Health Care and Aging: Fields of Opportunity
Begin with this premise: the Baby Boomers’ aging pushes a large portion of the population older. According to David Stevens, executive director of the Massachusetts Councils on Aging, in Massachusetts, this demographic currently accounts for about 20 percent of the state’s population—and by the end of the decade, will represent a quarter of the commonwealth. “Given that measure alone,” Stevens says, “it’s clear that a great deal of work specific to a population that is older, and is very often living longer than ever before, exists.”
Stevens does not mean to imply for a moment that the term “older adults” for people over 60 comes with a built-in connotation of frailty. On the contrary. there’s a wide range of needs under that umbrella. “People’s needs change over time,” he explains. “Fields that didn’t envision sub-specialties to cater to those changing needs for that growing population have to adapt. And at this point, we don’t have the workforce to meet the boomers’ needs.”
It’s no surprise that many of those jobs are and will be in the field of health care. Gerontology is a known medical specialty. Where the the population’s needs—and the more widespread employment opportunities—lie are in fields such as physical and occupational therapy and auxiliary health care provision: nurses, physicians’ assistants, social workers.
David Miller, dean of the School of Health Sciences and Rehabilitative Studies at Springfield College, works to ensure that the allied health professionals trained through Springfield College’s occupational therapy, physical therapy and physicians’ assistants programs are prepared to work with older adults. He emphasizes that graduates of the programs have little difficulty finding employment. He believes that his school’s graduates are well prepared for the workforce at least partly because of the school’s commitment to incorporating clinical experiences into the training process. This engagement begins on the campus. From “senior games” to a group that helps people exercise after suffering strokes, students have opportunities to experience clinical work early in their programs.
“The stroke group exercise classes offer a chance to teach and provide direct clinical supervision within the school setting for our students,” Miller points out. “They begin with learning to complete simple tasks. During intakes, they can learn to obtain medical histories, drug histories, and to take vital signs. Our students begin to understand the potential complexity some of these tasks may entail when a person’s life has been affected by stroke, as some people struggle with aphasia or mobility issues. Our students see the wide range of outcomes post-stroke. They also see how the exercise group can providecaregivers a small respite in what can be a very taxing duty, and thus begin to comprehend the enormity of that task.”
“As students progress through the PT program, they may use the group exercise class as an opportunity to look at movement patterns,” Miller adds. “We provide appropriate opportunities at varying points in their education.”
Both physical and occupational therapy offer robust employment opportunities; Miller cites a CNN statistic that placed occupational therapy tenth and physical therapy eighth as “top jobs.” It’s not just current job availability that makes these fields attractive; both are growing dramatically.
Joanie Simmons, associate professor of occupational therapy at Springfield College, cites the flexibility the field offers as having everything to do with the increased number of older adults in the population; predictions are for 35 percent growth. “The kinds of places our graduates tend to work are skilled nursing facilities, sub-acute rehabilitation facilities, such as Weldon, also home care and assisted living facilities,” she says. “There are expanded numbers of clients and places to work. … The leading reasons that someone needs our services are for rehabilitation after strokes, orthopedic issues—such as knee or hip replacements or hip fractures—or for assistance to make accommodations when coping with progressive disorders, ones like Alzheimer’s or dementia that affect cognitive skills and safety, or ones that affect physical skills and safety, such as Parkinson’s or arthritis. We also work with people adjusting to sensory losses, such as hearing or vision.”
Simmons explains that the occupational therapist’s job across this wide range of specific diagnoses is to focus on the day-to-day: from getting up and dressed on out, the OT works as a problem solver. “We help people to return to what they need and want to do during the day,” she says.
An example of this is a project partnering AAA, the AARP and the AOTA (American Occupational Therapists’ Association) called CarFit. The program does exactly what its name implies; it helps to ensure that people are physically well situated in their cars after an acute event or as someone’s physical status changes more gradually, such as losing physical stature over time.
There are two entry points to the occupational therapy programs at Springfield College, one for high school graduates interested in a bachelor’s degree and another for graduate students with bachelors’ degrees—often teachers or massage therapists interested in switching fields. The kinds of people who do well in the program are multi-faceted in terms of interests and skill sets. As Simmons says, “Occupational therapists have to be creative and crafty, and we have to work closely with people to teach them these skills that they used to take for granted. You need proficiency in the biological sciences, math, psychology and sociology, because mental health is integral to our field.”
Simmons and Kim Nowakowski, assistant professor of physical therapy and academic coordinator of clinical education at Springfield College, each enjoy seeing the students’ surprise when they discover that not every older person is sick or immobile. Nowakowski, a board certified specialist in geriatrics, describes how physical therapists’ work differs from occupational therapists’ work.
“Physical therapists address functional mobility, especially the mechanics of walking,” she explains. “Our work has a great deal to do with function: issues of mobility, mechanics, endurance and strengthening. We work with modifications from bracing and canes and walkers for individuals to home modifications such as ramps, rails and grab bars.”
Nowakowski says that a strong academic background is required. She emphasizes that all students learn to work with populations across the lifespan: “Because people are living longer, and living well with chronic issues, sometimes we find people whose first 20 years following a stroke were easier, and then, as becoming older is an additional factor, things get harder. There is a lot to learn.”
David Stevens describes the need to care for a large, aging population as an opportunity for communities to consider how to support people well. The ideal, he says, is “community-based care that keeps you at home or in an apartment, and in your world, with people of varied ages. You really don’t want to institutionalize people as they age if you can avoid it. A single solution doesn’t exist. You have to look at housing. You have to look at infrastructure and insurance and health care. You have to be creative.”
Part of the complexity has to do with the fact that aging is very different for different people. Simmons is careful to note this fact. She offers as an example an event hosted by Springfield College called Senior Games. This offers a chance for adults 55 and older to participate in track and field events.
“Students volunteer at the games,” she says, “and it’s amazing for them to see that older adults can compete in events like pole vaulting and the high jump. There’s a health promotion aspect to the games, which is the wave of the future.”•