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Researcher:
N. Jennifer Klinedinst, PhD, MPH, RN, FAHA, associate professor
Co-Director, Building Healthy Behaviors Across the Life Span Organized Research Center
Areas of Expertise:
Klinedinst specializes in behavioral interventions to reduce symptoms associated with chronic disease, such as depression and fatigue, among older adults in community and assisted-living settings. She studies the impact of engagement in meaningful volunteer activity on apathy, depression, loneliness, and sedentary behavior among older adults. Additionally, her clinical experience as a community health nurse working with older adults includes delivering preventative and wellness care through an interdisciplinary clinic in low-income senior housing settings.
The BIG Idea:
Klinedinst was awarded more than $800,000 in funding from the National Institute on Aging to support the Volunteering-in-Place (VIP) program, which creates meaningful volunteer opportunities, such as watering plants, feeding a resident pet, or helping with resident activities, aimed at decreasing apathy and reducing sedentary behavior among assisted-living residents with Alzheimer’s disease and related dementias (ADRD). Klinedinst developed the VIP program with Barbara Resnick, PhD ’96, RN, CRNP, FAAN, FAANP, professor, associate dean for research, and Sonya Ziporkin Gershowitz Chair in Gerontology.
Apathy is an often-overlooked determinant of well-being that affects more than half of individuals with ADRD and is associated with increased disability, poorer quality of life, and mortality among older adults with ADRD, Klinedinst says. Moreover, apathetic adults with ADRD are also more likely to be sedentary for long periods of time, which results in declines in function and negatively impacts overall health and quality of life.
The VIP program alters the philosophy of care in assisted-living communities from one in which activities are passive to one in which activities are meaningful for residents and contributory to the community.
Why does the research matter?
Nearly 80% of Americans over age 65 live with multiple chronic conditions that can lead to symptoms such as apathy, fatigue, loneliness, depression, and sedentariness. Klinedinst says such symptoms often cannot be managed medically, so engagement in health-promoting behaviors is the best way to address them. “We need creative behavioral interventions to keep older adults actively engaged in life, despite living with dementia or other chronic conditions that hinder engagement,” Klinedinst says.
Who does the research matter to?
Every day, more than 10,000 Americans turn 65. Within a decade, older adults will outnumber children for the first time in U.S. history, according to the nonprofit Population Reference Bureau. Maryland’s older adult population is growing slightly faster than the national average. The number of residents age 65 and older increased 3.35% from 2023 - 24, as compared to 3.10% nationally.
“All older adults benefit from engagement in meaningful and physical activity,” Klinedinst says. “But this work especially matters to older adults with chronic illnesses that limit their ability to engage in activities.”
What are the clinical applications of the research?
"When people experience ADRD, they lack the ability to plan and carry out directed activity. They become frustrated and stop engaging,” Klinedinst says. “It is not only detrimental to the person with dementia but also to the people caring for them, who don’t know how to engage them.”
Assisted-living communities can be wonderful places for people with dementia to reside and receive help with activities of daily living, Klinedinst continues. But residing in an assisted-living community, where everything is done for the resident, can lead to loss of incentive, reward, and control, which is a risk factor for apathy.
Klinedinst’s passion for this work stems from years spent supporting older adults in community-based settings, where she witnessed how traditional care models can unintentionally diminish motivation and engagement. The VIP program promotes the use of an active care model in which facility staff provide a structured framework emphasizing patient-centered engagement.
“When staff shift from doing for residents to doing with them, the entire philosophy of care transforms — restoring purpose and improving quality of life,” she says.