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Being There


Being There
Practicum experience provides graduate social work students with specialized geriatric training

Len Kaye
Len Kaye

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The Approaching Elder Wave
School of Social Work, Center on Aging among the first responders

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Theirs is a passion too few of us understand.

Michele grew up surrounded by the elders of her family and the richness they bring to life. Ken, who spent years grieving his parents' premature deaths, is committed to helping others through their bereavement.

For Mary, the last seven years of her mother's life heightened her awareness of geriatric mental health issues and the critical role of caregivers. Dyan, who changed careers to ease a growing sense that "a piece was missing" in her life, found what she was looking for in geriatric social work.

The four graduate students in the University of Maine School of Social Work spent the last academic year in a Geriatric Practicum Partnership Program (GPPP), made possible by a grant from the John A. Hartford Foundation under the auspices of the New York Academy of Medicine's Social Work Leadership Institute. The program provided specialized training in placements and rotations in agencies for elders statewide.

The goal is to increase the number of geriatric social workers and raise interest in aging as a field of practice among students.

The emphasis comes in light of the cresting elder wave aging Baby Boomers.

"We're educating students to be proactive in the lives of older adults," says Nancy Kelly, field coordinator for the School of Social Work who codirects Maine's GPPP with Len Kaye, director of UMaine's Center on Aging. "Most people think of elders as being at the end of their lives, but we're working with students to view them in the act of living."

With such specialized training, Master of Social Work (MSW) graduates provide services like counseling to elders in long-term care facilities and their families; work with assisted-living facilities and elders' families to find placements where mental health needs can be met; offer therapy as part of hospice services; and help to set policy and advocate for services to meet elders' needs.

"They graduate with a sense of how exciting it is to work with this age group, looking at the elders as the individuals they always were and will be," says Marjie Harris, coordinator of Maine GPPP. "It has to do with being part of a person's life at such an intense time and what an honor it is to be part of their life journey helping them live until they die."

Michele Garrity
Michele Garrity

Michele Garrity, Brewer
Brewer Rehabilitation and Living Center, Long-term Care

Michele Garrity is used to people being surprised that, at 25, she prefers working with the elderly, not children and families. But Garrity's career choice is as atypical as her upbringing that influenced her decision to pursue geriatric social work.

Growing up in Johnstown, Pa., Garrity was close to her four grandparents and two great-grandparents literally (they all lived within a mile radius of each other) and figuratively.

"From them, I learned respect," says Garrity. "When they said something, we listened. Hard work was huge, too. I also learned the value of friendship and creating those supports for yourself."

As an undergraduate in human development and family studies at Penn State, Garrity worked with youngsters for two years. But in her first year at UMaine, one of her graduate field placements was at Maine Cancer Consortium, where she assisted elders with their healthcare-related issues. In that setting, Garrity says she was on cloud nine.

"I have worked with children and families, but didn't get nearly as much out of the experience as I did working with older people. They have so much experience and knowledge. Sitting and talking with elders is awesome."

In GPPP, Garrity focused on chronic and terminal illnesses of elders in her primary practicum at Brewer Rehabilitation and Living Center. Two days a week, she worked with elders and their families, helping to coordinate care and ensuring that needs were met.

"I like the caregiver piece," says Garrity, who is now pursing a career as a hospice social worker. "I thought it would be hard working with people who are dying. I'm not good with death. But doing visits with a social worker at Hancock County HomeCare & Hospice, I saw how dignifying the dying process can be."

People with chronic illness typically reach a point in their treatment when they realize they will not get better, choosing then to live the remainder of their lives as comfortably as possible, Garrity explains. That's when a hospice social worker can help with grief and fears, supporting both the elder and caregiver.

"The biggest surprise for me is how much I love hospice work. This program gave me the chance to see that," Garrity says. "A lot of people when they go into a social work program say they don't want to work in geriatrics and aren't exposed to it. For me, the exposure drove my desire."

Mary Kellogg
Mary Kellogg

Mary Kellogg, Bangor
Community Health and Counseling Services, Mental Health Care

In May, Mary Kellogg received her MSW degree from UMaine, two decades after earning degrees in law and foreign service from Georgetown University.

The irony wasn't lost on the Bangor lawyer.

"I had a wonderful job in a legal practice," says Kellogg, "but I wanted to get into work that related to people differently than I did in law. And from the time I started in the School of Social Work, it felt like the right thing for me, a different way of thinking about the world."

In her primary practicum at Community Health and Counseling Services in Bangor, Kellogg focused on geriatric mental health, which is so inextricably linked to physical health in older adults. At the center, Kellogg did mostly home-based therapy, with some case management. In her rotations, she had access to elders and their care providers in inpatient units at hospitals and mental health facilities.

"Exposure to the interdisciplinary collaboration was an important part of my education," she says. "It opened my eyes. I was finding work in geriatric mental health very satisfying."

