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Aging population spurs rise in elder care jobs

By Joan Axelrod-Contrada, Globe Correspondent, 1/26/03

Social worker Ellen Richwine needed a job with a shorter commute and so applied to her local nursing home.

''I had all the usual misgivings people have about working in nursing homes,'' said Richwine, 50. ''I thought it would be depressing - the end of the road, watching people slowly die.''

Instead, Richwine found the work unexpectedly rewarding. Now, 13 years later, she is director of social services at Sun Bridge Care and Rehabilitation in Randolph. ''I have grown as a person because of the type of people I work with,'' she said. ''They have a lifetime of knowledge that I interact with on a daily basis.''

Richwine belongs to one of the fastest growing segments of the US work force: those involved in the direct care of elders. The US Department of Labor predicts rapid growth for a variety of workers in occupations related to aging, including nurses, physical therapists, social workers, personal and home care attendants, and home health aides.

Demographers expect the number of senior citizens to mushroom in the coming years - partly because people are living longer, and because baby boomers are approaching retirement age. In 2011 the baby boom generation will begin to turn 65, and by 2030 one in four people will be age 65 or older, according to the Federal Interagency Forum on Aging-Related Statistics. By 2030 the percentage of those 85 and older - the fastest growing segment of elders - is projected to increase to almost 5 percent of the US population.

All this is good news for people interested in careers in aging. Specialists use the term ''gerontology'' for the broad field of aging and ''geriatrics'' for the health care component within it. Health care represents about 12.6 percent of the gross national product, according to the Gerontology Center at the University of Massachusetts, Boston. Approximately 36 percent of that is spent on caring for elders.

Over the next 10 to 20 years, aging baby boomers will be in generally good health, setting their needs apart from those of older seniors. As a result, specialists expect a variety of recreation-oriented industries to court the active boomer's dollar.

''In the short run, baby boomers are a very different picture,'' said Frank Caro, president of the Massachusetts Gerontology Association. ''They won't be in need of long-term care. They'll be more interested in travel and educational expansion; in being physical.''

On the other end of the spectrum are the older seniors increasingly in need of personal care, homemaking services, and home health aides. A study by the Paraprofessional Health Care Institute in Boston predicts that in-home care in Massachusetts will increase by 42 percent by 2006.

Pay is low, and turnover high. But the Home and Health Care Association of Massachusetts is seeking to improve conditions for workers.

''We've had some success already,'' said Pat Kelleher, the association's executive director. The average hourly rate for home health aides in Massachusetts has increased from $10.15 in 2000 to $11.48 in 2002, she said. In addition, the state-funded and administered Extended Career Ladder Initiative program is helping home health aides get the education and training they need to move up to positions like supervisor or licensed practical nurse.

Assisted living facilities represent another area of growth. In addition to employing direct care aides and nurses, members of this relatively new industry hire a variety of personnel, including activities directors, marketing directors, and administrators. An experienced RN, for instance, might become a facility's resident care director. The Assisted Living Federation of America in Fairfax, Va., provides voluntary certification to administrators and marketing directors in the field.

Colleges and universities, meanwhile, have added gerontology programs at the certificate, associate's, bachelor's, master's, and PhD levels. Some are linked to a clinical area such as nursing, others are more interdisciplinary in approach. Alumni of gerontology programs work in a variety of settings, including city and state agencies on aging, health facilities, and advocacy groups.

Specialists predict that career growth will be much faster in direct service to elders than in the management and social policy arenas of gerontology.

''You don't need to hire another person to do research if the numbers of older people change from 30 million to 60 million,'' said James Callahan Jr., director of the Policy Center on Aging at the Heller School for Social Policy and Management at Brandeis University. ''The job growth will be more at the bottom and less at the top.''

Many people become involved with elders through their primary occupation, such as nursing or occupational therapy. Richwine took a more circuitous route.

Upon graduating from Northeastern University with a degree in journalism, she worked in hospital public relations, then moved into the emergency room, getting her license in social work from the state. Eventually, she enrolled in a certificate program in gerontology.

Now, as director of social services, a typical day for Richwine involves interacting with family members as well as patients. One family needs to be told that the patient is too frail to go home. Another patient's spouse needs to be reassured. Richwine knows it's important to be nonjudgmental, which isn't always easy. Nor is it easy for her to cope with federal and state cutbacks affecting patient care. But, Richwine knows that she's making a difference in people's lives.

Vanessa Calderon-Rosado, 38, came to gerontology from a background in speech pathology. After working for three years as a speech pathologist in a nursing home/rehabilitation center, she decided to enroll in a gerontology certificate program at the University of Massachusetts, Boston.

''A lot of people were having problems with what Medicare and Medicaid covered,'' she said. ''I got interested in the issues and policies of health coverage.''

Initially, Calderon-Rosado planned to go back to a more administrative, policy-oriented position in health care. But, once in the gerontology program, she decided to get her doctorate. Now a senior research associate at the National Center on Women and Aging at Brandeis, she is working on a study for the Centers for Medicare and Medicaid Services about the cancer disparities of minority elders.

Looking to the future, specialists are trying to predict whether the swelling ranks of baby boomers will help professionalize aging-related services or scale them back to a bare minimum for all but the wealthy.

Richwine is optimistic.

''Maybe we'll be allowed more of a voice because there are more of us,'' she said. ''Maybe things will improve.''

Joan Axelrod-Contrada is a freelance writer. She can be reached at axelrodcon@aol.com.

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