-being from participating in an elder functional fitness program. METHODS Participants included 17 chronically ill residents from an assisted-living center in Maine. Measures on mobility, metabolic equivalent estimation (MET) levels, resting heart rate, blood pressure, oxygen saturation, muscular strength, flexibility, and body weight were conducted at three intervals-baseline, 6 months, and 1 year. SAS software was used for analysis of means and paired t test. RESULTS Increases in or maintenance of function proved significant. The subjective hypothesis also proved significant. DISCUSSION Research on elder exercise focuses on one or two components, rather than the benefits of a thorough fitness program. This study illustrated improvements in physical function and well-being from participating in a comprehensive elder fitness...

Innovation in Aging, Jun 30, 2017

IAGG 2017 World Congress programs is not straightforward, because decision-making involves a comp... more IAGG 2017 World Congress programs is not straightforward, because decision-making involves a complex interplay of factors. Having demonstrated in a clinical trial that antibiotic prescribing can be reduced by over 25% through comprehensive antibiotic stewardship efforts, our research team implemented a dissemination research study in 28 typical community-based NHs to determine change in prescribing and the factors most critical to success in antibiotic stewardship. After one year of implementation, antibiotic prescribing decreased from 12.39 to 10.95 prescriptions/resident day, with most decrease evident for presumed urinary and respiratory tract infections. The session will also discuss the role of nursing home administration, medical staff leadership, staff and provider attitudes, and intervention activities in achieving and maintaining changes in antibiotic prescribing.

The Journal of the American Osteopathic Association, 2020

A collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine... more A collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine (AACOM) to recruit, peer review, publish, and distribute research and other scholarly articles related to osteopathic medical education.

International Journal of Clinical Medicine, 2015

The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project ... more The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were "admitted" into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or "culture" (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: "What it is like FOR ME to live in the Hospice Home?" The results focus on the students' common themes that include 1) Unknown Territory; 2) Support; 3) Role of Staff; 4) Role of Immersion Learning in Palliative and End of Life Care; 5) Facing Death and Dying; and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch; 2) significance of communication at the end of life for the patient, family, and staff; 3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring; 4) connection with and awareness of the person (rather than their terminal illness) and their family; and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.

Gerontology & Geriatrics Education, 2020

International Journal of Clinical Medicine, 2019

The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused... more The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused plan of care for nursing home residents diagnosed with dementia; and 2) maximizing and maintaining older adults' contentment, peace, and happiness while living in dementia care environments. There are three essential components within the FCM: 1) Person/Family Centered Care; 2) Slow Medicine; and 3) Team Care Management. The principles of "Person/Family-Centered Care" are coupled with the philosophy of "Slow Medicine," and neither can exist without the engagement of "Team Care Management." In short, the FCM maximizes the older adult's potential functioning in activities of daily living, cognition, gross and fine motor skills, communication, and physical well-being, while maintaining the highest possible level of contentment, peace, and happiness. This is accomplished through dynamically utilized professional modalities adapted to the changing needs of the older adult resident-pharmacologic, physical and occupational therapies, family education and involvement, dietary, spiritual, stimulating activities, as well as any individualized modality. The lead for operationalizing the Functional Contentment Model is the nursing home medical director, whose key role is assuring a team approach to care including the older adult resident, the family, and all staff (dietary, housekeeping maintenance as well as care and administrative staff). The FCM is a culture change model that has implications in practice and policy for each nursing home.

Gerontology & Geriatrics Education, 2001

... This is supported by the curriculum designed according to progressive and confluent ideologie... more ... This is supported by the curriculum designed according to progressive and confluent ideologies (Dewey, 1938; Tanner & Tanner, 1980; McNeil, 1990;). The Aging in Rurality CD-ROM ISM stimulates both cognition and emotions. ...

Family medicine, 2005

OBJECTIVE This study's objective was to prove or disprove four hypotheses, three addressing p... more OBJECTIVE This study's objective was to prove or disprove four hypotheses, three addressing physical function and a subjective measure of self-perceived well-being from participating in an elder functional fitness program. METHODS Participants included 17 chronically ill residents from an assisted-living center in Maine. Measures on mobility, metabolic equivalent estimation (MET) levels, resting heart rate, blood pressure, oxygen saturation, muscular strength, flexibility, and body weight were conducted at three intervals-baseline, 6 months, and 1 year. SAS software was used for analysis of means and paired t test. RESULTS Increases in or maintenance of function proved significant. The subjective hypothesis also proved significant. DISCUSSION Research on elder exercise focuses on one or two components, rather than the benefits of a thorough fitness program. This study illustrated improvements in physical function and well-being from participating in a comprehensive elder fitness...