Careers in the field of aging.
"Senior power!" "From all the media hype, you'd think old age was something new It's not, of course. From time immemorial, some people have lived out the allotted "threescore and ten."
What is new is the large number of people who are reaching old age. Equally new is the emergence of special organizations, facilities, services, and products for older people. Scientific interest in gerontology-from the Greek word geron, meaning old man-is new, too. Not until the late 19th century did biologists start trying to understand how and why living things change as they grow older. And only in this century did psychologists and sociologists begin to examine the impact of age on individuals, families, and society as a whole.
The focus on older people-and their special needs-has produced new jobs in what is commonly referred to as the field of aging, a field that will offer wide-ranging opportunities for challenging careers in the coming decades. What kinds of jobs are these? What draws people to them? What should career counselors know about them'? Answers to these questions and many otherssuch as what training they require and how much growth will occur in this field-are important to people planning their careers.
All Kinds of Jobs
The field of aging has much in common with other human service disciplines such as health, mental health, rehabilitation, developmental disabilities, education, and recreation. In all of these areas, human needs are addressed through the efforts of volunteers, neighbors, and family caregivers, as well as through trained personnel who work for pay. This article discusses opportunities for paid employment.
The jobs described here are practice jobs, as distinguished from research or teaching jobs. Many of them involve direct service to older adults in places like senior centers, family service agencies, welfare departments, nursing homes, adult daycare programs, or retirement communities. These are the jobs that come to mind when we try to picture what it would be like to work in the field of aging-people- oriented jobs that require personal qualities such as patience, tact, warmth, and a genuine respect for other human beings.
Direct service workers interact with older adults and their fanlilies one to one or work with groups. They drive vans, lead exercise classes, teach crafts, interview prospective clients, answer questions about hospital bills, counsel the bereaved, organize support groups, conduct nursing assessments, evaluate mental functioning, test hearing, and so forth. Melissa Brown, Lucille Morisse, RichardSpector, and Joan Hart, whose profiles appear later, all hold direct service jobs.
Three characteristics of direct service emerge from these examples. First, none of these workers is called a gerontology worker. This is not a title you are likely to encounter in the newspaper want ads or on the job. Second, direct service workers perform at widely varying levels of skill and responsibility, corresponding more or less to their formal preparation for the job. And third, all of them deal directly with their clients. If you are looking for personal contact with older people, direct service is for you.
Another category of jobs consists of positions in program planning, administration, and evaluation. These are found in area agencies on aging (AAA) and State offices on aging; in Federal, State, and local government departments such as health, housing, social services, transportation, education, and parks and recreation; in voluntary service organizations such as the Red Cross, Salvation Army, YMCA, and Catholic Charities; in hospitals, nursing homes, and retirement facilities; and in organizations such as the American Association of Retired Persons that promote the interests of older adults.
These are behind-the-scenes jobs that require skills in areas like budgeting, fundraising, publicity, survey design, program evaluation, and personnel administration . If you held an administrative or planning job in the field of aging, you might be asked to set up a speakers' bureau, recruit volunteers, organize a citizens' advisory group, write a grant proposal, or testify at a public hearing. Your job would offer limited opportunities for developing relationships with older people directly Your efforts would go instead into developing organizational responses to their needs. The profiles of Carolyn Carter, Deidre Rye, and Nancy Gorshe illustrate the diversity of these jobs.
In small agencies or organizations, administrators provide direct services some of the time. This is the case for Diane Amussen and Anita Martinez, also profiled.
People who work with older adults are usually in settings that address a particular area of human need-health care, mental health, rehabilitation, housing, transportation, legal counseling, financial counseling, job placement, education, recreation, leisure, or spiritual development, As a practical matter, then, it is important to have experience or education in one of these areas if you are aiming for a career in the field of aging.
Why an Aging Job?
The reasons people give for choosing a job in the field of aging vary a great deal. Among the most common are these:
Satisfaction. It's sometimes hard to tell whether the worker or the client gains more from the exchange. People who hold jobs in this field say that they learn a great deal from older adults about human nature and enduring values. They almost always emphasize how much they enjoy working with older people. This often reflects personal experience-a close relationship with grandparents is frequently cited as a reason young people are drawn to the field, while middle-aged persons may become interested through awareness of their own aging.
Challenge. The field of aging is a pioneering specialty, and opportunities abound to make a difference in older people's lives. Workers in this field have an opportunity to dispel myths and stereotypes, to suggest new ways of doing things, and to promote growth and development late in life. Many people are in the field because so much needs to be done.
Opportunity. Public and private funds have poured into this field for more than 20 years, supporting program expansion as well as considerable change in the way health, housing, transportation, and other services are provided to older adults. The Older Americans Act of 1965 and other legislation have spurred Federal and State expenditures for planning and development, direct services, and gerontological education and training. Today, the Older Americans Act fosters a billiondollar social services program and a structure of administrative and advocacy organizations at the Federal, State, and local level. Public support for aging programs is expected to continue, and private support seems likely to expand. The continued growth of the older population is the single most important factor in the proliferation of job opportunities in the field of aging. The number of Americans over the age of 65 has been rising rapidly for several decades and currently stands at about 30 million. By 2000, it will exceed 36 million. The oldest segment of our population-those 85 years of age and above-is growing most rapidly of all. The impending growth in the number of Americans in their eighties and nineties is bound to produce a sharp increase in the need for health, housing, long-term care, and social services in the years ahead.
Chance. The possibilities are endless. A casual encounter with someone in the field, experience as a student intern or volunteer, a job opening, the availability of financial aid for gerontology students-All are typical first steps on the road to a career in the field of aging.
Who Works in Aging?
Many people do not zero in on career prospects in the field of aging until they are in their thirties or forties. Academic programs in gerontology attract relatively large numbers of middle-aged women who want to return to the work force or prepare for more satisfying jobs.
This field also attracts individuals at midcareer. Many of these are seasoned human service professionals who want to find out what's involved in developing an aging specialization within their present field. Others, eager for a complete change of direction, want to explore opportunities for developing a new set of skills.
Social workers, for example, may wish to rejuvenate their careers by breaking into an area that is new to them. The ease with which they make the transition to providing aging services depends on a number of factors, including previous experience (medical social work may offer a better fit than child services), their success in tapping into the local aging network, and the kind of challenge they seek. People in this category may decide to create their own jobs or go into business for themselves. The section on entrepreneurship later in this article examines opportunities to do so.
A Cautionary Word
The needs of older Americans will almost certainly generate an abundance of jobs for practitioners in the field of aging. But there are some cautions to bear in mind. The field is evolving as new perspectives on older people's needs emerge. Moreover, key issues, such as the financing of long-term care, are as yet unresolved. We don't know which facilities and programs will dominate by the year 2000 nor what the hiring requirements will be.
