Older and wiser

Berks county has one of the biggest populations of older people in the US so it is vital to maintain high standards care and retain staff, says Janice Gasker. Which is where a mentoring programme comes in.

The great thing about this experience was that it felt like group therapy. Facilitating a group therapy session is not something I, as a social work professor, get to do very often. So it was with gratitude that I felt the familiar, rewarding emotion that happens when group members get much-needed support from others who have shared similar, painful experiences.

I sighed a bit and settled down in my chair, notepad in hand. Then I remembered that I wasn’t taking clinical notes. I was jotting down observations, the qualitative data for social work programme evaluation. A colleague and I were evaluating a mentoring programme for new staff working in geriatric care. This programme is an effort on the part of Pennsylvania, in Berks County, to help federally-mandated geriatric services attract and keep qualified in-home workers.

The needs of older people are changing rapidly here. Health insurance policy has resulted in a drive to keep down the number of people admitted to hospital, in-patient rehabilitation and nursing home care. This can be positive for clients: most want to stay in their homes for as long as possible. But in this context in-home care becomes critical, and a lack of in-home workers can be dangerous. This lack of service faces social workers each day: the “efficient” discharge planning demanded by health insurance providers is nearly impossible without community-based services. In addition, social workers know that high staff turnover in home-based services compromise the quality of care.

Berks is one of the oldest counties in Pennsylvania, which is one of the oldest states. The women in my group (a mix of Caucasian, African-American and Latina) have recently begun careers providing geriatric home-based care. They had participated in the mentoring programme as new employees who were supported by more seasoned workers. They and their mentors worked in the residences of older people, many of whom had lived in those same homes for more than 60 years and did not want to leave.

The gratitude of the clients was important in keeping these women in their jobs. But many other factors conspired to push them out, including low pay, the disrespect of a society that devalues older people and a basic loneliness that resulted from working alone. It was here that the mentoring programme intervened. Workers who participated received bonuses, the programme itself helped them feel valued and they appreciated a few hours of work with someone else.

Their good feelings were rewarding to me as facilitator. The mentoring programme is likely to continue, and it may be replicated across the state. Direct care workers will experience greater job satisfaction. Social workers will have services available for client referrals. And next academic year, a social work intern will have the chance to work with older people and participate in programme evaluation. Practising social work in this ageing nation, in one of its oldest counties, we know we’re getting older. Perhaps we’re also getting wiser.

Janice Gasker is a social work professor at Kutztown University of Pennsylvania. Contact gasker@kutztown.edu

Background

• The number of over-65s in the US is expected to double to more than 70 million in 2030.
• In 2000, four million US residents were older than 85. This is expected to rise to 19 million by 2030.
• In 2050, it is expected that 835,000 US residents will be older than 100.
• Personal care and home health aides are the ninth fastest growing occupation in the US.
• 74 per cent of Pennsylvania agencies serving the ageing population reported significant staff shortages.