Q&A with Brett M. McReynolds

How did you decide to work in the aging field?

My entry-level job out of college was at Vanderbilt University Medical Center working in their cancer center.  It was a scheduler position, so I answered phone calls all day and scheduled appointments for about 85 different physicians.  I didn’t really know that I would get into the aging field until I started to learn more about the patient experience- be it insurance issues, accessibility to care, payment issues, etc.  I found out quickly that healthcare was complicated, and I wanted to learn more about it.  After I moved on from there and got a job at a hospice agency, it all started to click.  I learned about the importance of the interdisciplinary approach to healthcare at very difficult time in the patient’s life, and I knew I wanted to advocate for those that needed that kind of care and for those that were the caregivers during that time.  My work with two associations, one with long-term care and another with hospitals were essential in helping me understand the entire healthcare spectrum.  I hope this experience helps me advocate better for those that work in the aging field.

Why is the training of the health care workforce to care for older adults so important?

I remember I visited a one-day training on dementia caregiving at an assisted-living facility in my area.  I didn’t know what I was getting into, but before I knew it I had glasses on that blurred my vision, marbles in my shoes, gloves on my hands, and headphones that muted most of the outside world.  I was then asked to do some basic activities of daily living; put on a coat, walk into another room and sit down, and the most difficult task- feed myself.

They gave me two caregivers during this process.  The first was rushed and demanded that I hurry up and put on my coat because it was cold.  She proceeded to yell when I didn’t hear her the first time, and when it was time to eat started shoving food in my mouth before I knew what it was.  She pulled me in and out of the cafeteria with a brisk walk that made me feel like I was going to fall on my face.  It was, honestly, frightening.  The second caregiver was the opposite.  She spoke to me in louder tones, calmly.  She helped with my coat.  She explained what we were doing, what I was eating, and ultimately treated me like a person.

What I learned in that moment was that basic education and resources can change everything for the both the patient and the caregiver’s experience.  Most of us will become older adults, and perhaps selfishly, I want to be cared for appropriately when I get there.

What do you see as the future of the elder care workforce?

Great question.  The demand for increased value of care for more older adults with limited funding will drive innovation in the home setting. And while this might save money initially, it puts the burden of care on the family, making family caregivers one of the fastest growing caregiver groups in the nation.  With the complex medical needs of the older adult that likely has multiple comorbidities, family caregivers and the direct care workforce that work with them must become a top priority for funding at the national and local level.  My hope is that a focus on geriatric educational opportunities become a stronger national priority and that Medicaid is more heavily invested in, not cut or reworked.