Another consequence of the evolving nature of the field is that the path from education to employment is not always clear. The very diversity of occupations indicates that a single training program, even one with gerontology in the title, will not always lead to a job. While there are a number of reasons for this, the relatively recent appearance of professional preparation in gerontology and geriatrics is quite important. Hiring officials may themselves have no formal preparation in gerontology and see little need for it. Employers in this field differ enormously in the value they place on coursework in aging or even on experience with older adults.
Another drawback is that pay levels are low in many of these jobs, as is the case in other human service areas as well. It is an irony of human services that work that is so responsible, challenging, and emotionally draining should pay so little. Not all aging jobs are low paying. Some social service agencies, health care facilities, and public interest organizations offer -very attractive salaries.
Despite the modest pay, competition is keen for many of the jobs in this field. Area agencies on aging, for example, are swamped by job applications. While many well-qualified people seem to be interested in providingsocial services for older adults, this is not the case in health care. Almost everywhere, nurses and rehabilitation therapists prepared to work in geriatric settings are in short supply Demand for nursing assistants and home care workers is greater still.
The following section highlights four traditional areas of employment in the field of aging: Social services, health services, program planning, and administration . It also looks at a nontraditional area-entrepreneurship-and concludes with some thoughts on emerging opportunities in the field.
What kinds of social service programs help older people'? All kinds! Supplemental Security Income is an income support program for elderly and disabled persons who are poor The Medicare and Medicaid programs help pay for health care. Transportation programs featuring lift-equipped vans, dial-a-ride services, and subsidized fares help those who have special transportation needs. Meals-on-wheels, group meals programs, and food stamps help assure adequate nutrition. Subsidized housing projects for the elderly, adult foster care facilities, and share-a-home programs illustrate varying approaches to senior housing. Employment programs help older people get jobs. Legal services programs help them get benefits and protection to which they are entitled by law.
Programs such as these don't help if people don't know about them. This is why the services known as outreach and information and referral are so important. Some agencies do nothing but provide these services, devoting all their efforts to publicizing community resources and pointing clients in the right direction.
Other agencies specialize in assessing older people's needs. Medicaid screening programs, for example, assess people applying for admission to a nursing home to be sure that nursing home care is really necessary. Geriatric assessment units in hospitals and community mental health centers examine the mental status of older people who are depressed or confused. Family service agencies take a comprehensive look at finances, living arrangements, and contact with family and neighbors, as well as assessing physical and mental health. Some programs not only assess a client's needs, but arrange for appropriate services and then follow up to see how things are going. This is called case management or care management.
The work environment in social service programs for older adults varies with the mission of the agency Large social service agencies-whether in the public or private sectors-tend to be highly structured in the way they do things, allowing staff less latitude than is the case in small community agencies. Workers must observe standardized rules and procedures-the infamous red tape that creates so much frustration for clients and staff alike. These agencies are also more rigid about hiring requirements than small agencies. Practices vary widely, but public agencies generally make less use of volunteers and have less direct community involvement than small agencies. However, they usually pay quite a bit more.
Many social service programs owe their existence to grass-roots initiatives, having been created by churches and volunteer groups and then organized as more or less formal institutions and integrated into the aging network in order to qualify for funding under the Older Americans Act. They continue to rely heavily on volunteers, who bring warmth and commitment to elderly clients.
An example of a small community agency is Emmaus Services for the Aging in Washington, D.C. This outreach program has a staff of three, relying chiefly on volunteers from nearby churches to carry out its work of locating older persons, assessing their needs, connecting them with appropriate services in the community, and speaking out on their behalf. Finding needy older adults takes energy and persistence. It means following up referrals from community residents, hospital social workers, and others. Mostly, though, it means walking the streets and talking to people. Diane Amussen, the director, spends much of her time in the neighborhood. She is profiled in the accompanying box.
Shepherd Center East, a senior center in Birmingham, Alabama, is a hub for activities and social services for older adults and shut-ins in the neighborhood. Like Emmaus, the center has interfaith origins and depends almost entirely on volunteers from local churches. A small part-time staff coordinates the work of hundreds of volunteers, who provide meals-on-wheels, transportation, home and appliance repairs, tax counseling, widowed persons counseling, education and recreation programs, and health and fitness activities from flu shots to square dancing.
Nearly all social service agencies stretch their staff resources by using volunteers, student interns, senior aides (older workers who hold subsidized part-time jobs), and consultants. Jobseekers should be aware that an ambitious program of services and activities does not necessarily mean that the agency has a large number of staff positions.
Senior centers, for example, make extensive use of volunteers and senior aides. Even so, they are an important source of employment for people interested in providing social services to older adults. "Senior centers offer excellent opportunities for people who are just starting out," says Susan Hirsch of the Baltimore County Department of Aging.
Senior housing facilities and retirement communities employ a small number of social service professionals to direct and operate their social work, recreation, and resident services departments. Retirement communities, like senior centers, hire consultants to lead many of the classes and activities they offer,
Lucille Morisse is one of 192 employees at Duncaster, a continuing care retirement community in Bloomfield, Connecticut. Like so many other facilities in this rapidly growing segment of the housing industry, Duncaster is new, only 4 years old. These communities provide housing in apartments or cottages together with services of many kinds-housekeeping, laundry, lawn maintenance, meals, recreation, social work services, and health care. Most have a fully staffed nursing home facility on the grounds. Lucille directs social services for residents in the nursing home unit. The accompanying profile will give you an idea of what her job is like.
Some people shy away from the field of aging because they can't stand the thought of working in a nursing home. That's not sunrising-the work is hard, the atmosphere can be depressing, and the pay is often low; most people are not cut out for a nursing home job.
But don't be too quick to dismiss a health career in aging! Many nursing homes are warm and loving places that provide residents with meaningful activities. A small but growing number of nursing homes are on the cutting edge of new developments in geriatrics, mental health, and rehabilitation. Among the pioneers are teaching nursing homes, so called because they serve as sites for clinical training of student doctors, nurses, social workers, psychologists, and others. One example is New Ralston House, one of several Philadelphia nursing homes collaborating with the Community College of Philadelphia to improve the gerontological expertise of students and staff alike. Gloria Boring, New Ralston's director of nursing, is profiled.
Besides nursing homes, where else could you pursue a health career in aging or long-term care? Many places. Hospitals, community mental health centers, adult daycare programs, home health agencies, case management programs, nursing home admission screening projects, senior centers, retirement communities, housing projects, and public health clinics all offer the opportunity to work with older people. The work of Richard Spector and Melissa Brown helps show the diversity of the health care field (see profiles).
Opportunities are growing in private practice, too. Geriatricians are joining medical group practices, for example. Other health professionals with geriatric or gerontological expertise-notably nurse practitioners, nutritionists, podiatrists, optometrists, psychologists, and rehabilitation therapists-are going into solo practice or setting up multidisciplinary groups.
