The space features eight cooking stations where health care professionals and students will learn culinary medicine, a growing field that integrates nutrition science with practical culinary skills that can lead to improved health, including better management and prevention of chronic illnesses such as diabetes and heart disease.

The kitchen supports the mission of the Trager Institute/Republic Bank Foundation Optimal Aging Clinic, which is dedicated to enhancing the lives of older adults in Kentucky through innovative, age-friendly health care practices. The Culinary Medicine Kitchen, located in the institute’s East Market St. facility, will host physicians, trainees, medical students and other health care providers for hands-on demonstrations that will help them guide patients to better health through healthy eating. The kitchen also will host nutrition-focused cooking demonstrations for the community.

“This wonderful educational venue is an outstanding example of our dedication to advancing medical education and community health, reinforcing our role as a leader in integrating innovative practices into health care training,” said UofL President Gerry Bradley. “It also highlights the Trager Institute’s distinctive approach and dedication to ensuring that older adults across Kentucky receive the care and support they deserve with dignity and compassion.”

The UofL School of Medicine joins 60 other medical schools in using the American College of Culinary Medicine curriculum to train health care professionals to understand and communicate the impact of good nutrition on their patients’ health. At UofL, the kitchen will serve as a vital resource for the Schools of Medicine, Public Health and Information Sciences, Nursing, Social Work and others, supporting their mission to train future and current health care providers and advisors in the role of nutrition in patient health.

“Research shows that good nutrition not only promotes overall health and well-being but also plays a crucial role in preventing and managing chronic diseases,” said Joe D’Ambrosio, director of behavioral health at the Trager Institute. “The Culinary Medicine Kitchen will help bridge the gap between what we know about nutrition and the practice of medicine.”

The Culinary Medicine Kitchen was created with support from GE Appliances, a Haier company, which donated state-of-the-art appliances for the buildout. Features such as an overhead camera and large-screen TVs in the kitchen give learners a bird’s-eye view of techniques for engaging, informative demonstrations. Integrated technology also enables live remote classes as well video recording to create enduring resources for sharing with patients and health professionals online.

Improving health for older adults

Beyond the kitchen, new and renewed funding for workforce training and support services has allowed the Trager Institute to expand its mission to improve the quality of life for older adults across the state. The institute has increased its age and dementia-friendly care and support services, particularly in underserved and rural areas to improve care for the Kentucky’s rapidly aging population.

Last year, the institute received $5 million from the Health Resources and Services Administration through the Geriatrics Workforce Enhancement Program (GWEP), the third consecutive GWEP grant awarded to the institute, following grants in 2015 and 2019.

The new funding allowed the institute to establish FlourishCare Centers of Excellence in the , Cumberland Valley and Barren River regions of Kentucky, bringing together experts from universities, health care providers, community organizations and local governments to improve how care is provided to older adults. Their goal is to ensure health care professionals have the specialized knowledge needed to care for aging adults and to help them stay independent, maintain their dignity and improve their overall well-being.

“By connecting different systems — hospitals, nursing homes, senior care programs and government services — the centers foster a coordinated approach to health care, ensuring that older adults, including those with Alzheimer’s and other memory-related conditions receive continuous and well-organized support, whether they are at home, in a hospital or in a care facility,” said Anna Faul, executive director of the Trager Institute.

In addition, the institute’s Republic Bank Foundation Optimal Aging Clinic was selected as a UofL Health demonstration site for the (GUIDE) model by the Centers for Medicaid and Medicare Services. This national initiative is focused on improving communication between primary care providers and specialists, provides educational resources and emotional support for caregivers, offers respite care and ensures health equity for dementia patients and their families. It is provided at no cost to eligible participants.

The Trager Institute also is expanding its FlourishCare initiative that supports vulnerable older adults with diabetes, depression and dementia, as well as their caregivers thanks to a $600,000 grant over four years from the Administration for Community Living. FlourishCare services aim to improve health outcomes and access to care for those in underserved areas of Kentucky, including:

• BRI Care Consultation: Supports people with dementia and their caregivers by addressing unmet needs, reducing stress and alleviating depression
• Diabetes Self-Management Program: Empowers participants to manage their diabetes effectively
• Program to Encourage Active Rewarding Lives for Seniors: Helps older adults manage and reduce symptoms of depression

To see more images from the ribbon cutting, visit the .

Matt Willinger contributed to this story.

