The field of social work faces an urgent need to prepare its workforce for the upcoming surge in the population of Americans over the age of 65. Current predictions state that by 2060 the United States alone will have 98 million older adults, nearly double the current figure (U.S. Census Bureau, 2014). With greater longevity comes a greater need for specialized health and mental health services, such as those provided by social workers. By as soon as 2020, an estimated 70,000 additional social workers will be needed to provide services to the older adult population (Pace, 2014). Despite the growing demand, literature has repeatedly cited a shortage of social work professionals who choose to work with older adults (Bures, Toseland & Fortune, 2003; Lee, Damron-Rodriguez, Lawrance, & Volland, 2009; Wang & Chonody, 2013). While 5,000 new geriatric social workers are needed each year, only 1,071 master’s level social work students select gerontology as their concentration (Wang & Chonody, 2013). Furthermore, only 12% of licensed social workers identify aging as their primary area of practice (Lee et al., 2009).
Coupled with the challenge of enticing social work students to practice with older adults is the challenge of student debt burden. According to the Council on Social Work Education (2013), educational debt is increasing for social work students, with over 80% of master’s students owing an average of $26,600. The most recent data from the University of Texas at Austin School of Social Work (UTSSW) shows that 80% of students carry debt averaging $48,700 per student (Melecki, 2014). Facing average salaries around $40,000, this compromising situation prevents many students from choosing to pursue social work graduate education, further contributing to the shortage of professionals serving older adults (DiNitto Center for Career Services, 2015).
These dual challenges place pressure on graduate programs to develop innovative solutions to recruit and educate emerging geriatric social workers. The UTSSW has teamed up with a community foundation to focus on this mission. The Gerontology Resources and the Aging Community in Education (GRACE) Program is a field-based learning collaborative designed to increase social work students’ knowledge of and experience with older adults. In partnership with the St. David’s community foundation, the GRACE Program offers substantial financial support to students in field placements in geriatric settings as well as intensive educational and training opportunities for students, field instructors, alumni, and community members. By outlining the function, design and impact of the GRACE Program, this paper aims to provide a framework for other schools that may be interested in implementing similar models.
The UTSSW has provided specialized education and training in gerontological social work for many years. In Fall 2006, the school joined other social work programs in the Hartford Partnership Program in Aging Education or HPPAE (Bronstein et al., 2012), receiving funding for student fellowships, faculty development and curriculum infusion in gerontological social work. Between Spring 2006 and Spring 2009, 13 UT HPPAE students graduated and 8 reported securing employment working with older adults. Although funding for HPPAE ended in July 2009, the UTSSW built on its academic foundation and support from the practice community to create the GRACE Program. The program has grown in size and reach from 6 advanced concentration students in Spring 2009 to a total of 22 students in foundation field and advanced concentration placements in Spring 2016.
To continue offering student funding, a foundational component of the HPPAE, the school initially received a small grant from a local family foundation. When that funding ended, the UTSSW Dean’s office offered some student fellowships while the program coordinator sought a sustainable source of support. In the summer of 2011, the GRACE program coordinator reached out to the St. David’s Foundation (SDF), a local community health foundation with a strong commitment to aging and healthcare workforce development (St. David’s Foundation, 2016). With encouragement from the SDF, the program coordinator submitted a request for $20,000 for MSSW fellowships to help defray the cost of graduate school as well as support workforce growth. Since that first request in Fall 2012, the SDF has awarded a total of $500,000 to the GRACE Program. The relationship offers mutual benefits. SDF increases its presence at the university, positively impacts the health of the community’s older adults and meets their objective of increasing workforce development in the field of aging. The UTSSW benefits by channeling the SDF’s funding toward much-needed fellowships and educational opportunities to students to increase their interest in the working with older adults, as well as strengthening the community network of providers in aging.
A statement by the SDF program officer gives support to the strength of the relationship:
St. David’s Foundation is proud to support the GRACE fellowship program for many reasons. As the aging population of Central Texas grows at record levels, there is an increasing demand for social workers to provide high-quality services to older adults and their families. The GRACE Program provides specialty training of the highest caliber to address that need, while also reducing the loan burden of students as they begin successful careers in gerontology. (personal communication, January 25, 2016)
The funding from the SDF has allowed the GRACE Program to provide innovative programming and greatly increase its reach into the student body and the community at large.
