When it comes to understanding the elderly population (70 and older), Ernestine Kotthoff-Burrell, PhD is hands down the go-to professional at CU’s College of Nursing. With a 35-year career, she understands what it will take to meet the growing demand for health care to seniors.
One of the biggest changes facing the country is the sheer number of older adults and those who live longer. “The number of health care professional providers who have special skills for older adults has not kept pace,” Dr. Kotthoff-Burrell says. “We have way too few, considering the exponential growth in the population. Some say the next fastest-growing population will be people who reach 100 and beyond. The number of centenarians is increasing at an astronomical rate.”
The ability to anticipate future needs has often led Dr. Kotthoff-Burrell to look for opportunities to fund new ventures. In 1985, as the administrator for an outpatient clinic, she submitted a proposal to a private foundation to establish a nurse practitioner-staffed clinic for senior adults. Serendipitiously, a retiring physician wanted to work in the clinic as well. The grant was successful, and those humble beginnings grew into today’s Seniors Clinic on the fifth floor of the Anschutz Outpatient Pavilion. “It started as a nurse practitioner/physician consultation for older adults, and over the years has grown to be a large inter-professional, integrated clinic for the care of senior adults in one setting,” Dr. Kotthoff-Burrell reflects.
That same vision was at work in 2010, when Dr. Kotthoff-Burrell’s proposal was funded by a grant from the U.S. Department of Health and Human Services, called the Advanced Education Nursing Grant, designed to stimulate the number of health care professionals available to care for older adults. The College of Nursing was one of the first in the country to respond to the 2010 recommendation of accrediting agencies and the American Association of Colleges of Nursing that gerontological content be incorporated all adult practitioner programs by 2013.
CU is at the cutting edge. Many other nursing schools and colleges need to awaken to the need, Dr. Kotthoff-Burrell says. “Even presently, so few nursing programs across the country have specialized content on the care of older adults.” She is clear about the long-term goal of increased understanding.
“We want to provide patient centered quality care to the older adult individual and their family,” Dr. Kotthoff-Burrell says. “We seek to prevent unnecessary hospital readmissions. We want to teach providers the complexity of illness and the number of comorbidities. We want to decrease unnecessary medications and prevent as much as we can adverse drug events.” All of these efforts are aimed at enabling the individual to continue safely living in the community.
Dr. Kotthoff-Burrell left the small Alabama town in which she grew up for the challenge and excitement of the Charity Hospital School of Nursing of New Orleans. There she saw diseases and disease processes that were varied and rare. “It was extremely beneficial for my foundation in nursing,” Dr. Kotthoff-Burrell says. “It spurred me on to continually advance my education.”
Indeed, added to her advanced practice nurse degree is a PhD in higher education, focusing on the adult learner. It has enabled her to assess students’ learning modalities, adapt her teaching to diverse learning styles and propose better evaluation methods to assess learning.
Dr. Kotthoff-Burrell never thought she would leave her fast-paced work as an ICU and ER nurse until her own parents needed help. “They turned to me,” she recalls. “I never realized how fragmented the care for older adults was and how many holes there were out there.”
Now she is a cheerleader for seniors. “They’re my favorite population,” she says. “I love their stories. I love their ability to reflect on things. And all their complex illnesses and issues makes it intellectually challenging."
For advanced practice nursing students who want to become adult-gerontology nurse practitioners, Dr. Kotthoff-Burrell is an ideal faculty resource and mentor.