“The window of time when people are willing to accept behavioral health help is sometimes narrow,” said Kelly Gillooly, M. Ed., LCADC, UofL Health system director of Behavioral Health. “With PeaceNow, the 3-4 month waiting period has been reduced to days and eliminated in some cases. The virtual environment allows us to see many referred patients immediately or on the same day.”

A PeaceNow pilot program began in July 2022, opening first to referrals from UofL Physicians. In its first six months, more than 1,200 patients have been served. Today, referrals are accepted from all providers, mental health therapists, school counselors and social workers in Jefferson County and surrounding Kentucky counties. Future plans include adding Indiana counties, following regulatory approvals.

“Physical health and behavioral health cannot be separated. One influences the other and I see the impact of both with my patients,” said Traci Edwards, M.D., UofL Physicians – Primary Care. “Primary care physicians are ideally suited to refer for behavioral assessments since we know they already have the relationships, know the health history and are located all across the community.”

Referrals to PeaceNow are open to patients age 12 and above with a range of mental and substance use concerns, including:

• Depression
• Anxiety
• ADHD
• Substance use disorders
• Bipolar disorder
• Schizophrenia
• Trauma
• Grief
• Other mental health

“Individuals seeking care for their mental health are often met with long wait times before they receive appropriate treatment. This delay increases the likelihood that their symptoms and condition may worsen before care is provided,” said Nancy Brooks, executive director of the National Alliance on Mental Illness, Louisville chapter. “The access to more immediate professional care that is now being offered through PeaceNow will help many individuals bridge the gap between the onset of mental health concerns and proper diagnosis and treatment.”

Telebehavioral health assessments, through PeaceNow will be performed by a clinical psychologist or a licensed therapist, with additional referrals to the appropriate level of care. Some brief therapy may also occur over the telehealth platform. All care will be supervised by psychiatrists and psychiatric APRN’s, who will also provide clinical services to patients.

“The virtual assessment may not entirely replace the need for in-person therapy, but it is a critical new access point,” said Robert Caudill, M.D., UofL Physicians – Psychiatry and Depression Center and professor of psychiatry at University of Louisville. “By launching PeaceNow, we hope to make behavioral health more accessible and expedite the connection of patients to definitive care.”

Older adults may be referred through PeaceNow to the at the University of Louisville Trager Institute.

“Our focus at the Trager Institute is on older adults. It is estimated that 20% of people age 55 or older experience some type of mental health concern, such as anxiety, severe cognitive impairment, depression or bipolar disorder,” said Anna Faul, Ph.D., executive director of the institute. “Combining the PeaceNow team and the Trager team, we believe that we are filling a void in our community that will lead to better health outcomes in the future.”

More information on PeaceNow is available through your primary care provider, mental health therapist, school counselor, social worker or at: 

The Commission on Accreditation of Rehabilitation Facilities (CARF) has accredited the Behavioral Health Service Organization at Trager for three years for outpatient treatment of adults and older adults. Trager is one of only 10 organizations around the globe accredited by CARF for mental health services for older adults.

“Accreditation is a public statement that our organization strives to ensure that our services are of the highest possible quality,” said Joe D’Ambrosio, the Trager Institute’s director of behavioral health. “At Trager, we are committed to reducing risk, addressing health and safety concerns, respecting cultural and individual preferences and providing the best possible quality of care.”

Mental health is an important aspect of overall health and well-being. Losses that can occur with aging – social activity, identity and physical health – put individuals at higher risk for developing behavioral health issues. However, signs of mental illness in older adults often are overlooked or dismissed as normal symptoms of aging. Without treatment, conditions such as depression and anxiety can lead to further physical decline. Behavioral health services are provided as part of the clinic’s comprehensive care to help individuals maintain health as they age. 

In order to be CARF-accredited, programs and services must demonstrate that they conform to internationally recognized standards for service delivery and are committed to continuous quality improvement and a consumer-driven focus. CARF International is an independent, nonprofit accreditor of health and human services providers in aging services, behavioral health, child and youth services, durable medical equipment, employment and community services, medical rehabilitation, opioid treatment programs and vision rehabilitation services.

“For our Trager team, accreditation demonstrates our belief that all people have the right to be treated with dignity and respect, have access to needed services that achieve optimum outcomes and are empowered to exercise informed choice,” D’Ambrosio said.