Kellogg says she has learned important lessons about human dynamics, and the environmental, social and economic factors that can affect people's mental outlooks. She also came to better understand the ongoing struggle of elders to navigate the often daunting and fragmented system of social services.

"Understanding how different components of the system work is very important in providing effective service to the elderly," says Kellogg, who is considering a career in geriatric case management, helping elders and their families find the services they need.

Her focus is in keeping with her view of elders as "people who have lived rich and full lives, and who want to stay connected with others." People like her mother, who was in declining health in the last few years of her life.

"She opened my eyes to what it is like to try and help someone with the sorts of needs she had," Kellogg says. "Yet even as the dementia progressed, the core of who she was as a person remained. She helped me understand this, and that was a gift."

Kenneth Gates
Kenneth Gates

Kenneth Gates, Belfast
Waldo County Home Health & Hospice, End-of-life Care

After a stint in the military and years of running his own businesses, Ken Gates worked in the corporate world until he felt "a quiet nudge from behind." Ageism.

That's when he decided to put his life experience to better use. And he followed his heart.

Three years ago, at age 61, he enrolled in UMaine's School of Social Work.

"I've always been interested in older folks. I seek them out for their wisdom, their different perspective," he says.

"I lost my parents when they were in their 60s. I wasn't able to help them wind down their lives. That's why clinical work with the elderly is what I wanted desperately to do."

In his practicum with Waldo County Home Health & Hospice, Gates has seen the physical struggles of aging adults. In his in-home hospice therapy, he focused on the patient and caregiver until the day came that only one remained; then it was time to turn his attention to the bereavement process.

"A lot of hospice work is with the patient who is progressing to death, but our work doesn't stop when a person dies," Gates says. "When someone moves on, the caregiver vacillates between remorse and relief. We shift to the family, helping them through the bereavement, especially two or three weeks after the funeral, when they're alone. That's especially important in the case of someone losing a spouse."

For both the patient and caregiver, the hospice social worker is a listener, facilitator and advocate, Gates says, often posing the pertinent yet sensitive questions about estate planning and other end-of-life directives. While modern medicine can provide physical comfort like pain management, social workers like Gates offer emotional and spiritual support.

During an in-home visit, that support may take the form of talking about the past, taking down a letter to a family member far away or playing a quiet game of cribbage. All the while listening and observing intently.

"We're there to buoy them up, to give them a sense of belonging and purpose," says Gates, whose new career may focus on palliative care. "It's important that they know that their life has meaning. And that they are not alone.

"There's a great deal of satisfaction in helping people empower themselves. That's what social work is all about. We're not doing for them, but helping them help themselves."

Gates says the experience also has taught him that one person can make a difference in people's lives.

"I don't have the patience to change policy, but I admire people who do. I need the short-term reinforcement that what I'm doing is making a difference."

Dyan Villeneuve
Dyan Villeneuve

Dyan Villeneuve, Augusta
State Office of Elder Services, Policymaking

Dyan Villeneuve knows the passion of advocates for the elderly working at the grassroots level throughout Maine to ensure older adults get what they need to live healthy lives. She's also seen the difference statewide policymaking can make for individuals.

Villeneuve hopes to be part of a concerted effort to bring issues facing older adults more to the fore in preparation for the cresting elder wave aging Baby Boomers.

"I'd like to see this population get more respect in terms of funding. It seems a lot of times with state, federal or private funding, geriatrics is not considered 'sexy,'" she says. "People want to focus on children and families, and the elder population gets forgotten. I want to make elders and their needs more of a known entity."

As an undergraduate in social work, Villeneuve discovered her love of geriatrics while interning at Brewer Rehabilitation and Living Center. Her interest in planning and policymaking surfaced during a placement with the state Department of Health and Human Services' Children's Services division.

"I like the idea of a large system like DHHS that can still react and offer services to people on an individual basis," Villeneuve says. "My supervisor was a social worker who had an amazing way of making every person or family that dealt with her department feel as if she was only working on what they needed. It was a very caring, individualized approach."

In the state's Office of Elder Services in Augusta, a division of Health and Human Services, Villeneuve was involved in policy planning activities, testimony before legislative committees and survey data compilation.

"This year focused me more on the political arena and I found the energy at the Statehouse intoxicating," says Villeneuve. "I see myself running for political office one day, something I didn't see myself doing before this year. Social workers are perfectly suited because we are trained broadly in how to deal with people and communities."

When it comes to older adults, an overarching concern statewide is the need for more long-term care options. Communities need to work in concert to achieve a larger voice of advocacy, presenting a unified message that they're ready to plan for the challenges the elder wave will bring. To be prepared, they need state guidance, support and resources, Villeneuve says.

"I think our state needs to be more proactive and less reactive. There are so many people in the state with a love for elders. We just need to get all of them together to plan for the inevitable, important issues like housing, transportation, healthy aging, integration of generations in communities."

by Margaret Nagle
September-October, 2007

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