One of the largest employers of health services workers in the field of aging is the Veterans Administration (VA), which employs professionals from virtually every health specialty in its network of hospitals, nursing homes, clinics, adult daycare programs, and home-care programs. Opportunities to develop geriatric expertise are very good in the VA, not only because the veteran population is aging more rapidly than the population as a whole, but because the VA supports geriatric research and training. For information on geriatric traineeships and other forms of student financial aid, contact your local VA medical center.
Nowhere, perhaps, does the field of aging exhibit more vitality and change than in the area of program planning and development. Opportunities to design a service or program for older adults seem to spring up daily as organizations of every description try to respond to the graying of America. These efforts call upon the special skills of program planners and developers.
Theirs are typically staff jobs in agencies and organizations that serve older adults. The most visible of these jobs are in senior centers, retirement communities, and government agencies that serve older people-the network of State and local offices on aging plus govemment departments responsible for consumer protection, parks and recreation, housing, health and mental health, and the licensing, certification, and inspection of health facilities and personnel. Similar positions are beginning to emerge in hospitals, libraries, educational institutions, social service agencies, religious organizations, and business firms of all kinds-from travel agencies to banks.
Program planners and developers operate somewhere between the direct service and administrative levels. Planners need to be visionaries, able to see beyond what their agency is doing today to what it could be doing tomorrow. Whether they work for a public or private nonprofit agency or a profitmaking organization, their role is much the same. Typically, a planner is assigned responsibility for designing and developing a new service or special project. The scope and purpose of the project are generally established at higher levels, but the planner has a free hand in bringing it into being. Unlike administrators, who usually are distant from day-to-day operations, program planners are involved in all of the nittygritty as their projects progress. In a small agency, planners typically write the proposal to secure funding, organize an advisory committee, formulate a plan of action, select staff, oversee the project, arrange for an evaluation, and prepare interim and final reports. In larger agencies, program managers or coordinators are responsible for implementation. Some planners eventually move into administrative positions, but others prefer not to because that usually means less direct contact with older adults.
Carolyn Caner is 1 of 2 planners for the Area Agency on Aging in Fairfax County, Virginia. Although she does some grant writing and program planning, her job chiefly involves strategic planning. Strategic plans help organizations set their priorities in light of everchanging circumstances. Keeping track of the changing needs of county residents is an important part of Carolyn's job, and she uses a number of different research methods-from surveys to community forums-to obtain the information. The profile tells more about her workday
A surprisingly large number of jobs in the field of aging are administrative. Unlike direct service jobs, which involve considerable contact with older adults, administrative jobs primarily involve contact with other staff members as well as with staff of other agencies, advisory board members, govemment officials, community leaders, and the public. The top job in a human service agency is notunlike a top job anywhere-chiefly concerned with securing funds, managing facilities and personnel, and other aspects of organizational development. Every aging program or agency has an executive director or the equivalent. After that, however, the number and kind of administrative positions depend on the size and complexity of the operation.
Many programs are very small, with a total staff of no more than two or three. Others-the New York City Office on Aging is an example-are large, with upwards of 250 staff members. In organizations as large as that, administrative positions are generally of two types: Staff positions in areas such as budget, public relations, and personnel, and line positions with operating responsibility for one or more programs. This kind of specialization is out of the question in small agencies, where everyone on the staff is expected to wear several hats.
No matter how large or how small the program, administrators of human service programs have certain tasks in common: Securing funds and other essential resources; managing staff, facilities, and programs; handling community relations; ensuring smooth relationships with other agencies; and negotiating with lawmakers. Money matters dominate the top administrator's workday and, depending on the way the agency is organized, may be the central concern of one or more assistants. Whether the issue is raising funds or disbursing them, financial management is a critically important task that has grown more complex over time.
People enter administrative jobs from a variety of backgrounds. In small agencies especially, many administrators come to their jobs from direct service roles and acquire their knowledge of management on the job. Hiring requirements vary a great deal, but differences in the complexity of administrators' jobs are only pan of the reason. The nature of the competition is important, too. Agencies that don't pay very much, rural agencies in particular, find it much more difficult to recruit staff with graduate or professional degrees than agencies that pay well and those located in major metropolitan areas.
Following is a broad overview of the kinds of administrative jobs you can expect to find in major employment settings serving the elderly: Area agencies on aging, senior centers, housing facilities, and nursing homes.
Area agencies on aging. As a prospective administrator, you will want to acquaint yourself with your local area agency on aging. (Check the local govemment listings in the telephone directory for the exact name and phone number.) There are 672 of these agencies in the United States, and there is an office on aging in each State. It is through this network of State and local agencies that Federal funds are distributed to help pay for group and homedelivered meals, transportation, and many other programs for older adults. Community-based long-term care is a major thrust of aging network programming at present. Advocacy is another area of considerable activity, with agencies on aging initiating and supporting long-term care ombudsmen, legal services, consumer protection, age discrimination, elder abuse, and similar programs. Deidre Rye, who is profiled, is long-term care ombudsman for Northem Virginia.
The typical area agency on aging has a director, an information and referral specialist, an outreach coordinator, and one or more program coordinators, in addition to clerical support staff. The director may handle fiscal and administrative matters directly, or delegate this area to an assistant.
Senior centers. Multipurpose senior centers are community facilities that provide social, referral, recreational, nutritional, and educational services to older people. Most centers are fairly small, having a staff of no more than three or four people, assisted by volunteers and senior aides. In these centers, the administrator oversees the whole program, securing funds and maintaining financial records, supervising personnel, training staff, coordinating volunteers, and managing public relations. As the profile of Anita Martinez indicates, the administrator frequently plans and leads some of the activities as well.
Housing facilities. The development of housing for older people who want to maintain an independent lifestyle has created employment opportunities for professionals who administer large living facilities. Many of these retirement facilities provide several levels of care, requiring housing managers to have a good understanding of the different needs and wants of older residents, as well as a familiarity with many aspects of facilities management and human services. Typical management positions include administrator and assistant administrator, comptroller, director of resident services, director of marketing and development, and personnel director.
Nursing homes. Nursing home administrators must be licensed, a rigorous procedure in many States. Nearly half the States require applicants to complete a 1-year internship before taking the licensing examination. Most applicants for licensure take a special preparatory course in long-term care administration. Management skills are of paramount importance in this job, and employers look favorably upon graduates of programs in business administration and health services administration. Virtually any college major is acceptable, however, provided the applicant has strong organizational and leadership skills.
Nursing home administrators spend a great deal of their time evaluating programs, planning budgets, assuring compliance with govemment regulations, overseeing staff, and making policies. As nursing home chains have expanded the scope of their operations, opportunities have developed at the corporate as well as the facility level. Administrative positions at the corporate level are typically in staff areas such as human resources, community relations, marketing, strategic planning, and financial management.
