During my first year of graduate school at Columbia University, I worked at a home care agency as a medical social worker, making home visits to elderly clients with a wide range of acute health and long-term chronic illness needs. After conducting many home visits with frail elderly clients, I began to notice the lack of coordination of care by the various parties involved. Given the extremely large caseload that nurses, social workers, and physical therapists undertook at the home care agency, the tendency was to visit a client as quickly as possible and interact minimally with other health professionals so that one had time to complete all necessary paperwork.
That experience opened my eyes to the direct impact of a model of care that lacks patient-centered goals. It also illustrated the effects of a fragmented and extremely ineffective health care system for the aging adults in our nation.
So when I came to the John A. Hartford Foundation as an intern for the summer of 2012, I was curious about how a foundation could address the needs of the increasing numbers of older adults. I learned that one of the ways the foundation achieves its goal is by building the capacity of health care professionals trained in geriatric care. In addition, the Hartford Foundation funds efforts to implement models of care focusing specifically on the geriatric population so that older adults receive the appropriate care to maintain quality of life. The coordination of funding, management, and direct service will inevitably help bring real change to the health care system and its impact on older adults. It is my hope that, through collaboration among the varying levels of health care professionals and institutions, we will achieve our goal of improving the health care of older adults.
My summer at the Hartford Foundation also deepened my understanding of the importance of training our health care professionals in geriatrics, as the older adult population often requires specialized treatment. (As a social work intern, I was never trained to understand the complexities of and differences in caring specifically for older adults.)
The foundation’s support of certain initiatives, such as scholarship programs, centers of excellence, and curriculum improvements, demonstrates an effort to increase the number of scholars and professionals who better understand the importance of caring for older adults. However, what’s equally as important as supporting scholars and professionals is how these professionals use their geriatric training and skills to ensure that the health care system is serving the growing number of older adults.
This brings us full circle to the importance of direct care, such as that provided by a medical social worker. There is no single, best form of advocating on behalf of older adults, so we must all work together to discover paths to improvement and success.
Although it was not apparent to me when I first arrived, I came to realize that my own career goals are actually aligned with the work of the foundation. As I completed my first year in the Master of Social Work program at Columbia, I realized that I want to create change at the systems level—whether it is through creation of policy, more effective and efficient service delivery, or improved organizational structure among agencies working on behalf of an important issue.
One of my dream jobs is to be a director of a program within a nonprofit agency, which I view as a way to accomplish my goal of participating in the creation of systemic change in our society. Through effective management and direction, an agency can better serve those in need. During my work at the foundation this summer, however, I quickly discovered that I could also accomplish my macro-level goal of being an agent of change by working at a foundation. As I observed the committed Program Officers collaborating with the foundation’s grantees, my desire to become a leader in nonprofit management and the field of aging heightened.
So, how will you contribute to improving the health of older adults? If you work at an educational institution, are you striving to build your geriatric curriculum and staff? If you are at a social service agency, do you have geriatric care models in place? As a health professional, have you received the proper training to truly understand the challenges of caring for older adult patients?
Think about it. Let’s work together.