Judy Howe and Bob Maiden both stumbled into their careers, but are now committed to making students aware of joys of working with the elderly.
We have both dedicated our careers to working with older adults. Now that we are in our sixties, we hope that younger people will be drawn to us. However, that doesn't seem to be happening at this point -- why aren't young people selecting careers in aging? Being a gerontologist or geriatrician is a rewarding career, with complexities, challenges, and opportunities given the aging of our cohort, the Boomers. Gerontologists study and teach about the aging process and the issues related to aging, whereas geriatricians practice a specialized field of medicine and provide clinical care to older adults. Gerontologists work in a wide variety of occupations from social workers to certified nurses aides, from directors of area agencies on aging to in-home health aides, from certified planners to financial planners, from biologists to thanatologists and so on. But younger people are not choosing gerontology or geriatrics as a career in part because it is an unknown profession to most students. Those who have been working in the field of gerontology and geriatrics have been struggling for years about the flat rate of recruitment into the field.
The 2008 Institute of Medicine report, "Retooling for an Aging America: Building the Health Care Workforce," underscores that our current health care system is ill-equipped to deal with this pending crisis. The report lays out the demographics, health status, and long-term needs of this population, and the challenges in caring for the aging population. It recommends that all health care professionals be trained to care for older adults and that there needs to be increased recruitment and retention of geriatric specialists in all fields of practice. There have also been several bills before Congress to provide incentives for individuals working with older adults, including the Caring for an Aging America Act co-sponsored by Senators Boxer, Kohl, Collins, and Sanders. This bill provides loan forgiveness for health professionals who pursue geriatrics and gerontology training into law.
In New York State, a study co-directed by one of us was undertaken to establish a better understanding of the number of programs and courses that exist in the field of gerontology or aging studies. At first, it was generally believed that the state inventory would show that most schools in higher education offered courses on aging and that the majority of them would have programs in gerontology. The findings of the survey, however, were shocking and mystifying. Of the 241 colleges and universities surveyed in the state, 137 schools had no courses on aging at all. Of the remaining schools that offered courses on aging, four percent had majors, two percent had minors, 16 percent had certificates and only one school (Fordham) had a Ph.D. program in gerontology (which is now defunct). This situation has not changed to this day despite the fact that we are an aging society. If anything, there are fewer programs today than there were several years ago.
Explanations for this institutional lack of interest in developing courses and programs on aging have been provided in the literature. It has been noted that most agencies do not require any education in aging for their new hires, for example, relying, instead, on their life experiences or learning on the job. Other factors include low salaries for positions working with people, and a lack of a mechanism such as service-learning courses that can excite an interest in students to work with older adults in their communities. Another consideration is that the fields of gerontology and geriatrics are not well known and therefore not as respected by peers as other professions.
Students and the public in general are ignorant of the meaning of gerontology. One of our colleagues who polled her students about the meaning of gerontology received responses such as: "it is the study of fossils" or "it is about the study of the earth." Perhaps the students were confusing the word gerontology with geology. Others believe that gerontology has something to do with the study of plants or insects. Those of us working in the field of aging have not done a good job in connecting the demographic imperative with the need for professionals to work in the area.
With this type of misunderstanding of the term gerontology, it is not too surprising -- as we found in an article we recently published -- that there is a critical shortage of specialists in the field of aging. There is national shortage of physicians trained in geriatric medicine. There are only 7,000 physicians nationally certified to treat and manage the multiple and chronic medical conditions of older adults. This number actually represents a 22 percent decrease in the number of geriatricians practicing over a seven-year period. Because of the exploding older population, it is estimated that 37,000 geriatricians will be needed. Like Groundhog Day, we see this same picture play out over and over again in the workforce for older adults. For example, it has been estimated that the United States has only five percent of the geropsychologists currently needed to provide clinical psychology services to the elderly. Of the 76,000 active psychologists nationally, only 200 to 700 devote a minimum of part-time services to older adults, and, of these clinicians, three-fourths of them have received little or no specialized training in working with older adults.
Again, we see this pattern in the field of social work, a field renowned for its compassionate therapists, where less than five percent of the social workers have identified a specialization in gerontology even though it is common for them to work with older adults and their families in health care and other settings. The Department of Labor has selected social work as a growth field, but the number of social workers trained to work with older adults is far below the 60,000 to 70,000 projected need over the next few decades. Other areas in the workforce such as service providers and home health care specialists also report similar shortages.
So, how do we recruit people into gerontology and geriatrics? Many colleagues in our generation have noted that they stumbled into the field -- now we need to figure out a way to move from accidental gerontologists and reshape the landscape so that it is viewed as an attractive, rewarding, and esteemed career. In late 2010, the State Society on Aging of New York (of which we are both past presidents), surveyed past presidents to find out what got them into the field of aging. This was an initiative geared to providing students potentially interested in the field with information about this career choice. Some noted a close relationship with a grandparent. Another common avenue was being in a graduate program and taking a course in aging, or being assigned to a research grant, or meeting a dynamic faculty member interested in the then-emerging field. Other past presidents were early in their careers and were presented with specific projects (management, research, policy) which sparked their interest while working in a related field such as social work or demography.