Fine motor skills are among the many functions that decline as people age. Yet, despite the many daily tasks that rely on the coordination of the hands — operating a telephone, opening a jam jar — they’re rarely the focus of research on aging.

PhD student Rachel Logue Cook wants to change that. Through the Motor Control Lab of movement science associate professor Susan Brown, Logue Cook oversees Hands and Health at Home, an innovative program where students work in the Ann Arbor area to help older adults improve their hand function. 

The initiative predated Logue Cook’s time at the university, but as a researcher primarily interested in aging, she quickly became its leader — which Brown says has been a boon.

“She’s really poured lifeblood into an original study that started before her tenure here,” Brown says of Logue Cook, who began her fifth year of doctoral study this fall. “I am kind of just in the corner watching, because she’s made fabulous progress.”

Hands and Health at Home began as a grant proposal from Ann Arbor Meals on Wheels (AAMOW). The U-M Health Department of Community Health Services, which houses AAMOW, had funding available for community organizations to address priority areas, including obesity and related illnesses. Through Hands and Health at Home, AAMOW and Brown’s lab sought to address this issue by improving older adults’ hand function and thus increasing their ability to access and consume healthy foods.

“One of our big focuses at Ann Arbor Meals on Wheels is supporting folks to age in place for as long as they would like to do so,” says Courtney Vanderlaan, the organization’s director. “And this project felt like a very tangible way to further support this goal and those who we serve.”

The initiative developed from there into an independent study course where students would visit older adults in their homes and teach them exercises focused on improving the dexterity and strength of their hands.

“When I heard about the program, I thought, ‘Oh! This has teaching, this has aging, this has all the different aspects that I really enjoy in one project,’” Logue Cook says.

Logue Cook had participated in similar, service-oriented coursework as an undergraduate at San Diego State University. She knew from early on in her doctoral study that she wanted to focus on teaching and community engagement as part of her research — a natural fit for Hands and Health.

Before sending students into their clients’ homes, Logue Cook (along with Brown) spends three or four days teaching the students how to conduct their sessions: how to perform the exercises and monitor their clients’ progress but also how to keep sessions on track in the face of distractions like enthusiastic pets or clients who tell meandering stories. 

In training Hands and Health students, Logue Cook has built up not only instructional experience for herself but also the chance to teach students how to themselves become teachers.

“I feel strongly,” she says, “that one of my responsibilities as somebody who has a lot of knowledge to give is to be able to share that with the next generation and prepare them for their future careers.”

Since most Hands and Health students plan to go into physical therapy or medicine, preparing students for the workplace is one clear outcome of the program.

But its benefits hardly end there. The program is a demonstrable good for the older adults who participate in it, many of whom report both increased hand function by the end of each term and a greater sense of well-being, thanks to the interactions with younger adults that are baked into their sessions.

“The students were the best part!” says one of the participants. “We did all this fun stuff, and I actually tried everything. I was terrible at some of it but got better!”

For Logue Cook, who collects data at each client’s first and last session to monitor their progress, the program generates quantitative information on hand function in older adults — something that’s vital for both her dissertation and the larger work of Brown’s lab.

“We have enough evidence now,” Brown says, “to say we could make recommendations. You know: ‘Here are activities that you could be doing on your own.’ This could go into a nursing home. This doesn’t have to be one-on-one in a home setting.”

The women are now working on finding a more permanent place for Hands and Health lessons in U-M’s movement science curriculum and looking at ways to share their training with other organizations — from memory care facilities to rural senior centers — that might benefit.

“There’s a lot of different directions this program could go in,” Brown says, “so right now it’s just, ‘How do we build it up?’ Because we know it works.”

Photos by José Juarez and Erin Kirkland/Michigan Photography