D’Ambrosio said that during Trager’s accreditation survey, the CARF surveyor commended the institute’s FlourishCare^TM service, an integrated lifelong wellness care approach focused on lifestyle and preventative medicine for adults of all ages, as well as the use of student interns and telehealth, increasing accessibility to services.

Trager’s aging services include the FlourishCare^TM assessment, care coordination, family support, medication management and education, organized education programs, end-of-life care and grief support, all available in a nationally recognized, age-friendly clinic.

Now she is creating a sponsorship program to assist area children with clothing and supplies once they can go back to school.

UofL News talked to Miceli about her efforts, the support she has received and what needs still exist in the flooded communities.

UofL News: How have you been able to help those affected by the July flooding?

Chelsea Miceli: My work has varied greatly from day to day. I have assisted in coordinating hot meals to remote communities. I have prepared meals and delivered them door to door. I have taken up donations and delivered them to homes throughout Knott, Breathitt and Perry Counties. I helped find individuals to sponsor a Perry County High School football player who lost all his sports equipment. I worked with national disaster relief food organizations to create hubs for food pickup for those that still do not have access to roadways. I connected the shelters to resources to get oxygen for those staying in the shelters. I assisted in finding a location for a birthday party for a young girl that lost everything. I assisted in connecting affected individuals with showering and laundry services. The Trager Institute and Republic Bank Foundation Optimal Aging Clinic staff and I worked to coordinate services for the Deaf and Blind community that is being sheltered at Hindman Settlement School.

UofL News: What makes the work personal for you? 

Miceli: As a resident of Whitley County who has family members across Eastern Kentucky, I understand the value of Appalachia and the history surrounding the culture which makes these individuals and their families so strong. When the recent flooding disaster hit in Eastern Kentucky, I knew I could not sit idly and watch those that I have an obligation to serve suffer alone.

When a disaster of this magnitude takes place, it is an immediate call to help your neighbor. Given my connection to this region and these communities, this work is very personal to me as I understand the geographic remoteness of this area of our state. These communities already face structural and systemic inequities such as generational poverty and trauma, oppression and a lack of resources in rural areas, and this disaster will only exacerbate these challenges.

These are my people, the people that I want to serve, the people that I feel could most benefit from additional services, the people that I know need advocacy and the people I know that are appreciative of the simplest act of kindness.  

Living and working in this region, I know that the communities of Eastern Kentucky are tough and resilient people, yet we all need help from time to time. I have delivered supplies and food to homes where people have said, ‘I hate to take it if someone else could use it more than us.’ The culture of wanting to work for what you have and always lending a helping hand is something that is instilled in our communities from birth.  

UofL News: What specific skills and experiences have helped you in this work?

Miceli: As a recent graduate from the Kent School and now a Trager Institute and Republic Bank Foundation Optimal Aging Clinic employee, my educational and professional background has instilled in me the value of taking action. During my time in the MSSW program and as an intern, I learned the importance of trauma-informed care and the long-term implications that you can have on someone’s life through acknowledging what they endured.

Throughout my time helping in Eastern Kentucky, my main goal has been to offer dignity and worth to individuals who have lost everything. Taking the time to stop and hear their stories and let them know that someone is there for them and is working with them is the best service anyone can offer.  

UofL News: How has your position at UofL and hat connection been helpful?

Miceli: As a program coordinator with the Trager Institute and Republic Bank Foundation Optimal Aging Clinic, I develop and facilitate services, provide education, training and supervision to our student interns and facilitate collaboration and services with partnering sites across Eastern Kentucky for our projects funded by Health Resources & Services Administration grants. One of the core missions of these projects is to provide workforce development and services to rural communities across the state.  

The team has been instrumental to my flood relief work. I have reached out numerous times needing assistance in identifying contacts and resources to provide services to these individuals. Without hesitation, they connected me to individuals and organizations that could assist with high priority needs of the communities including oxygen, hearing aids and sign language interpreters.

The staff has gone above and beyond to help me serve these individuals, most of whom they will never see nor meet. Without their help I don’t know if my work in Eastern Kentucky would have been as fruitful.

Our partner sites across Eastern Kentucky have faced many challenges during this time as well, primarily Mountain Comprehensive Health Corporation. However, any time I picked up the phone and explained a need they were quick to act and put me in contact with individuals and resources to resolve the issue.  

UofL News: Tell us about your project to gather supplies for students as they go back to school.

