Glennan Center marks 25-year milestone
Jim Morton was feeling overwhelmed. His wife, Lynne, was showing warning signs of dementia — memory loss, confusion and an inability to manage tasks the retired bookkeeper once had easily handled, such as balancing the family checkbook.
As the couple sought answers, they found themselves dealing with a dizzying array of medical specialists. Traveling from one doctor’s office to the next, Mr. Morton felt the burden of trying to make sense of everything he was hearing.
“What do I do?” he recalls thinking. “What does this mean? How do I pull all this information together?”
A friend recommended he consider the Glennan Center. Mr. Morton did his research, then contacted the center. Since that time, Lynne has been diagnosed with Alzheimer’s. Today, Mr. Morton says he is confident Lynne is in good hands.
“I realized the Glennan Center is a place where it all comes together,” he says. “I don’t know what I would do without the Glennan Center. We look forward to coming here. It’s a resource to help us understand.”
The Glennan Center has been an important part of the community for 25 years ever since philanthropist Virginia Cooke Glennan Ferguson chose to fund the center and name it in honor of her father’s family.
While Mrs. Ferguson died a decade ago, her legacy lives on. Over the course of a quarter century, the Glennan Center has become the hub for geriatric-related education, patient care and research at EVMS. In the process, it has helped countless older adults live better, fuller lives. Today, the Glennan Center stands as a shining example of the power of a shared vision, sustained by the enduring impact of philanthropy.
Face-to-face with patients
As Jim and Lynne Morton discovered, the Glennan Center provides a spectrum of patient care thanks to a team of highly trained physicians and staff with expertise in geriatrics, dementia and palliative care.
While Glennan staff see patients in offices on the EVMS campus, much of the care takes place in community settings, such as affiliated hospitals, skilled nursing facilities, assisted living facilities and continuing care communities throughout the region.
As director of the Glennan Center for 10 years before retiring in spring 2021, Robert Palmer, MD, has witnessed the center’s impact firsthand. “The Glennan Center has made invaluable contributions to the health of older adults and to those with serious illness,” he says.
Dr. Palmer left his mark. He helped create the Acute Care for the Elderly (ACE) unit, to provide enhanced care for older adults in specially designed hospital units. The interdisciplinary care team includes geriatricians, advanced practicenurses, social workers, pharmacists and physical and occupational therapists.
Programs like ACE care — which significantly reduce the length of hospital stays — are crucial because of a shortage of geriatricians, says Marissa Galicia-Castillo, MD, MSEd
(MD ’97, Internal Medicine Residency ’00), the John Franklin Distinguished Chair for Geriatrics, Director of the Glennan Center and Professor of Internal Medicine.
“There’s no way geriatricians can see all the older adults who are at risk,” Dr. Galicia-Castillo says. “We can do more good as consultants on complex cases in the hospital, in the clinics, in nursing homes, where we’ve got all the pieces of the puzzle teased out and sorted out so that we can get the patient on the best path.”
One of the key puzzle pieces is memory assessment, a longstanding specialty of the Glennan Center. That’s where Jim and Lynne Morton found help.
The Glennan Center Memory Consultation Clinic offers diagnosis, treatment and support for patients with dementia and other cognitive disorders. It also provides in-depth assessment of memory problems for patients who have experienced cognitive changes. The clinic cares for some 1,500 patients and has an extensive support system for caregivers.
“Regardless of age, we see patients with all different types of dementia, other memory problems, or patients who are concerned about their memory lapses,” Hamid Okhravi, MD
“Regardless of age, we see patients with all different types of dementia, other memory problems, or patients who are concerned about their memory lapses,” says Clinic Director Hamid Okhravi, MD.
“We collaborate very closely with our clinical neuropsychologist, geriatric psychiatrist, neuroradiologists, nuclear medicine specialists, occupational therapists, speech therapists and our local Alzheimer’s Association chapter,” says Dr. Okhravi, who is also the Alfred E. Abiouness Distinguished Professor in Geriatrics and Associate Professor of Internal Medicine.
The Mortons have been impressed with Dr. Okhravi as he has overseen Mrs. Morton’s care.
“Dr. Okhravi has been very clear constantly throughout our journey,”Mr. Morton says. “His calm demeanor, his extensive experience and his willingness to just answer our questions are very reassuring.”
Lynne and Jim Morton discuss her care after a visit to the EVMS Glennan Center.