Entrepreneurship Like so many other areas of American life, the field of aging offers opportunities to go into business for yourself. Gerontological consulting is coming into its own with the growing demand for information about older persons' spending patterns, use of leisure time, housing preferences, eating habits, and the like.
So intense is the interest in the older consumer that many of America's largest companies have launched advertising campaigns targeted at adults over 50. But their perceptions of older people leave a lot to be desired, observes David Wolfe in the July 1987 issue of American Demographics. "Few marketers understand older Americans," he says, "and their advertising campaigns repel the very people they're 'trying to attract." Age-grading of products and services intended for older people usually backfires, he warns. A marketing strategy that presents the product or service as an opportunity for personal growth is far more likely to succeed.
In an effort to link gerontologists with the business community-showing advertisers how to avoid age stereotypes, for example-the American Society on Aging has organized a Business Forum on Aging that includes representatives from Bank of America, Sandoz Corporation, American Express, Marriott Corporation, Edison Electric Institute, and others.
Turning the hunger for information about older people into a business opportunity for gerontologists requires ingenuity and an eye for a suitable market niche, says Nancy Peppard of Peppard Associates. Taking her own advice, she organized her firm in two divisions. One advises corporations about marketing, advertising, and sensitivity training for employees; the other advises health care facilities about setting up special units for dementia patients.
Jean Coyle, founder of the International Association of Gerontological Entrepreneurs, warns of the challenge of setting up your own firm. The most commonly mentioned issue is the tremendous amount of time it takes to set up a small business. "There's just not enough time to do it all," say entrepreneurs who are hard pressed to manage the business end of the operation as well as provide a professional service,
The consulting business is fiercely competitive, observes Jane Yurow of Leo, Inc., a firm that specializes in senior housing. Her advice? Plan on putting a lot of effort into marketing. Marketing skills are important, agrees Susan Hartenbaum of Aging Information Services. Personal style is at least as important as subject expertise in bringing in business, she adds. A warm, outgoing, engaging personality helps in making calls to prospective clients, and helps, too, with the networking that is so important in generating referrals. You have to be able to talk to clients in their language, says Susan, and put yourself in their shoes. Your goal as a consultant is to help clients see their situation in a new light and help them develop an appropriate solution. Imposing your own expertise is one of the pitfalls to avoid.
What are the rewards of entrepreneurship?
* Creating my own role
* The challenge of doing something
* Pursuing my own vision
* Being my own boss
* Setting my own limits
These are typical responses.
Private case management offers excellent opportunities for gerontological entrepreneurs with clinical expertise. Case managers assist older persons and their families for a fee, offering such help as information and referral, brokering of services, and counseling. They personalize their services, providing as much or as little assistance as the client wants. Private case managers generally have at least some graduate education in a human service discipline and substantial experience working with the elderly More often than not, they are social workers, although nurses, psychologists, and gerontologists operate case management firms, too.
"My experience directing social work services in a nursing home made me aware of the anguish of families worried about an elderly relative hundreds of miles away," explains Grace Lebow of Aging Network Services in Bethesda, Maryland. She and colleague Barbara Kane are clinical social workers. The two founded their firm in 1982, when private practice by social workers was still a new idea, and geriatric case management was virtually unknown. In addition to monitoring the needs of clients who live nearby, they offer longdistance coverage through a network of social workers all over the country Today, the firm employs two social workers, two social work assistants, and an office manager. It is a little larger than the typical firm, which usually consists of one or two social workers plus a part-time clerical worker.
Barbara Kane ticks off the professional skills important for success in this field: Counseling skills, notably the ability to develop trust and confidence; assessment skills; the ability to involve the client and facilitate decisionmaking; the ability to resolve conflicts and negotiate agreements; and the ability to act as a liaison between clients, service providers, and families. But business skills such as bookkeeping, office management, and marketing are necessary, too, she wams.
Building a clientele is by far the most important task on the business side. This is a matter of marketing-evaluating the need for services in the community, assessing the competition, selecting a target client population, establishing a referral network, and maintaining it. But office management and recordkeeping can take a surprising amount of time. And hiring staff adds a whole new dimension to the business: Contracts and work agreements, personnel policies, benefit packages, add pay scales must be developed. Tax records and workers' compensation must be attended to.
According to a study conducted in 1987 by the InterStudy Center for Aging and Long-Term Care, the popularity of private case management owes much to a convergence of several trends: Growth in the older population, fragmentation and complexity of the services offered, and the growing respectability of private practice in the eyes of human service professionals. Prospects should continue to be very good, considering the rapid growth projected in the number of people of advanced age and the increased willingness of many people to use social work and mental health services. Competition from case management programs sponsored by hospitals, area agencies on aging, and other organizations could affect opportunities for some private case managers. Others, however, are likely to benefit from burgeoning corporate interest in the eldercare issue, which could lead to contracts with private firms to provide case management as an employee benefit.
The dynamism and vitality of this field
make it impossible to predict what it's going to look like by the year 2000. New kinds of organizations are constantly emerging because of the emphasis on encouraging providers to develop new ways of serving older adults. Consider, for example, that senior centers, area agencies on aging, Elderhostel, and meals-on-wheels programs didn't come into their own until the 1970's. Hospice programs, caregiver support groups, adult daycare centers, and continuing care retirement communities were virtually unknown just a decade ago. Teaching nursing homes, geriatric assessment clinics, and private case management firms are still quite new.
There is every reason to believe that many more pioneering programs will appear in the years ahead. Contributing to organizational innovation in the field of aging is the need to keep costs under control, together with a consensus that the current system for delivering services is seriously flawed. Government and foundation grants for projects that demonstrate new approaches to delivering services are likely to continue, leading to more pioneering efforts. We can almost certainly count on visionaries and profit seekers alike to develop new ways of addressing old problems.
Housing and long-term care are likely to remain a major focus of their efforts through the year 2000. This reflects demographic trends: The number of Americans over the age of 75 is projected to skyrocket, rising from 12 to 18 million between 1985 and 2000. The need for assistance rises sharply at advanced ages due to fairly predictable declines in vision, hearing, and mobility-the latter often associated with disabling conditions like arthritis, stroke, and Alzheimer's disease.
There is no question that the need for long-term care services will grow enormously, but concern about the cost stands in the way of developing a suitable response. In the meantime, rental complexes, retirement communities, and neighborhoods are grappling with the needs of residents who are aging. Devising appropriate services for the very old represents one of the principal challenges for specialists in aging as the 20th century draws to a close.
Depending on the kinds of solutions that evolve, employment opportunities could emerge in areas as diverse as home equity conversion, private longterm care insurance, architecture and design, assisted housing, transitional and supervised living, board and care facilities, homemaker services, transportation, delivery services, remote health monitoring, and computer-aided assistive devices.