Miceli: I am working to create an ‘Adopt-a-Student’ sponsorship program. We will ask sponsors to purchase a backpack, clothing essentials (e.g., socks, shoes, underwear and two outfits), along with basic school supplies to be distributed to students in Knott County when they are able to return to school. With so much uncertainty surrounding when school will begin, this gives us time to begin gathering items in hopes that as students return, they will not have to worry about having school clothes and supplies. Given the financial hardship the parents are already facing, between clean-up costs and restarting their lives, the goal is to relieve some of the burden on them as well. This program’s goal is to let the students and parents start this school year without additional stressors during this trying and difficult time.

An has been created for school supplies for the students. To contribute to the Adopt-a-Student program, contact Miceli.

“It is so exciting that the Republic Bank Foundation Optimal Aging Clinic received the Age-Friendly recognition so shortly after celebrating our one-year anniversary,” said Anna Faul, executive director of the UofL Trager Institute and the Optimal Aging Clinic. “This recognition serves as a testament to . We strive to be on the forefront of patient care for older adults and we look forward to continuing to provide every older adult with the best care possible as part of the Age-Friendly Health Systems initiative.”

As part of the  initiative, The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States, are helping hospitals, clinics and other care settings implement evidence-based interventions specifically designed to improve care for older adults. 

The interventions are tested and adapted through participation in Age-Friendly Health Systems Action Communities. These collaborative entities are comprised of health care teams from across the country that are committed to sharing data and learning together. The teams work to implement best practices across emergency departments, intensive care units, medical-surgical units, general wards and primary and specialty care settings.

The Optimal Aging Clinic now joins more than 450 health systems working to make care for older adults even more tailored to patients’ goals and preferences and consistently of high-quality as part of the initiative, which is based on a series of practices focused on addressing four essential elements of care for older patients known as the 4Ms:

• What Matters: Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.
• Medication: If medication is necessary, use age-friendly medications that do not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care.
• Mentation: Prevent, identify, treat and manage dementia, depression and delirium across settings of care.
• Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

Joe D’Ambrosio, director of behavioral health at the UofL Trager Institute and Republic Bank Foundation Optimal Aging Clinic, says the Age-Friendly initiative also is infused in the organization’s Behavioral Health Services Organization.

“We are so happy to include this initiative in the work we do with our therapy patients,” D’Ambrosio said. “The 4Ms of the initiative align perfectly with the behavioral health interventions we share with patients in their efforts to age optimally and we are excited to build upon the progress we have made in our first year to continue to help older adults thrive as they age.”

Learn more about the Republic Bank Optimal Aging Clinic in a .

“Our strong line-up of speakers, breakout sessions and poster sessions is not to be missed for anyone working in the aging field or who has interest in inspiring our understanding of aging,” said Anna Faul,  executive director of the Trager Institute. “After having to cancel last year’s event, we are excited to bring back the Optimal Aging Conference this year on a virtual platform that allows for an incredibly rich and engaging experience.”

The 2021 conference, scheduled for April 18-20, will feature experts in aging, dementia and Alzheimer’s research, innovation and public health and will be held virtually.

“The 2021 Optimal Aging Conference will provide outstanding resources, inspiring ideas and continuing education for Kentucky’s aging service professionals,” said Anne Wildman of the Kentucky Association of Gerontology. “The conference is a great opportunity for networking and professional development.”

2021 Optimal Aging Conference topics and speakers:

Aging Inspired in Kentucky: Directions in Aging Policy (Panel Discussion)

• Sandy Markwood, CEO, National Association of Area Agencies on Aging
• Eric Friedlander, acting secretary, Kentucky Cabinet for Health & Family Services
• Lindsey Hix, deputy director, Office of Senior Protection & Mediation, Office of the Kentucky Attorney General
• Victoria Elridge, commissioner, Department for Aging and Independent Living

A Community Network Approach to Health

• Eric Feigl-Ding, chief health economist, MicroClinic International; faculty member, Harvard Medical School and Brigham and Women’s Hospital, Boston

Ending the Alzheimer’s Pandemic

• Dale Bredesen, professor, UCLA; founding president and professor emeritus, Buck Institute for Research on Aging; author of New York Times bestseller, The End of Alzheimer’s

AARP Keynote: Examining the 50-plus Experience During COVID-19

• David Wolf, professor and chair, Department of Health and Aging Services Leadership, Bellarmine University

Alzheimer’s Update

• Gregory Jicha, professor of neurology and director, Sanders-Brown Center on Aging at the University of Kentucky

Guided by the theme “Aging Inspired,” conference attendees also will hear from experts on how to prevent financial elder abuse, national programs and arts activism counteracting ageism, programs for caregivers of persons with Alzheimer’s disease and related dementias, the future impacts of artificial intelligence and robotics in senior care, trauma-informed care of older adults, international evidence-based falls programs, lifestyle medicine nutrition and more.

through April 16. 

