When Magdalen Balz polled residents at a Dorchester, Mass., senior housing facility about factors that determine quality of life, she wasn’t expecting one of the answers to be “feeling victorious.”
“We know that being social, active, and engaged in your community are positives for health and wellness as you age,” says Balz (’09), a clinical assistant professor in Sargent’s speech, language, and hearing sciences department and a longtime speech-language pathologist. But feeling victorious?
“When I asked the senior what they meant by ‘victorious,’ they said feeling as though they had an important role in their day, where they were active in their community and successful at what they did,” Balz explains, adding that she wouldn’t have thought to ask someone if they felt successful that day.
That’s the beauty of an open-ended study, she says. And that’s why in 2019, she surveyed residents of Olmsted Green—affordable senior housing operated by the nonprofit Hearth—about what constitutes quality of life. Their answers helped her construct the Cognitive Wellness Program (CogWell), designed to combat age-related cognitive decline in seniors who have experienced homelessness.
From the get-go, Balz knew she wanted to create a cognitive therapy program for older adults historically excluded from such resources. That’s how she ended up partnering with Hearth: a selection of units in its seven Greater Boston complexes are reserved for formerly homeless individuals.
“There’s a body of literature that shows that doing preventive cognitive therapy helps seniors maintain their independence—in terms of managing their activities of daily living—longer,” Balz says. “One of the reasons we picked Hearth is that they have a diverse group of seniors with diverse cognitive needs who could likely benefit from cognitive exercise. Other seniors might be able to sign up for a class at a university. But that’s not a resource available to all seniors. So we bring the class to them.”
CogWell is run by Balz and graduate students in the speech-language pathology program. Each cohort is free, lasts a semester, and involves weekly sessions at one of Hearth’s locations. Participating seniors practice attention, memory, language, and organization skills; at the same time, student speech-language pathologists accumulate clinical hours by leading therapy sessions. The activities vary: sometimes facilitators have seniors listen to a podcast and answer questions about what they remember; other times they’ll create brain teasers for participants to solve. Often, Balz says, the seniors dictate what a day’s tasks should be: for example, a recent conversation about preparing for doctor’s visits led to an organizational activity where seniors created appointment-prep checklists.
There’s a body of literature that shows that doing preventive cognitive therapy helps seniors maintain their independence—in terms of managing their activities of daily living—longer.
—Magdalen Balz
Such activities help even if participants aren’t exhibiting cognitive decline. For one, the tasks often help seniors practice memory strategies for use in their daily lives. But CogWell’s main goal is preventing decline in the first place, Balz says.
Much of the program is tailored to support individuals’ needs. CogWell sessions started out in person at Hearth’s Olmsted Green and Anna Bissonnette House buildings in 2019 and 2020, but switched to Zoom for much of the COVID-19 pandemic. During that time, Balz and her students had participants pick a task to accomplish and set goals to attain it. One senior chose to practice latch hook, a craft similar to rug-making, and established goals for how many rows to complete each week. “At the end of the very last session, they held up their finished latch hook for us to see, and it was a nice, tangible moment of success,” Balz says.
Feedback from seniors and grad students has been positive, according to Balz. Last semester, one senior suggested renaming the program Intergenerational Dialogue and Collaboration for Cognitive Wellness. “He wanted to change the name because he liked that he got to give life advice to the students, and they brought him tasks for cognitive activity,” she relates. “It’s this really lovely exchange.”