"Elder-care is likely to become the new employee benefit of the 1990's," according to Dana Friedman of the Conference Board. Corporate assistance for employees who are caring for an elderly relative is likely to come about sooner than corporate support for childcare, as Friedman sees it. Relatively few elder-care programs exist at present, however. Recently launched programs focus on providing information-by means of caregivers' fairs, resource directories, information and referral hotlines, or data banks. Some firms contribute to community services, such as adult day care. Others offer caregiver support groups, flexible schedules, and unpaid time off.
The Travelers Corporation is noted for its innovative programs in the field of aging, so it is not surprising to learn that the company is one of those that has already launched an elder-care program. The company's special interest in aging dates back to 1979 and has led to a job bank for retirees; a change in the pension plan to permit retirees to work half-time; preretirement counseling; a model program on health, aging, and productivity; and research on older workers.
Some of tomorrow's jobs in the field of aging will enserge because older people themselves are changing. Not losing sight of the vulnerability and care needs of the poor and the very old, it is nonetheless true that the great majority of older Americans will experience many years of good health, vigor, and economic security A new phase of the life cycle has emerged, a time that has been termed the third age. Adults in their sixties and seventies, many of them free of debilitating health conditions, are capable of continuing activities, whether inside or outside the work force. Better educated and more affluent than their parents or grandparents, many will seek opportunities for personal growth and change.
Through sheer numbers alone, older adults are bound to become an increasingly important influence on American society The leading wave of baby boomers will celebrate their 50th birthday by the year 2000. This could produce a surge of demand for employment, educational, and leisure services in the early years of the 21st century Major increases in the number of older people involved in educational pursuits can be expected, for example. When the baby-boom generation enters the third age, around the turn of the century, almost one-third will have 4 or more years of college, and almost half will have some college education, They will likely seek opportunities for further education, cultural enrichment, and job training, which suggests the need for a response from libraries, museums, colleges and universities, adult education, broadcasting, journalism, and related institutions.
Older adults have begun to attract the attention of the travel and tourism industry, which scents an untapped market for quality leisure activities. Helena Koenig is a travel agent who saw a new direction for her long-time career when her first grandchild was born. Her vision was simple: Nurture the relationship between grandparents and grandchildren by organizing intergenerational tours. She prepared by researching the sociology and psychology of grandparenting, then plunged in. "The demand is unbelievable," she says. "This market is totally unexplored."
Education and Training Requirements What kind of preparation do you need for a job in these fields'? That depends on your background as well as the job you have in mind. Jobs are so varied that a person with practically any level of education can find employment. High school graduation is sufficient for many jobs, but if you expect to work with older people in a professional capacity, you should plan your college major accordingly This is a pretty straightforward affair in the health professions, where entry level preparation in a specific profession is the first step. In the case of nursing, for example, this involves 2 to 4 years after high school in an approved nursing education program, followed by a licensing examination.
The situation is more complicated for fields other than health. Positions with similar titles may have vastly different hiring requirements. Some positions require professional credentials such as a master's degree in social work, a master's in public health, or a master's in public administration. Others do not. None of this variation is unique to the field of aging, but it does make the problem of choosing a training program more difficult. Determining the usefulness of academic credentials in gerontology is especially difficult; this question is looked at in the next section.
Social services. Entry level jobs including activities coordinator, outreach coordinator, information and referral specialist, and casework aide are generally open to high school graduates or, if a college degree is required, to graduates regardless of major. Generalizations are risky, however, since requirements for social service jobs vary so much.
Agencies and programs that provide social services to older adults hold widely different views of the importance of formal credentials. Neighborhood-based outreach programs such as Emmaus, for example, attach great importance to knowledge of the community when filling a job opening. A mature individual who had lived and worked in the area for many years-as a postal worker, perhaps-might be preferred to a new college graduate from out of town.
At the same time, public social service agencies and many private agencies are bound by regulations or traditions that specify that social work jobs require a bachelor's or master's degree in social work, other college graduates being limited to lower paying jobs as social work assistants or casework aides. Graduates who hold degrees or certificates in gerontology, family and community development, and related fields may run into problems if the job they want is classified as a social work job. Lucille Morisse encountered this obstacle twice, once in a home health agency and the second time when she applied for the job at Duncaster Each time, the problem arose because the social service job she had targeted was in a health-related facility Health facilities are subject to more stringent licensing and st-affing rules than other settings that provide services to older adults.
Differences in local labor market conditions also help explain why hiring requirements vary so much. Not surprisingly, applicant pools for social service jobs in the field of aging are vastly different in small towns and big cities. In some communities, an individual with no formal education past high school might qualify for a position as an activity coordinator in a nursing home, adult daycare program, or senior centen In other places, the job might require a college degree with a major in social work, therapeutic recreation, or occupational therapy
Health services. Educational requirements for jobs in the health services range from a high school diploma or less to a graduate or professional degree followed by a postgraduate traineeship. Licensing and certification are important too, especially in long-term care, where staffing standards are subject to State and Federal law A growing number of States require certification for nursing home assistants and a few require it for home health aides; employers often provide or pay for the necessary training.
High school graduates are qualified for many jobs in the field of aging, and high school as well as college students are welcome to apply for parttime and summer jobs. Nursing homes and retirement communities have openings for nursing assistants, geriatric aides, dining room attendants, kitchen workers, building cleaners, laundry workers, and clerical support staff. Senior centers hire high school graduates as receptionists and secretaries, information and referral clerks, van drivers, and activity aides. Rome health agencies and temporary help firms employ them as nursing assistants, home health aides, home care workers, and companions.
Two-year associate degree programs in health, public service, or human services prepare graduates for direct service jobs, as a rule. Since these programs serve local needs, there is a great deal of variation in program emphasis. Some programs prepare graduates to lead recreational activities, for example, while others prepare them to work with frail and disabled persons in adult daycare or group homes. Other positions that may require an associate's degree include mental health technician and therapy assistant.
A college degree in an appropriate course of study is the usual requirement for dietitians, nutritionists, occupational therapists, pharmacists, physical therapists, physician assistants, recreational therapists, and respiratory therapists, all of whom may work with older patients. Extensive graduate and postgraduate training is, of course, required of physicians. To qualify for licensure as a registered nurse (RN) or licensed practical nurse (LPN), one must complete a State-approved nursing program and pass the licensing examination. Programs for LPN's typically take 18 months, while RN programs take anywhere from 2 to 5 years, depending on whether they lead to a diploma, an associate degree, or a bachelor of science degree in nursing.