“It would be impossible for us to fulfill our mission of innovating the aging experience without first ensuring the safety and health of our older adult patients and staff during the pandemic,” said Anna Faul, executive director of the Trager Institute. “This partnership with LoDI has been beneficial for us to understand what we need to do to return to normal capacity when the positivity rates are at a level that would be absolutely safe for our patients and staff.”

Through the collaboration, LoDI and Trager Institute leaders established capacity and utilization estimates to allow Trager staff to transition from telehealth and work-from-home policies to hybrid policies allowing a return to in-clinic visits for patients and location-based work for Trager students, faculty and staff.

LoDI, housed at the , is dedicated to developing innovative delivery processes for industries including manufacturing, service and health care. Students and faculty at LoDI recently worked with businesses in the oil and refinery field, a public utility and the .

For the project at the Trager Institute, a team led by Lihui Bai, co-director of LoDI, used a simulation model to determine a safe volume of traffic that allows proper social distancing at the Optimal Aging Clinic. In particular, the study team, which included Monica Gentili, Arsalan Paleshi and LoDI Fellow Shahab Sadri, simulated operations at the clinic to determine the maximum number of clinical staff, patients, faculty and students, as well as Trager faculty and staff, that safely could be present in the building.

The results of the study will serve as a guide for Trager Institute leadership in determining the percentage of clinic appointments that must be kept virtual and the number of learners and institute staff and faculty who safely could resume on-site activities. The clinic will implement the guidelines provided by the study once coronavirus infection rates in the community reach an acceptable level to resume in-person visits.

“Our study found that patient and staff movements at key common areas throughout the facility are within the safety measures of a COVID-19 environment,” Bai said. “We were happy to be a part of this collaboration by applying our simulation model to study the traffic patterns at the Optimal Aging Clinic. We look forward to extending this study to evaluate other operations measures such as utilization and possible improvements in a joint future research with the team at the Trager Institute.”

“We are grateful to the LoDI team for their expertise in helping us determine safe and efficient operating procedures at the clinic,” Faul said.

UofL President Neeli Bendapudi announced the gift at her inauguration as the university’s 18^th president on the steps of Grawemeyer Hall. The donation will enhance UofL’s Institute for Sustainable Health and Optimal Aging, which connects providers in the aging services community to resources for older adults, caregivers, businesses, service providers and researchers. The institute will be renamed the Trager Family Institute for Optimal Aging. Additionally, the gift will create the Republic Bank Foundation Optimal Aging Clinic, which will apply the research conducted and offer hands-on services to its clients.

“The Trager Institute for Optimal Aging will bolster our current efforts and launch new initiatives in research, treatment and programming that will improve the quality of life for our older citizens,” Bendapudi said. “Louisville is a hub for aging care businesses, insurance companies and health care organizations. Our goal is to create partnerships that will leverage this expertise to improve the lives of people in the Commonwealth and throughout the world.”

The Trager Family Foundation and Republic Bank Foundation will contribute equally to the Trager Institute for Optimal Aging. Bendapudi called the contributions “generous and significant.”

“As both a family and organization, our roots with the University of Louisville run deep.  So, at the beginning of this new chapter for the university, with much optimism for the city, the university, and President Bendapudi, we felt that it was important to show our support,” said Steve Trager, chairman and CEO of Republic Bank. “Considering the importance of the eldercare industry to Louisville’s economic development, we are proud to partner with the University of Louisville to introduce the Trager Family Institute for Optimal Aging.  It is our hope that this gift will help develop a world-class conduit that eldercare companies can partner with in research, innovation, and career development.  Additionally, local citizens will become beneficiaries of the Institute’s efforts through the newly established Republic Bank Foundation Clinic.”

“On behalf of the entire Trager Family and the Republic Bank Foundation, we are excited to be able to support one of President Bendapudi’s and the University of Louisville’s core focuses, aging and eldercare,” Trager said.