A field agency earns designation as a GRACE placement if it serves primarily clients over the age of 60 and has a programmatic focus on issues such as aging, physical healthcare and end of life. The program coordinator brings new GRACE placements on board in collaboration with the field clinical faculty, the Office of Field Education and the school committee responsible for screening new field sites. An average of four new GRACE placement options have been added each year, many in emerging practice areas such as a “virtual village”, assisted living dementia care, geriatric care management, and early onset memory loss programs. Exposure to innovative programming in aging is critical to attract students to the field.
GRACE Program field instructors meet twice per semester with the program coordinator to provide input on program direction and to plan enrichment events for GRACE students. The program coordinator strengthens relationships between the school and the field sites by serving as faculty liaison for GRACE students. This role involves mentoring and teaching students in the GRACE Program, visiting them in their field placements throughout the year, communicating with field instructors about their progress and acting as a bridge between student and agency.
Student fellowships are a key component of the GRACE Program. The Foundation has increased its commitment to impactful awards to fulfill its mission of addressing the healthcare workforce gap and decreasing students’ overwhelming debt. Fellowships in the amount of $7500 per student are awarded following a competitive application process.
Throughout the school year, the GRACE Program hosts at least six educational enrichment events to expose students to critical issues and innovative approaches to geriatric social work practice. In the 2015-2016 academic year, enrichment topics included Medicaid/Medicare 101, elder mediation, social work practice with people with dementia and aging in the Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) community. SDF GRACE Fellowship recipients are required to attend a specific number of these events as a condition of their financial award. The academic year’s events culminate in the annual Gerontology Resources Symposium, which is planned in collaboration with the UTSSW’s Office of Professional Development and the community-based Aging Services Council. This daylong symposium brings students in contact with a wide variety of professionals serving older adults to learn together about topics in aging. The 2016 symposium focused on aging and sexuality, with the afternoon devoted to ethical issues in sexuality and long-term care with people with dementia.
Competitively selected GRACE students also have the opportunity to attend the Aging in America Conference, the American Society on Aging’s annual gathering of professionals in aging. Funds from the SDF provide students, the program coordinator and one field instructor an all-expenses paid trip to participate in this prestigious conference. Students get first-hand experience with national issues and “thought leaders” in the field of aging, connecting with new service delivery models and opening their minds to ways they can contribute to the field.
By 2014, the program coordinator noticed that many GRACE Program alumni consistently attended the GRACE educational events, leading her to create the GRACE Graduates Network. Initially formed using LinkedIn, this network gives alumni a way to maintain connections to each other, the GRACE Program and the UTSSW. The program coordinator uses the network to organize social gatherings, mentoring events, and continuing education for alumni. Keeping GRACE alumni involved in the program throughout their careers also increases the likelihood that they will become field instructors for future GRACE students.
Since its start seven years ago, a total of 113 students have completed internships in GRACE placements; of that total 14 have completed two GRACE placements. Thirty-six educational enrichment events have been held, with the average attendance increasing from fewer than 10 people to over 25 at each event. The program’s impact can be seen on the field program, students, and larger community.
Impact on the Field Education Program
As mentioned above, the UTSSW field education program continues to expand as new GRACE placements are added each year. Since the program began, a total of 25 new GRACE internship sites have been approved. As GRACE graduates begin working in geriatrics, they create and deepen agency connections with the UTSSW; as of Fall 2016, more than 30 professional social workers have served as GRACE Program field instructors. Significantly, four recent graduates currently serve as field instructors at GRACE internships. This continual “seeding” of the aging services field in our community stands as a noteworthy program outcome.
Impact on Students
The GRACE Program utilizes the graduate employment survey conducted by the UTSSW’s career center each year as one measurement of outcome data. According to the most recent published survey, five percent of students reported accepting a job in the field aging. While this figure appears small, it represents a significant increase from the two percent reported in 2011. Furthermore, it does not account for the 13% of students who reported working in healthcare and hospice, settings that also serve a significant population of older adults (DiNitto Center for Career Services, 2015).