Program planning. Program planning for aging populations, a strong growth area, is an area where a background in business is gaining in importance. Whereas area agencies on aging, senior centers, and social service agencies look favorably upon planners and consultants with human service backgrounds, other kinds of organizations prefer business credentials. Housing facilities, hotel chains, department stores, and insurance companies are likely to set more store by expertise in marketing than in gerontology
Hospitals, too, seek business and management expertise when they fill planning jobs. "Gerontology has long been undervalued in the hospital setting, and that situation is only now beginning to change," says Mary Jane Milano, who heads the American Hospital Association's section for aging and long-term care services. Experience in planning and program development for community agencies that serve older adults is a strong selling point. Nancy Gorshe (see profile) brings just such experience to her planning position at Providence Medical Center in Portland, Oregon.
Administration. Jobs in administration usually call for a college degree, relevant experience, or both. A background in business administration or public administration is increasingly important in all human service fields, including aging. Too many job applicants are long on humanitarian instincts and short on practical skills, warns an offical from the Illinois Department of Aging. The practical skills that aging jobs require include budgeting and accounting, proposal writing, and management information systems. An opening for the position of senior center director, for example, may call for a solid financial background and marketing experience.
Master's degree programs in human services administration, social welfare administration, and long-term care administration have sprung up, and dual degree programs are increasingly popular. Some offer joint degrees in public administration and social work. The University of Illinois at Chicago recently launched a joint degree program in business administration and public health that features a specialization in gerontology management. The new program is designed to prepare graduates for positions in hospital systems, longterm care facilities, health maintenance organizations, planning and regulatory bodies, and govemment health departments.
Few degree programs exist to prepare persons for a role as a senior center administrator, although workshops and other continuing education offerings are available for those already in the field. One example is the Senior Center Training Institute offered every summer at the University of Maryland. Current administrators are likely to have a background in recreation, social work, or another human service field, and quite a few have been promoted to the job on the basis of experience.
Until recently, people with academic preparation in gerontology or long-term care rarely sought positions in senior housing management. This is changing, however, thanks to an explosion of interest in housing options for the affluent elderly Rapid growth in the number of life care and continuing care communities, retirement residences, and luxury rental buildings has generated demand for professional housing managers whose skills go beyond the traditional focus on property and financial management. Running a senior housing facility requires strong "people" skills, notably the ability to work with others to create and sustain a pleasant residential environment for older adults.
All kinds of backgrounds provide the requisite skills, says Richard R. Jaffe, president of the Retirement Housing Corporation in Dallas, Texas. Teachers are good at working with people, he observes, as are experienced managers fromthe hotel and hospitality industries. Business experience of most kinds is appropriate, he believes, and health administration graduates are in demand in facilities that provide health care as well as residential services.
Entrepreneurship. Because entrepreneurs are self-employed by definition, there are no hiring requirements. Successful entrepreneurs do exhibit certain characteristics, however, such as those discussed above. Also, they generally have many years of experience in the field in which they eventually become self-employed.
Should You Study Gerontology?
People interested in working with the aging often ask if they should take courses in gerontology The answer is, "It depends." Surprisingly few employers require it, although they almost always attach great importance to experience with older adults. According to Ruth Todd, who runs a job clearinghouse once a year for the National Council on the Aging, "experience with older people seems to be the key that unlocks the door to an aging job." Relevant experience can come about in several ways-through the fieldwork component of a gerontology program, volunteering, community activities, and previous jobs.
Gerontology is clearly no substitute for knowledge of a field such as social work, property management, dietetics, or transportation. Nor is it a substitute for technical skills, such as survey design, information management, or budget analysis. At the same time, there is no question that an understanding of the aging process and sensitivity to the infinite variety of ways in which people experience old age enable those who work with the elderly to do so far more effectively
There are other benefits to enrolling in a gerontology program if you are interested in pursuing a career in aging. Faculty networking with local agencies and practitioners is commonplace in human service fields such as this, and frequently leads to practical tips about job openings and the hiring process. Then, too, there is the snowballing effect of successive classes of graduates who tum to these programs when they are in a position to hire.
Opportunities to take courses in gerontology and related subjects have grown phenomenally. More than 1,000 colleges offered such courses in 1985, up from 600 in 1976 and only about 150 in 1967. Most colleges offer I to 6 gerontology courses annually, according to a 1985 survey, but a few institutions offer more than 50. A number of schools offer associate's, bachelor's, or master's level programs in gerontology These lead to a certificate, a minor or concentration, and-in a few cases-to a degree in gerontology Certificate programs have also been developed for people who already hold jobs in the field of aging. The study of aging at the doctoral and postdoctoral levels is clearly on the rise. Adult and continuing education programs in aging are widely available, too. Thanks to all this activity, an estimated 335,000 students have completed at least one course in gerontology over the past 20 years, and 200,000 have completed noncredit workshops or seminars. The number of people with degrees ,or concentrations in gerontology is much smaller than this, of course.
Students in health professions can generally choose one or more electives in aging and request placement in a geriatric clinic or nursing home during the clinical phase of their undergraduate training. The quality of this initial exposure to health care of the elderly varies a great deal, however, since many health professions schools have not yet developed expertise in this area. At the graduate level, health professionals do get a chance to specialize in geriatric or gerontological practice. The number doing so is still very small. The need for more geriatric specialists is enormous, and this has stimulated an outpouring of financial support for geriatric training in the form of scholarships and traineeships for nurses, physicians, biomedical researchers, psychologists, social workers, long-term care administrators, and others. Financial aid informationis available from school admissions officers.
One way of finding out about educational opportunities in gerontology is to request a computerized search of the data base maintained by the Association for Gerontology in Higher Education (AGHE), This can be done for a modest fee. Details are available from
Association for Gerontology in
Higher Education 600 Maryland Avenue SW West Wing 204 Washington, DC 20024
AGHE publishes a National Directory, of Educational Programs in Gerontology. The 4th edition (1987) contains infoffnation about courses, degree and certificate programs, and persons to contact at colleges, community colleges, and universities that teach gerontology or geriatrics.
Learning More About These Jobs
Most jobs in aging are not listed as such in newspaper want ads. You have to search them out. Your area agency on aging can identify local agencies and organizations that provide services to older people. Don't limit your search to agencies that have a formal aging program, however Contact any and all likely employers-bearing in mind that it may just be a matter of time before a housing authority, hospital, or church develops a program for older adults or institutionalizes services they are already providing.
Get to know people. In this field, as in most others, personal contacts are the best source of job leads. Use every opportunity to expand your network by getting to know people already involved in the field of aging. How? Discuss your career interests with practitioners, faculty members, gerontological consultants, and community activists. Make yourself known to civic and community leaders who are concemed with aging issues. Find out whether the local chapter of the American Nurses Association, for example, has set up a study group or task force on aging.
