Numbers in isolation are impersonal by nature, but Professor Edward Helmes has spent his career finding ways to take them personally.
Always numerically inclined, his undergraduate minor in statistics and Honours degree in psychology merged with an interest in quantitative methods to form the focus of his PhD in psychological measurement, following a Masters degree in physiological psychology. These combined interests developed into a career-long campaign to convince his clinical students that measuring characteristics of their clients is relevant and useful, even essential.
Professor Helmes says that past methods have tended to be unsystematic, relying heavily on clinical judgement. But he says the scientific reviews lead to one overwhelmingly dependable finding:
“If you contrast quantitative decision-making with clinical judgement, the quantitative approach will win almost every time, if only because it is consistent,” he says. “It works better than a lot of alternatives, which is not often appreciated.”
He gives the example of a person in hospital for a medical problem and with a psychological disorder. Are they well enough to be safely sent home?
“It is an important practical question for the entire treatment team,” Professor Helmes says.
“Staff have to make that decision regardless of whether there is some quantitative evaluation that documents whether the patient is less depressed at discharge than when they came into the unit,” he explains. Access to a scale that is reliable, meaningful and can assist in that important evaluation is a valuable tool for clinicians.
Professor Helmes’s first job after graduating was working on the development of a scale for older people living in residential care facilities, which proved to be very successful and continues to be widely used today. His interest in working with older patients was also prompted by the concern that their decision-making capacity was often compromised by health issues or neurological conditions like Alzheimer’s disease.
“All kinds of decisions are regularly made in residential care by pressured staff,” he says.
“People with little time to make a decision often use heuristics – cognitive shortcuts – which work fine under many conditions, but they are less effective than if somebody had time to think through complications and alternatives. Making mistakes is also more likely when relying too heavily on heuristics and this can have consequences for people who are often in a vulnerable state.”
Stereotyping the elderly - by those working in the healthcare industry and the patients themselves - is another common and potentially damaging practice Professor Helmes addresses in his research. He describes a “therapeutic nihilism”, where a “what’s the point – they’re not here for much longer” attitude exists. “But that is often inaccurate,” he says.
“A woman of 65 might live for another 20 years. Inaccurate stereotypes vary in the amount of harm they can do.” Such stereotypes fail to take into account the high diversity among older people and the broad range of differences among older individuals of the same age.
Professor Helmes is currently involved in a collaborative project with the Ageing Mind Institute at the University of Queensland looking at the views older people have about ageing. He says there is growing literature on self-stereotypes, where people adopt a stereotype at large in the community, taking negative connotations literally to heart.
He cites a US study where older people were shown words like weak, frail or stupid for very short intervals, too short for people to be consciously aware of the words.
“When experimenters measured the stride length and walking speed after the test,” he says, “people exposed to the negative words associated with ageing actually walked more slowly.”
But in reality stereotypes do not work well with older people.
“There is so much variability. Somebody at the age of 70 may have dementia, or be physically frail with a serious medical problem while others of that age go kayaking or hang-gliding and play competition-level bridge every other Wednesday.”
As Australia’s population approaches a major demographic shift where older adults will outnumber the young, the opportunities for study are growing. Examining aspects of normal ageing and the associated changes in executive functions, changes in working memory functions and in cognition associated with physical exercise are other current areas of interest.
“There are all kinds of research possibilities from the work on stereotypes to people considering retirement and work in other relevant areas of ageing,” Professor Helmes says.
“I can see some evidence that more young students are open to those possibilities.”