Keeping Pace With an Aging U.S.

James J. Kelly, Ph.D., ACSW, LCSWFrom the President

This month I feel it is imperative to discuss social workers practicing with aging individuals, particularly as we’ve seen the baby boom generation, which comprises 27 percent of the U.S. population, start reaching the age of 65 this year.

Working with older people can be especially challenging because it raises very personal issues about one’s future. On one hand, and this is the joy, we are able to work with incredible role models, many of whom display tremendous strength and wisdom. On the other hand, we face the enormous struggles of the frail elderly who face economic, physical and emotional hardships.

Social work has a significant role to play in supporting older adults address barriers to continued productivity and active aging through counseling, substance abuse treatment, caregiver support and, in general, facing down and turning around the pervasive ageism in society.

In 2009, there were 39.6 million people over 65. In 2030, there will be about 72.1 million. Older people in our nation increasingly are ethnically and culturally diverse. By 2050, projected the Federal Interagency Task Force for Aging in 2008, 40 percent of the nation’s 65-and-over age group will be nonwhite. In fact, the population of Hispanic elderly will increase by 224 percent by 2030. They are also older — in fact, the fastest-growing segment in the nation’s aged are those 85 and over. This population is disproportionately found in nursing homes and other long-term care settings.

As a group, older adults have unique and complex needs. Thirty percent of those 65 or older suffer from three or more chronic diseases; and 20 percent of those older than 55 suffer from mental health issues (most commonly anxiety, cognitive impairments or mood disorders).

Elders require comprehensive services for health, mental and behavioral health, housing, disabilities, economic challenges and other support and social services in both rural and urban environments. The ratio of older people to working-age adults also tells a story. For example, California currently averages 18 older people per 100 working-age adults. By 2040, the San Francisco Bay area will average 41 older people per 100 working-age adults, placing extreme pressure on the working caregiving generation.

The need for long-term care services and adequate funding streams is especially critical. As a profession, we will do well to seek out the opinions of elders and engage them in the work that needs to be done.

There are currently 30,000 licensed social workers specializing in gerontology. The National Institute on Aging projected that in 2010, up to 70,000 social workers would be needed. We still have significant recruitment, retention and retraining to do if we are going to keep pace with the growing demands of this population. The baby boom generation is redefining retirement and aging; people are living longer, and technology use by clients and service providers alike continues to shape care options. Moreover, the social work labor force itself is aging, with almost a third older than 55.

Social workers fill numerous roles with aging individuals and their families, including in health care settings, community-based programs, nursing homes and other long-term care settings; in hospice and palliative care; and during transitions of care from one place to another. They provide services to family caregivers, as well as to individuals with dementia, Alzheimer’s disease, chronic illness, mental illness and to those who have experienced elder abuse. Social workers provide a continuum of services, from communicating with family members, accessing community resources and evaluating services and programs to acting as advocates for their clients.

Professional social workers who provide services to older adults and their families are adept at negotiating complex issues and organizations to ensure that the best outcome possible is achieved for the client. Numerous social workers run or own successful organizations, agencies or companies aimed at serving the needs of older adults. And lest we forget, social work had a leading role in the development and implementation of major national social policies — Social Security, the Older Americans Act and others.

One piece of legislation, the Elder Justice Act, has the potential to place more emphasis on elder abuse as a field of service for the social work profession. According to Dr. Anita Harbert of the San Diego State University School of Social Work, that institution, with funding from the Archstone Foundation and the U.S. Department of Justice’s Division of Victims of Crime, is developing and testing nationally a model of a standardized curriculum in the field of elder abuse.

Though most social workers specialize in children, youth and families, they will spend significant portions of their careers working with the elderly. Our profession needs to lead by guiding social workers into aging and family concentrations so that we develop professionals properly educated and trained to assist this population in the U.S. and globally. Indeed, one can easily argue that population and individual aging will affect every aspect of societies, from architecture to zoning laws and immigration patterns, to health care and even defense, to name a few. As a profession, social work has the necessary knowledge and skills to be a leader in gerontology and an advocate for those older adults who need us the most.

NASW supports social workers in the field of aging with updated practice information, continuing education offerings, professional standards for social work practice, NASW Press publications, government relations activities, a specialty practice section and a professional credential in aging. I applaud those of you who have chosen to focus your career on older Americans. You are supporting the generations that helped to make our nation great.

I also encourage those of you who may not have experience with older adults to begin to educate yourself now by visiting Practice/Aging, because no matter your field, you will no doubt serve clients of all ages in the years ahead.