Consider volunteering. This not only provides an opportunity to test your career interests, it gives you a chance to make contacts. Student internships and volunteer experience are standard practice in the human service field, and often lead to paid employment. This was the case for Melissa Brown, whose volunteer work paved the way for the job she holds now (see profile). Melissa's year as multiarts coordinator for a senior housing facility was arranged through Cathederal Volunteer Service Community in Washington, D.C., one of a number, of public service organizations that pay a small stipend to the volunteers they place in longterm assignments. Hospitals, nursing homes, visiting nurse associations, hospice programs, and the Red Cross all seek volunteers. Other sources of volunteer opportunities are mental health associations, senior centers, churches and synagogues, and volunteer clearinghouses
Become familiar with major organizations in the field. By means of magazines, newsletters, technical assistance reports, library services, and conferences, these organizations provide information about programs and services for older persons, public policy issues, and the aging process itself. The National Council on the Aging distributes general information on careers in aging. It and other organizations provide information about their activities and respond to specific requests. Major organizations include the following:
of Retired Persons 1909 K Street NW Washington, DC 20049 American Society on Aging 833 Market Street Suite 512 San Francisco, CA 94103
Gerontological Society of America 1275 K Street NW Suite 350 Washington, DC 20005-4006
National Council of Senior Citizens 925 15th Street NW Washington, DC 20005
National Council on the Aging Library 600 Maryland Avenue SW West Wing 100 Washington, DC 20024
Regional and State gerontological societies, such as the Mid-America Congress on Aging and the Virginia Association on Aging, can be sources of job information. Most of these societies sponsor an annual conference for gerontology educators, service providers, students, and older persons themselves. Check with your State office on aging to learn whether any regional aging organizations are active in your area.
Many professional organizations sponsor job banks at their annual meetings. Most of the openings are for college faculty, researchers, policy analysts, or administrators. Positions requiring gerontological or geriatric expertise are listed at meetings of the following:
* American Association of Homes for
* American College of Health Care
* American Psychological Assoc, 'ation
* American Public Health Association
* American Society on Aging
* American Sociological Association
* Association for Gerontology in
* Gerontological Society of America
* National Council on the Aging
Many associations that represent health and human service professionals have developed career information and training materials in geriatrics and gerontology Some, such as the American Psychological Association and the American Public Health Association, have special membership sections on aging. A few professions have established credentials and other standards for professional practice in the field of aging. If you have settled on a particular field-pharmacy, nursing, or counseling, for example-contact the association and inquire about aging-related materials. Addresses and phone numbers may be found in the Encyclopedia of Associations, available in large libraries.
Other sources of career information include the following:
Priscilla McCutcheon, A Manual for Artists: How To Find Work in the Field of Aging. Washington, DC: National Council on the Aging, 1986. $2.50.
Martin Murray, Your Future Working With Older Adults. New York, NY: Richards Rosen Press, 1982. $9.97, plus $1 postage.
David A. Peterson, Career Paths in the Field of Aging. Lexington, MA: Lexington Books/D.C. Heath and Company, 1987. $12,95, plus $2 postage.
David A. Peterson, David Bergstone, and Joy C. Lobenstine, eds., National Directory of Educational Programs in Gerontology, 4th edition. Washington, DC: Association for Gerontology in Higher Education, 1987. $45 prepaid, $40 for AGHE members.
Ellen Williams, Opportunities in Gerontology Careers. Lincolnwood, IL: VGM Career Horizons/National Textbook Company, 1987. Paper cover, $7.95; hard cover, $9.95. Aging-Related Jobs in the Occupational Outlook Handbook
The 1988-89 Occupational Outlook Handbook published by the U.S. Department of Labor does not have a separate statement describing the work of gerontologists. Instead, for each of the following occupations, the Handbook explains how rapid growth in the older population will affect the number of jobs in the year 2000. Most of these statements provide some information on practice opportunities in gerontology and geriatrics.
Dietitians and nutritionists
Emergency medical technicians
Health services managers
Homemaker-home health aides
Human services workers
Licensed practical nurses
Nursing aides and psychiatric aides
The Occupatiotial Outlook Handbook, 1988-89 Edition (BLS Bulletin 2300) is available from the Superintendent of Documents, U.S, Government Printing Office, Washington, DC 20402. Paper cover, $22; hard cover, $24.
As director of gerontology at Providence Medical Center in Portland, Oregon, Nancy (jorsne proposes ways in which the hospital can do a better job of addressing older people's health care needs. This means making some sense of 40 different programs already in existence, determining what additional efforts are needed, and finding ways to bring the hospital's geriatric expertise to the attention of physicians and older Oregonians alike.
Exploring community needs was the first step, a familiar task for Nancy, who brought aging network experience to her job as a hospital planner. A field placement in a senior center during her college years introduced her to the field of aging. After earning a master's degree in social work, she built a background in administration, working in an area agency on aging, a home health agency, an adult daycare center, and the National Association of Area Agencies on Aging.
Hospitals all over the country are adding positions like hers. "They're eager to build bridges to the community," Nancy points out, "and aging network personnel have the knowledge of community resources that hospitals need."
The Pressing Need for Gesriatric Specialists
Experts agree that the United States-a world leader in high-technology treatment of acute illness-does not do a very good job of addressing the needs of elderly patients with chronic, irreversible conditions. Studies conducted by several blue-ribbon panels document the scarcity of physicians, nureses, and allied health professionals with geriatric or gerontological expertise. More attention to aging in the professional education of all health and human service prsonnel is recommended, altogether with a significant increase in the number of geriatric or gerontological specialists. Recent reports on the subject include the following:
Institute of Medicine, Inproving the Quality of Care in Nursing Homes. Washington, DC: National Academy of Sciences, 1986.
U.S. Department of Health and Human Services, Personnel for Health Needs of the Elderly through Year 2020. Bethesda, MD; National Institute on Aging, 1987.
U.S. Congress, Office of Technology Assessment, Life Sustaining Technologies and the Elderly. Washington D.C.: U.S. Government Printing Office, 1987.
"An Aging Society: Implications for Health Care Needs, Impacts on Allied Health Practice and Education," Journal of Allied Health, Vol. 16, No 4, November 1987; final report of the National Task Force on Gerontology and Geriatric Care in Allied Health.
Director: Arts Outreach Program
Joan Hart is the executive director of Mueseum One, an arts outreach program in Washington, D. C., that she started in 1981 in order to bring the arts to nursing homes, adult daycare centers, and senior centers.
Today she is leading a class at a downtown church that serves the homeless and mentally ill. Comments flow freely as works by Van Gogh, Matisse, and Monet follow one another on the screen. "Many of these people are confused and very frail," Joan acknowledges. "For whatever reason, their capacity for relating to art and appreciating the arts is vastly undesrrated. Yet the fact of the matter is that older people don't hold back in their as so many others do."
Museum One began when Joan, who has a master's degree in fine arts but found herself stuck in a clerical job, decided to offer an art appreciation class at a nursing home. The enthusiastic response psersuaded her to follow her dream. That, and the advice of a career counselor, who encouraged her to launch her own business. An encounter with a community leader who suggested possible funding suoursces led her to the aging network, and hesr decison to concentrate on educational programming for older adults.
