Clark College
Certified Nursing Assistant
Fundamentals of Caregiving
http://cce.clark.edu/
Washington State University Vancouver
Certificate in Gerontology
http://hd.vancouver.wsu.edu/certificate-and-minor-gerontology
Clark County Career Development Center
Certified Nursing Assistant
360-574-1535
When Janessa Cobb’s grandmother was bedridden for eight months by a severe infection, Cobb took on the equivalent of a crash course in caregiving.
“Before taking care of her, I hadn’t had any reason to do it,” Cobb said. “Jumping in full force and having to learn everything was difficult. It put a lot of things into perspective.”
The experience inspired the 21-year-old Vancouver resident to pursue a career as a caretaker for the elderly and disabled. She’s studying at Clark College to become a certified nursing assistant.
Cobb is an exception to the rule. Interest in careers in gerontology lags far behind the need, raising concerns about how society will care for a flood of aging baby boomers.
Nursing assistants, along with other jobs serving seniors, are expected to grow faster than average for all occupations as 70 million baby boomers reach the age of 65 or older by 2030, according to the Bureau of Labor Statistics.
“There is a strange paradox here, because demand for people with a background in gerontology is increasing, but one of the problems we’re experiencing is reluctance in terms of students who want to do coursework in gerontology,” said Graham Rowles, president of the Association for Gerontology in Higher Education and University of Kentucky professor of social and
behavioral sciences.
Gerontology is a multidisciplinary specialty in the scientific study of aging. The specialty can be used in a wide range of fields, from medicine to home design.
Burgeoning need
An average of about 10,000 people turn 65 each day nationwide, according to the Social Security Administration. Clark County’s 65-plus population grew 48.5 percent from 32,808 in 2000 to 48,710 in 2010, according to the U.S. Census Bureau. Although the county’s growth outpaced the nation’s, those 65 and older still make up less than 12 percent of Clark County’s population compared with 13 percent nationwide. The growth was faster in Clark County’s 90-plus population. Those 90 and older increased by 84.9 percent from 1,214 in 2000 to 2,245 in 2010.
This aging population will need physicians, nurses, psychiatrists and nursing assistants who understand the unique health needs of the aged. They’ll be looking to spend their money on financial planning, fitness and wellness programs, travel, home design and consumer products geared toward their demographic. Some of the jobs that will be needed haven’t been created yet, said Cory Bolkan, assistant professor of human development at Washington State University Vancouver.
Lack of interest
Despite offering what promises to be a refuge of job security, gerontology as a field cannot draw enough interest to keep up with demand, Bolkan said.
Only nine universities in the country offer doctoral degrees in gerontology, Rowles said. Hundreds of master’s degree programs exist, but they’re not filling up, he said. Less than half of available fellowships for geriatricians were filled in 2009, according to a study by the University of Cincinnati. Geriatricians are physicians who specialize in medical and psychological conditions of old age.
Nationwide, fewer than 1 percent of internal medicine and family medicine residents went into geriatrics last year. Two out of 97 graduates of the Family Medicine of Southwest Washington physician residency program at Vancouver’s PeaceHealth Southwest Medical Center specialized in geriatrics, said physician David Ruiz, program director.
Low pay, demanding work conditions
Low pay, demanding work conditions and a cultural phobia of old age hamper recruitment into gerontological academic programs and account for high turnover in the workforce, Rowles said.
For instance, geriatricians earn half to as little as a third as much as physicians with other specialties, according to Medical Group Management. That’s because seniors primarily rely on Medicare to pay for their health care, and Medicare reimbursements are significantly lower than that of private insurance, Ruiz said.
“Geriatrics is a growing market with abysmal reimbursement for the physician,” Ruiz said.
Nursing assistants earn median wages of between $9.71 and $13.76 per hour, according to the Bureau of Labor Statistics. In Washington, the median pay for a state-employed nursing assistant is about $10.40 per hour, said Linda Lee, a Vancouver caretaker on the board of the Service Employees International Union’s local chapter. Low pay, odd hours and the emotional and physical toll of caring for clients cause high turnover in the industry, Lee said. Unemployed workers have turned to caregiving during the recession because cost of training and educational requirements are low, but they may be just as likely to turn away from the profession once other job opportunities open, she said.
Clark College student Lisa McCort, who works as a caregiver through a private agency, said she works 12 hours a day, four days a week and doesn’t receive health insurance or other employment benefits.
“The feeling it gives you can be up and down,” McCort said. “It can be stressful. It’s kind of fulfilling to be able to help people through their problems.”
