Rebecca Mabe is the Senior Social Worker and the Supervisor for one of the three interdisciplinary outpatient teams for the Mental Health Service at the George E. Wahlen Department of Veterans Affairs Medical Center VA Salt Lake City Health Care System (VASLCHCS). She is also a Health and Aging Policy Fellow for 2015 – 2016. 

What is the Health and Aging Policy Fellows program and why did you choose to get involved?

The Health and Aging Policy Fellowship is a program that provides opportunities to professionals in the health and aging arena to develop and implement policies that affect older Americans. It is supported by the Atlantic Philanthropies and the Hartford foundation.

Why did you decide to work in the aging field?

I became excited about working with older Americans in graduate school. My mentors suggested branching out to develop skills in different populations while I was working at my first internship; a scholarship I was awarded to work with traumatized children and the new Christmas Box House program through Salt Lake County Youth Services. Because of this, I began to research opportunities to work with older veterans, as I come from a family of veterans, including my son. I fell in love with the population and realized that the mental health needs of the aging population were going unmet, and that I would need to develop an additional skill set to appropriately provide clinical social work skills to older adults.  At the time my university (the University of Utah) did not have training in geriatrics, so I applied to the school of Nursing.  I graduated with a Master’s degree in Clinical Social Work and a Master’s Certification in Geriatrics.  Since then I have not only worked in the field but experienced firsthand becoming a caregiver to my parents, who both became catastrophically disabled at the ages of 69 and 64.  Though I knew many of the programs and processes involved, obtaining the hands on caregiving experience of trying to keep my parents at home took a toll on my health and relationships, as I also had two of my three children at home at the time. Now, having placed my father in an assisted living facility and my mother in a long term care facility, my sister and I continue to struggle to ensure their care is appropriate and to obtain mental health care for my mother.

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

Not enough of our current health care (including mental health care) workforce is trained in the care of older adults, who will soon be greater than 20% of the overall population. From the clinical care  provided by professionals to hands on care provided to disabled and older adults impaired in their daily activities of living, these needs are greater than can be provided by the current workforce, even if they were trained to meet these needs effectively. Those who can provide the resources, and develop and implement this training, will also need to be fully informed about health needs of the older adult population, as well as  the ethical, political, and financial costs of not providing this training to the health care workforce.

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

The eldercare workforce is becoming increasingly strained in terms of federal, state, and local funding, but upcoming rule changes in Medicare and Medicaid will impact insurance providers and direct employers of the workforce.  This will hopefully raise wages, improve the quality of jobs, and increase professionalism in the field to draw more providers of care to this area.  Professional organizations and labor unions will continue to press for more state and federal support of this workforce.  Universities and colleges have also begun to look at ways they can increase training and education for the future workforce.  It will take all interested parties working together creatively to come up with financially-viable and evidence-based models of care, programs to support them, and training for implementers in order to create the future of the eldercare workforce.