Innovations in treatment
Another vital aspect of the Glennan Center is its effort to continually improve care. The center provides the residents of Hampton Roads with access to cutting-edge experimental treatments that otherwise might not be available locally.
In the past two decades, Glennan Center faculty physicians and scientists have studied a range of potential treatments for various ailments predominant in older adults — a study of ginseng extract that showed some benefit for respiratory illness, research toward a flu vaccine tailored
for the aging immune system and the evaluation of a simple screening tool that proved valuable in identifying drivers who might have trouble on the road because they are cognitively impaired.
Today, the center’s greatest research focus is on Alzheimer’s disease and dementia, Dr. Okhravi says. His research includes cure-oriented studies with a focus on the biology of the disease and care-oriented research, which develops best practices of treatment.
“My approach is to bring both types of research opportunities and high-quality clinical trials for our patients and caregivers in the Hampton Roads community,” Dr. Okhravi says. To that end, he is working to expand campus collaborations to promote team-based, multidisciplinary science.
“We are also very mindful to the needs of patients who are cognitively intact but are at higher risk of developing Alzheimer’s and other types of dementia,” he says. Along those lines, the center is a site for one of the first trials of a medication designed to prevent Alzheimer’s disease. Among other research trials underway at the center are two that target
agitation in individuals with Alzheimer’s disease. Dr. Okhravi and colleagues nationwide are studying whether CBD oil or the medication escitalopram can help. Four in five people with Alzheimer’s experience agitation or aggression, but there is no FDA-approved treatment.
Recruiting the next generation of caregivers
One of the driving forces behind the establishment of the Glennan Center was the need to prepare future physicians and healthcare providers to deliver specialized care to older adults.
EVMS was among the first U.S. medical schools to require students to undertake specialized training in geriatric care. That was one of the aspects that drew Mrs. Ferguson’s interest and helped inspire her gift to found the Glennan Center.
In part, that training was established to help counter the tendency of physicians to be turned off by the challenge of treating chronic illness.
“They want something they can fix,” John Franklin, MD, former Chief of Geriatrics, used to say. “Geriatrics is not a popular field of medicine.” Another deterrent to attracting more students to geriatrics — then and now — is the pay.
“Geriatrics is not a lucrative specialty,” says Dr. Galicia-Castillo. “One student told me, ‘I love geriatrics, but I’ve got loans I have to pay.’”
Dr. Marissa Galicia-Castillo, once an EVMS student herself, now teaches and mentors students, residents and fellows in geriatrics. Teaching is just one of her many roles in her capacity as Director of the Glennan Center for Geriatrics and Gerontology.
This isn’t just a local recruitment problem. The U.S. is experiencing a serious shortage of geriatricians, and the need is only growing. A report released earlier this year by the Alzheimer’s Association estimates that Virginia and the nation as a whole will need a 10-fold increase in geriatricians by the year 2050.
Over the past 25 years, the Glennan Center has done its part to bolster interest in the care of older adults. Medical and physician assistant students rotate through hospitals, nursing homes and long-term-care facilities to shadow Glennan Center faculty physicians as they care for patients in clinics and at bedsides.
In fact, Glennan Center physicians are seldom without a learner at their coattails, Dr. Galicia-Castillo says. “We’re teaching nearly all the time.” Students also are introduced to this specialized field in other ways.
Two student groups supported by the Glennan Center — Students for the Advancement of Geriatric Education and Beyond Clinic Walls — foster interest in geriatrics and stoke the passion of students interested in the profession. The clubs offer students a forum to share ideas and pair student teams with an older adult, so they can witness the challenges of aging.
With support from donor Rosemary Grime Jordan, the Glennan Center launched a fellowship program to provide sub-specialty training in geriatrics for two fellows each year. The center’s “geri-med” program serves as a pipeline for the fellowship — drawing interested students to attend EVMS for their residency training and to then go on to complete the fellowship.
“We find someone who enjoys taking care of older people, get them from the beginning to foster that interest and help them continue into their fellowship,” says Dr. Galicia-Castillo, who was the fellowship’s first graduate.
Another specialized training program — the Brock Fellowship for Hospice and Palliative Medicine — emphasizes the need to help patients maintain quality of life throughout the course of a serious disease. Established through a gift from Joan Brock and her late husband, Macon, the fellowship trains physicians to focus on treating symptoms while making patients comfortable.