Training capacity
In Clark County, there are no associate’s, bachelor’s, master’s or doctoral degrees offered in gerontology. However, both WSU Vancouver and Clark College offer certificates related to the field. Clark County Career Development Center, a new school founded by Vancouver gerontologist Gail Haskett, will begin offering a program for nursing assistants in January.
WSU Vancouver has offered a gerontology minor and/or certificate since 1994. The interdisciplinary certificate requires taking 18 credits in gerontology-related classes in sociology, human development, biology, neuroscience, psychology and political science.
In the past five years, the program’s tiny enrollment has tripled to 24 students, said Jackie McReynolds, academic coordinator for WSU Vancouver’s Human Development Department.
“Historically, we’ve seen students want to work with children and don’t want to work with older adults,” McReynolds said. “More and more are open to it, as they are seeing the different settings where they can use gerontology, and the possible employment opportunities.”
Camas preschool teacher Maria Lattanzi, 53, is one of them. She is studying for a bachelor’s degree in human development with a minor in gerontology at WSU Vancouver. She plans to use the degree to transition from her career as a preschool teacher to a social worker.
“Americans are living longer and living healthier lives, and I want to be part of that,” Lattanzi said. “Because I’m a baby boomer, I want to be part of the movement of looking at aging differently as people who can make a difference in the world.”
Clark College offers programs for certified nursing assistants and home health care aides. The college offers two sections of a five-week nursing assistant class per term and plans to offer a third in the spring, said Kevin Kussman, Clark College’s associate vice president of corporate and continuing education. Each class has capacity for about 20 students. The college also offers four Fundamentals of Caregiving classes per year.
In January, the college will launch a program with required training for anyone who owns or operates a home health care facility.
Part of the growing demand for classes comes from increasing state training requirements for caregivers. Starting in January, caregivers are required to have 75 hours of training instead of 28.
“We aren’t prepared yet, but we all see (the need) coming and are trying to come up with solutions,” Kussman said.
Regional awareness about the need to serve the aging population also is increasing. Southwest Washington Workforce Development is part of a consortium of organizations that applied for a $4.7 million grant from the Department of Labor to pay for health care training. About $225,000 of that would go toward training 80 nurses in the Portland metro area, including Southwest Washington, in integrating care of older adults.
On Thursday, President Barack Obama announced a proposal to require that in-home caregivers receive federal minimum wage and overtime. Washington would be minimally impacted, as it already requires that caregivers receive minimum wage. Independent providers who are not paid by the state are not required to charge overtime.
“This is a statement by the most powerful man in the world that the work home care workers do is vitally important,” said Adam Glickman Flora, director of public affairs for the state Service Employees International Union. “We owe it to them to pay a living wage and stabilize the workforce.”
Although the economic downturn may have boosted enrollment in gerontology programs, the interest is still not enough, Bolkan said.
Nationally, there is one geriatrician per 2,600 people 75 and older, according to the American Geriatrics Society. By 2030, that is expected to reach 1-to-3,800, twice what is considered the acceptable ratio.
Finding solutions
Addressing the worker shortage will require a combination of incentives for going into gerontology and changes in perceptions about aging adults, experts say.
Government and higher education institutions need to offer more incentives for students to study gerontology, including more scholarships and fellowships, said Rowles of the Association for Gerontology in Higher Education.
Currently, the reverse is true. WSU Vancouver’s gerontology scholarship, which amounted to $500 to $1,200 for one student per year, ended this year because of lack of funding. Bolkan said the university would welcome donations to revive the scholarship.
Overcoming phobias about working with older adults is another hurdle. The phobia stems in part from living in an age-segregated society where older people and younger people rarely meet for social events, Bolkan said.
“We live in a society that is pretty anti-aging,” Bolkan said. “Think about the products that are aimed at fighting aging. There is a very negative stigma attached to getting old.”
Interacting with older people is the best way to cure that phobia, Bolkan said.
“They can tell you stories most people couldn’t tell you,” said Clark College student Rebecca Trent, 28, who has worked in an adult family home. “They can tell you how it was in the past, where they’re from. It’s like a form of college.”
Research shows that younger people tend to have a negative view of older people, Rowles said.
“But when you ask about their grandparents, their view is very positive,” he said.
That was true for Cobb, the Clark College nursing assistant student. Cobb said her close relationship with her grandmother, Pat Thompson, gives her a strong empathy for older people.
“Everyone needs some kind of relationship,” Cobb said. “I feel for (older people who are alone and sick). I’m the kind of person that wants to sit with them and hold their hand.”
Paris Achen: 360-735-4551; http://www.twitter.com/Col_Trends; http://www.facebook.com/ColTrends; paris.achen@columbian.com.