Today, Joan works full time managing Musuem One, conducting classes, writing grant proposals, and supersvising the five-part-time teachers she employs. Like so many in this field, she has developed an intense personal commitment to older people and is awed by their capacity for creativity and growth.
Area Agency on Aging Planner
Human services planners don't necessarily have planning degrees, explains Carolyn Carter of the Fairfax County Area Agency on Aging (AAA). What counts most is experience working effectively with community gdroups, sesvice providers, and a virtual thicket of State an local government rules, regulations, agencies, and authorities.
Carolyn knows how to operate in that world, thanks to years of administrative experience in an AAA. She is an old hand at preparing budgets, overseeing grants and contracts, and pulling together the reports, documents, and other paperwork the AAA must submit to other agencies. She also holds a master's degree in family development and a graduate certificate in human services administration.
Knowing how things really work is essential for a planner, says Carolyn, since human sersvices planning is ultimately a matter of identifying emerging issues, obtaining relevant data, and then suggesting ways in which groups within the community might respond to those issues.
Identifying issues just as they come over the horizon and determining what other agenices and organizations are doing about them is a major part of any planner's job. It means attending meetings, ferreting out new sources of information, designing surveys, and much more. "Keeping up with all that's going on is the biggest challenge I face," Carolyn says.
Director: Social Service Agency
Daine Amussen has been in charge of Emmaus Servies for the Aging
in Washington, D.C., since the agency was created 10 years ago, an linterfailth response to the plight of needy elderly people cut off from everyday life in their downtown neightborhood. Some are alcolholics, many are lhandicapped, nearly all are poor. It took along time before Emmanus' outreach workers- all volunteers- were accepted by the community and permitted to help.
Diane once worked in the publishing industry in New York City, but at midcareer whe was drawn to connect with people in hands-on ways. "I was tired of looking at the world in terms of possible book ideas," she says. She decided to pursue graduate study in adult education and gerontology at the University of Minnesota.
While in New York, Diane had volunteered to spearhead a local effort to save low-income housing. This neighboorhood organizing experience plue her education in gerontology made her a perfect choice to get Emmanus up and running.
What advice does Diane offer about jobs like hers? She says, "Above all, remember that you bring yourself to a dirct service job. When you're trying to earn the trust of an older adult, the person you are inside matters more than all the professional preparation in the world."
Social Worker: Retirement Facility
Lucille Morisse loves being with people, and and she is in her element at Duncaster, a continuing care community in Bloomfield, Connecticut. Spending time with the older adults who live there is the best part of her job, she says. As social work director for the nursing unit, Lucille keeps a professional eye on residents who require skilled nursing care, but she is a familiar sight in the apartments, too, and somewhow manages to be where she is needed most. "The residents energize me," she explains.
Although she holds a master's degree in gerontology. Lucille fond herself out of the running for jobs in aging more than once because she did not have a master's degree in social work. Duncaster was willing to compromise: A consultant comes to the facility to provide professional supervision, thus satisfying State regulations.
Does she have second thoughts about having pursued a degree in gerontology rather than social work? "Not at all," she says firmly. She values her proparation inc counseling, psychology, and human development-all essential to helping older peoople cope with their changing lives.
The gerontology background also equips her to conduct training sessions for nursing aides and other members of the staff. Educating others is an important role for aging practitioners, she observes. "So many professionals who work with older poopulations have no background whatsoever in aging; it's up to those of us with that preparation to spread the word."
Director of Nursing: Nursing Home
"I never really thought I'd end up in long-term care," says Gloria Boring, "but then, you never know what lies around the corner." As director of nursing at New Ralston House in Philadelphia, Gloria supervises a staff of 60 and ensures that residents receive topnotch nursing care.
That means paperwork, meetings, daily rounds, visitors and telephone calls from families. Interruptions are frequent. When a patient suffering from Alzheimer's disease wanders into Gloria's small office and regales her with an improbable tale, Gloria listens patiently, having learned long ago how to respond to the confusion and complaints and fears of the very old.
She has worked in nursing homes for 13 years. "I didn't expect to like it," she explains, "and I thought I might last a month. Much to my surprise, I fell in love with the old people and was astounded at the difference I could make in their lives."
One of the things that keeps Gloria in long-term care is the opportunity to make her own decisions. The layers of staff found in a hospital-interns, residents, doctors, technologists, and other nurses-do not exist in nursing homes, which means that nursing home nurses assume much more direct responsibility. Professionally and personally, Gloria is glad she took a chance on long-term care.
"Older people are dubious about therapy," says Richard Spector. "They didn't grow up on Woody Allen films." Richard should know-he heads a geriatric therapy team at the Woodburn Mental Health Center in Annandale, Virginia. Despite the reluctansce of older adults to seek help, the geriatric team has more work than it can handle. Most cases involve families that can no longer cope with an older relative's deterioration. The toughest cases, however, involve older adults who have always lived on the margins of society-alcoholics, eccentrics, loners. Pulling together the necessary financial, medical, and social work assistance for people who are old, ill, and friendless can be draining.
Richard holds a master's degree in social work and completed additional training in family therapy. Intrigued by the therapeutic uses of creativity with older adults, he decided to specialize in the field of aging, only to discover that positions in geriatric mental health were few and far between. Richard worked as a family therapist until the position as a geriatric family specialist opened up.
Mental health services for older adults will be generally acceptable in the not-to-distant future, he believes. Pioneers like Richard Spector are helping to bring that future a little nearer.
Senior Center Director
Anita Martinez is gifted with superb organizational instincts and a vibrant personality She loves to see people enjoy themselves, and the musicmaking, laughter, and hum of conversation at La Puerta de Oro testify to her success in helping older Hispanics have a good time together
La Puerta de Oro has come a long way since Anita prevailed upon the Salvation Army to support her dream of launching a senior center program for the Hispanic community in Oklahoma City The center has its own building, offers activities 4 days a week, provides employment for five senior aides, and is alive with activity and laughter. The choir and mariachi band are in demand throughout Oklahoma and have performed at the Smithsonian Institution's Folklife Festival in Washington, D.C. The center also caters fiestas; center participants handle everything from decorations to music and, of course, the food,
Like so many others in this field, Anita was drawn to her life's work through personal experience. "I've always been able to relate to older people," she says. "I know how to draw them out, how to get them to open up and have a good time." Being able to motivate people is a key skill for a senior center administrator, she asserts, and the elderly ladies who don their Sunday best for weekly programs at La Puerta de Oro would surely agree.
|Printer friendly Cite/link Email Feedback|
|Publication:||Occupational Outlook Quarterly|
|Date:||Sep 22, 1988|
|Previous Article:||You're a what? Cartographer.|
|Next Article:||Cooperative education: working towards your future.|