These programs dovetail nicely with another Glennan Center staple: sit-down rounds.
Dr. Franklin and Desmond Hayes, MD, another EVMS geriatrics pioneer, created the program to provide an interprofessional educational opportunity to highlight the medical management and social issues facing older patients, says Madeline Dunstan, MS, Associate Director of Education and Instructor of Internal Medicine in the Glennan Center.
“Each month, a resident, geriatrics fellow or student presents details about an older patient and seeks advice from the group,” she says. “The learning is bi-directional. Presenters and others in attendance learn about valuable resources from participants, representing a host of organizations and services for older adults. The community participants, in turn, enrich their understanding of the diagnoses and medical management of complex older patients.”
The Glennan Center also regularly teams up with the M. Foscue Brock Institute for Community and Global Health at EVMS to sponsor community lectures on a range of health topics. It was a gift from the Cooke Fund — a Hampton Roads Community Foundation fund established by Mrs. Ferguson in honor of her mother’s family — that established the Glennan Nutrition Symposium. The symposium highlights the value of nutrition education.
Despite the focus EVMS has placed on geriatrics, few students choose to pursue the specialty. And it’s an issue plaguing medical schools nationwide. “It’s sad,” Dr. Galicia-Castillo says. “But you hope they take some of the concepts they’ve learned and integrate them into their practice.”
The intersection of care and philanthropy
“People who go into medicine like to help others,” Dr. Galicia-Castillo says. “Studies have shown that geriatricians enjoy some of the best job satisfaction even though they’re not the best paid.”
For her, the satisfaction comes from helping patients successfully battle the challenges of aging.
“Sometimes you make just one little change in their medicine, and it makes such a difference for them. You stop [one medication] and there’s no more brain fog. It’s these crazy simple things, but it’s so impactful for patients and families. It might be the thing that keeps them from going to a nursing home.”
It was that kind of impact that led Mrs. Ferguson to fund the center.
Virginia Glennan Ferguson celebrates the opening of the Glennan Center in 1996 with then-Director Dr. Stefan Gravenstein, left, and geriatrics pioneer Dr. John Franklin.
As a hospital volunteer in the 1960s and ’70s, Mrs. Ferguson came to understand the challenges and risks facing adults as they age.
“I saw many patients brought to the emergency room from nursing homes,” she once recalled, “and I developed a deep respect and concern for them.”
Initially, Mrs. Ferguson, who lived her life modestly, was put off by the funding request to set up the center, says Rob Goodman, her attorney and Cooke Fund advisor.
“She said there was no way she was going to part with $1.5 million,” he recalls of the initial request from the school. Mr. Goodman helped guide her to a compromise. She agreed to donate $1.5 million at the time of her death and in the meantime to give the school $75,000 annually to support geriatrics.
As Mrs. Ferguson saw the center in action and witnessed the care that Glennan Center physicians provided to patients — including her own friends and family — she more than tripled her commitment to the school by eventually donating $5 million.
Other donors have enjoyed the same fulfillment of watching their gifts at work. Their combined generosity has played an integral role in the center’s success, says Paul Aravich, PhD, a neuroscientist and member of the interdisciplinary team behind the Glennan Center for the last quarter century.
“The generous gift of Virginia Glennan Ferguson, of subsequent donors, of major grant support earned by faculty, and by EVMS itself has allowed the Glennan Center to revolutionize the care of older persons in Hampton Roads,” Dr. Aravich says. “The Glennan Center embodies the community vision of EVMS and has had a global impact.”
Contributions from donors have been pivotal to the establishment and advancement of the Glennan Center. Among the programs established thanks to philanthropy:
FELLOWSHIPS
The Brock Fellowship for Hospice and Palliative Medicine
The Lillian and Gideon Welles Grime Fellowship in Geriatrics
ACADEMIC HONORS
The John Franklin Chair in Geriatrics
The Sue Faulkner Scribner Distinguished Professorship in Geriatrics
The Westminster-Canterbury Professorship
The Rosemary, Fenton and Garnett Jordan Professorship in Geriatrics
The Alfred E. Abiouness Distinguished Professorship in Geriatrics
The McKinnon Family Professorship in Palliative Medicine
To learn more about donor opportunities, visit evms.edu/giving.
Read more magazine stories from issue 14.2 or read stories from past issues.
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