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Monday, May 2

Social Workers in Aging: Reflections on the Past, Imperatives for the Future

Phyllis Mitzen, AM, MSW, NASW Illinois Older Adults SIG Chair

In 1972, almost forty years ago, I began my career working with older people, so please indulge my reminiscing on the reason I chose social work as my profession.

When I started out, it was only seven years after the passage of Medicaid in 1965, shortly followed by passage of the Older Americans Act, and we were at the very beginning of the burgeoning nursing home industry. Researchers were already publishing articles documenting that many people living in nursing homes wouldn’t need to be there if there were sufficient community services and supports. My first job was in a nursing home, and I quickly realized that working with, and on behalf of, an older population was deeply interesting and challenging to me. I saw firsthand that while many of the people who lived in the nursing home needed twenty-four-hour nursing care, others might have been able to live at home if only there was someone to look in on them, help them with meals, and take care of laundry and housekeeping. After several years, I decided to go to back for an MSW, believing that a degree in social work would best prepare me with the foundation and professional identity I would need to do the work I hoped to accomplish in my career. I’ve never been sorry.

The 1970s were a very exciting time. Bernice Neugarten, Shelly Tobin, Morton Lieberman, and Robert Havighurst led the Committee on Human Development at The University of Chicago in interdisciplinary research into aging. Neugarten’s Middle Age and Aging—a watershed compilation of aging research—was published in 1968 as a response to a dearth of text books on this stage of life. Neugarten wrote extensively on the heterogeneity of people we think of as ‘old’, stressing that there are differences between people 55–75, the ‘young old,’ and those 75 and older, the ‘old old’. Robert Butler, physician/psychiatrist, was principle investigator in the 1950s and 60s for the first National Institute of Mental Health Longitudinal Study on Aging which concluded, among other things, that senility was a function of disease, not an inevitable result of aging. And then there was Representative Claude Pepper who chaired the House of Representatives Select Committee on Aging well into his 80s.

In the 1970s, we knew that 2011 was the year that the first of the baby boomers (People born between 1946 and 1964) would begin turning 65 and that the country needed to prepare itself for the “pig in the python*” generation growing old. I was born four years before that generation came on the scene – the generation that has shaped and reinvented each decade it passes through. Today boomers represent 27% of the population. Every day, it is estimated that 126,000 people worldwide turn 65. By 2031 that number will swell to 216,000, resulting in 72.1 million people over age 65, almost twice as many as today. As Neugarten stated, “Aging is an underlying dimension of social organization, for in all societies the relations between individuals and between groups are regulated by age differences” (Neugarten 1968).

*A spike or surge in a statistic measured over time, especially in demographics

For young and not-so-young social workers, we must face the reality that this older cohort will dominate your practice for the foreseeable future. It is up to us, or to you, to decide how the profession of social work should rise to the challenge. In her recent essay, “A Broader Vision for the Social Work Profession,” NASW Executive Director Elizabeth J. Clark described social work as the “holder of hope.” “We do not live or work by denying the reality of the society of today. Instead, we recognize that hope transcends reality, and that our combined efforts will continue to improve the world in which we live.” As holders of hope, we must not only deal with today’s reality, but anticipate the future. We are as challenged today as we were in the early days of the profession to participate in shaping the future. Beyond the iconic work of Jane Addams, we can take pride in knowing that most of the safety net that we have come to rely on today was fashioned by social workers. Frances Perkins was the first woman and social worker to be appointed to a cabinet level position, and she chaired President Franklin Roosevelt’s President’s Committee on Economic Security that ultimately crafted the Social Security Act of 1935. Harry Hopkins, who drafted the charter for the precursor organization to NASW, “established a relief program that distributed federal funds to the states and imposed national standards.” (Cohen 2009). Despite an illustrious history of anticipating and responding to societal problems, our profession has been slow to recognize and prepare social workers for the demographic tsunami. In 1987 the National Institute on Aging projected that by 2020 up to 70,000 social workers prepared in geriatrics would be needed, a 43% increase over the needs at that point in time. However, the number of social workers trained in geriatrics has not kept pace; as recently as 2003, only 29% of MSW programs offered an aging specialization. Is it any wonder that in 2006, only 3.7% of MSW’s identified aging services as their primary practice area? Unfortunately we’re not alone—only 1% of physicians, nurses, physician assistants, and pharmacists identify themselves as specializing in geriatrics (Institute of Medicine 2008). As a member of the pre-boomer generation, this is not good news.

However, there is good news. In the last decade, noteworthy strides have been taken to remedy this situation. In 2000, the Council on Social Work Education (CSWE) developed competencies specific to geriatric social work. Building on this work, the John A. Hartford Foundation supported a number of initiatives to expand social work’s reach in this specialization. Most noticeable here in Chicago has been the impact of the Hartford Partnership Program for Aging Education (HPPAE). Three universities—The University of Chicago’s School of Social Service Administration, Loyola University School of Social Work, and Dominican Graduate School of Social Work—received three year Hartford grants through the New York Academy of Medicine to develop a curriculum, partner with field sites, develop a rotation model, and provide a stipend to second-year social work students. Over the past six years, these schools have graduated more than seventy Hartford Fellows, most of whom are working in the field of aging here in the Chicago area. Most exciting is that the schools not only remain committed to maintaining their older adult concentrations after the Hartford Grant ran out, but they are now mentoring other schools of social work in the area and throughout the state. Now, six years later, the fellows are growing into leadership roles in a wide variety of settings—in social service agencies, area agencies on aging, and at the Administration on Aging. They have played a key role in developing Chicago Bridge (a networking organization for professionals new to the field of aging) into a nationally recognized and replicated model.

The NASW Illinois Chapter is also playing an important role. We have learned that many of the jobs available to new MSW’s are in nursing homes. This year, the NASW Illinois Chapter Older Adults Shared Interest Group (Older Adults SIG) has focused its attention on how it can support social workers in these settings. We are also interested in strengthening the important role that social work can play in nursing homes; with the residents, their families, and the staff, work that can be beneficial for the people involved, and cost effective for the nursing home.

I believe today, even more than I did forty years ago, that social work, with its strength-based, person-centered perspective, can and has an obligation to assert its professional wisdom and leadership in what is certain to be a challenging and exciting time. I would like to see what a social worker (Undoubtedly one of the Hartford Fellows) will reflect on forty years from now!

  • Cohen, A. (2009). Nothing to fear: FDR’s inner circle and the hundred says that created modern America. New York: Penguin Group (USA) Inc.
  • Neugarten, B. (1968). Middle age and aging. Chicago: The University of Chicago Press.
  • Institute of Medicine. (2008). Retooling for an aging America: Building the health care workforce. Washington, DC: Author.

Phyllis Mitzen is co-director of the Center for Long-term Care Reform at Health and Medicine Policy Research Group. She is a member of several statewide advisory boards including the Illinois Council for Long Term Care. She has also been coordinator of the Older Adult Studies Program for the School of Social Service Administration, The University of Chicago. For twenty-four years Phyllis worked for Council for Jewish Elderly (CJE) where she developed and managed many of CJE’s home and community-based services. With Martha Holstein, she is co-editor of a book, Ethics in Community-Based Elder Care.

Posted on 05/02/11 at 08:39 AM


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