Dr. Wilkerson, Nursing

Dr. Karen Buhler-Wilkerson, nursing professor, historian, author, and co-creator of an innovative care program for poor and frail elderly, died February 13, 2010, at the Pavilion at the Hospital of the University of Pennsylvania, where she was hospitalized 10 times in the past four months for complications of ovarian cancer, first diagnosed in 2004. She was 65.

Dr. Wilkerson taught at the University of Pennsylvania School of Nursing from 1972 until her death. Having retired in 2006 as a professor of community health, she continued, as professor emerita, to write for scholarly journals, advise doctoral students, consult on grants and special projects, and participate in professional organizations and on advisory boards. During her illness, she completed a seminal paper published in The Milbank Quarterly on “Care of the Chronically Ill at Home: An Unresolved Dilemma in Health Policy in the United States.” In the final months of her illness, as a recipient of intensive, sophisticated and technical care at home, she often remarked how much more she was learning about the complexities of care for the chronically ill and hoped to write further about it one day.

Dr. Wilkerson’s final paper, completed with her partner, Penn nursing professor Neville Strumpf, will be published this summer. Aptly titled “Living with Cancer,” the paper details a journey of more than five years, a story “reaffirming the centrality of expert and compassionate care, along with timely and honest communication, as crucial to the preservation of integrity, dignity, control and hope in the face of serious illness.” Dr. Strumpf described Dr. Wilkerson’s approach to her illness as “unflinching, honest, brave, and determined,” amply demonstrated by the acquisition of a rambunctious standard poodle shortly after her diagnosis, and the purchase of her dream car, a 1986 Porsche 911, following a recurrence of the cancer in 2009. Last summer, on a vacation in the Adirondacks, she joyfully demonstrated how such a machine can easily travel 100 mph over a mountain pass, added Dr. Strumpf.

“Professor Wilkerson was integral to the 20th century renaissance of research in the history of nursing and health care,” said her long-time Penn colleague, nursing professor Joan Lynaugh. She published three books and 40 articles, but is best known for her award winning book, No Place Like Home: A History of Nursing and Home Care in the United States. Fascinated by place, and its influence on the delivery of health care, Dr. Wilkerson traced home care from its earliest beginnings in 1813, by the Ladies Benevolent Society in Charleston, South Carolina, where Dr. Wilkerson spent much of her later childhood, to its reinvention with the Visiting Nurse Service, under the leadership of Lillian Wald, in New York City in the late 19th and early 20th centuries. The story culminates with the role of Medicare in the delivery of home care services, a story still unfolding today.

Never content to convey the breadth and richness of nursing and health care history simply in publications alone, Dr. Wilkerson was instrumental in the creation of an exhibit at the Fabric Workshop in Philadelphia in 2003 on the past, present and future of the nurses’ uniform, for which she received a media award from the American Academy of Nursing, as well as “The Nightingale’s Song,” depicting images of nursing in posters and other artistic media at the Philadelphia Museum of Art in 2000. From 1995 until her retirement, Dr. Wilkerson directed the internationally renowned Barbara Bates Center for the Study of the History of Nursing at the School of Nursing, and mentored the scholarly careers of many students and colleagues.

In keeping with her views and values about care at home, Dr. Wilkerson was crucial to the founding of Penn Nursing’s LIFE program, Living Independently For Elders, which provides daily care for 500 poor and frail residents of West Philadelphia who otherwise would be placed in nursing homes. As a Program of All-inclusive Care for the Elderly (PACE), supported by Medicare and Medicaid, LIFE uses an innovative, individualized, interdisciplinary approach to deliver healthcare services in the community, including all nursing and medical care, as well as essential therapies, socialization, and palliative care. At the 10-year anniversary celebration of the LIFE Program in 2009, still the only program of its type in the United States owned and operated by a school of nursing, Dr. Wilkerson remarked that, “This is such an un-American approach to care, which remains so fragmented in the United States, but we made it our job to demonstrate that we could save money and keep people at home.” Nursing School Dean, Afaf Meleis concurred, adding that “At its launching, LIFE was a very risky thing to do, but, where there was once nothing for a vulnerable group of West Philadelphians, now there is life and hope.”

“Dr. Wilkerson was a phenomenal leader whose vision will transcend time. Her book is now considered a classic, and her contributions to home care and care of elders will help many people for years to come. The innovative LIFE program that she co-established will always be remembered as the model for care for vulnerable populations, helping elders to remain in their own homes for as long as possible,” said Dean Meleis.

Dr. Wilkerson received her BSN and MN degrees from Emory University and her PhD from the University of Pennsylvania. She twice received the Lavinia L. Dock Award for Exemplary Historical Research and Writing from the American Association for the History of Nursing (in 1989 and 2001), as well as the Agnes Dillon Randolph Award for Significant Contributions to the Field of Nursing History from the Center for Nursing Inquiry at the University of Virginia School of Nursing in 2000. She became a Fellow of the American Academy of Nursing in 1989 and received the Emory University Alumna Award of Honor in 1990.

Survivors include Dr. Strumpf, her partner of 17 years; two sons, Jonathan and David Wilkerson, and their wives, Kerri Wilkerson and Marie Thoma; two grandchildren, Billy and Sonya; a brother, John Buhler; and her former husband, Dr. L. Douglas Wilkerson.

Contributions can be made to the Karen Buhler-Wilkerson Faculty Research Fund at the Barbara Bates Center for the Study of the History of Nursing. Checks can be made out to the Trustees of the University of Pennsylvania and mailed to the School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217. Donations may also be made online at www.nursing.upenn.edu/history.