A student satisfaction survey administered at internship’s end also documents success. Data from the 2014-2015 academic year shows that the program positively impacts students’ interest in and knowledge about working with older adults. Fully 100% of the survey respondents indicated that since receiving funding, their interest in gerontology has increased. Furthermore, all students reported that the GRACE Program educational events increased their skills and knowledge about working with older clients. On the comment section of this survey, students repeatedly share their positive experiences with the program. One student responded:
I originally was not interested at all in working with older adults when I entered the MSSW program. But after trying a GRACE program placement for my final field internship, attending the GRACE events, receiving the GRACE Fellowship, and having the opportunity to attend the 2016 AiA [Aging in America] conference, my outlook has changed dramatically. My knowledge of the many issues older adults face increased significantly. I am now definitely applying for jobs that work with older adults after I graduate and I am grateful for this experience.
Finally, the GRACE Program measures success through its impact on relieving student debt. As part of its social justice mission, the program seeks to help students avoid the compromising situation of graduating with a crushing loan burden. As a public institution, the UTSSW faces limitations on how many scholarships and grants it can award, so partnering with a community organization such as SDF brings significant financial benefits to students. Every dollar from a fellowship reduces the number of dollars students must repay as emerging professionals.
Impact on the Community
On the community level, the GRACE Program aims to increase knowledge of, interest in and involvement with older adults. The program coordinator constantly seeks creative ways to engage the community. For example, in the spring of 2015, the program coordinator worked with local aging services providers to screen a documentary on sexuality and aging at a local theater as a GRACE educational event. The community responded by packing the theater and staying for an hour afterwards to engage in dialogue about sexuality and aging. This sold-out event built significant interest in that spring’s symposium on sexuality in the lives of older adults.
Another way the GRACE Program impacts the community at large is through the seeds planted by its students and graduates. As students complete their final placement or graduate and enter the field, they bring expertise, knowledge and creativity to their agencies. This can lead to the creation of new programs that improve care of older adults. For example, one student expressed his concerns about the staff’s lack of awareness of LGBTQ issues facing the older adult clients at his field placement at a local psychiatric hospital. His field instructor encouraged him to train his fellow staff people on realities faced by this population in aging. At the end of his internship, the student was hired on at the hospital and now acts as a resource on LGBTQ issues. By inspiring agencies to expand and develop their programs in this way, GRACE graduates open up further internship opportunities for students and contribute to program growth.
One of the biggest challenges facing the GRACE Program is the constant flux of field internships as field instructors leave agencies and programs shift areas of focus. Striving to keep the quality of all placements while ensuring that students have enough options requires ongoing effort and outreach. The program coordinator continually seeks out new placement sites, including those that are not explicitly in aging services but which serve an aging population or work with related issues. She also leverages her participation on the Community Partnership Development Committee, which recruits and vets new placements, to steer interest toward placements in geriatrics.
Another ongoing challenge is recruiting potential GRACE candidates from the incoming and current student body. Many social work students do not indicate a preference for working with older adults. Therefore, it is important to reach out to students, faculty, and the social work community at large to spread the news about GRACE Program training offerings and financial incentives. The program coordinator captures many students’ interest by representing the program at the final field agency fair and continually seeking opportunities to feature student stories on the UTSSW website and other media outlets. In the 2015-2016 academic year, GRACE Program students were profiled in three website stories and in a number of UTSSW social media posts.
Areas for Growth
The UTSSW is committed to continuous improvement of the GRACE Program. One possible area of growth is to include BSW students as well, piquing interest in geriatrics as early as possible in students’ career trajectories. More fellowship funding and interested field agencies are needed before this expansion can be made. Another goal is to engage a doctoral student to do outcome research on the GRACE Program.
Given the swiftly rising population of older adults in the United States, the workforce gap in the field of geriatric social work cannot be overlooked. Well-trained and competent social workers are urgently needed to help address the complex array of issues that can arise with aging. Schools of social work are uniquely positioned to help fill this gap by recruiting and preparing students to work with the older adult population. Research shows that having clinical experience with older adults is the most predictive factor for choosing a career in gerontology (Chippendale, 2015; Koder & Helmes, 2008; Wang & Chonody, 2013). Field education programs such as GRACE are one way to introduce students to these experiences as they set out on their career paths.
This article aims to inspire other schools to work with community organizations to create similar programs. Additional sources of funding can be leveraged in collaboration with family, corporate or community foundations. The local philanthropy community may respond to inquiries on finding a shared mission related to healthy aging and workforce development. Through these mutually beneficial partnerships, organizations make positive impacts on the community while social work students are introduced to the rewards of geriatric social work. By thinking collaboratively and innovatively, schools of social work have the opportunity to stand at the forefront of bridging the workforce gap to better serve older adults.
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