Career Perspectives: Working with seniors

As an person ages, their needs change. They require different health care, new opportunities for socialization, altered living accommodations. Over the coming years, young grads might find new and plentiful work opportunities in these areas.

Because our country is getting older. As of 2021, 1 in 5 Canadians was 65 or older, and the number of persons over 85 had doubled within 20 years.*

Today, we're listening in on a conversation between two alumni who know a lot about working with seniors. Tiffany Moraes is a Therapeutic Recreation grad who has worked in senior living for 12 years. And Rebekah Churchyard, a grad in Social Development Studies, works in home and community care support services. She's also the founder of social enterprise Green Care Farms, a program for people with dementia. Tiffany and Rebekah discuss how they ended up in this field, the challenges that come with it, and why they love working with seniors. Keep listening. 

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*Statistics Canada (2021): https://bit.ly/3g5LAiq

Transcript

Tiffany: I don’t know if I really got [to learn] more about you when we first chatted — about how you ended up in senior care.

Rebekah: Yeah, so I’m a social worker by education and by training. I specialized in gerontology in school, and have always specialized in gerontology, or older people. I think I’ve been destined for seniors care since the very beginning. When I was even a child, I would go home from church with older folks in our church, and I’ve always just  felt drawn to older people. I’ve been called an old soul many, many times for sure. I volunteered when I was a teenager in a few different day programs,  playing cards with people, doing some visiting services. Then I got some part-time jobs throughout university in long-term care, retirement homes — those sorts of roles. 

We had the opportunity to specialize in our programs, so in my first degree in the social development program at Renison, I chose to specialize in gerontology and psychology. Then I did a BSW, a bachelor of social work, and finally in my master’s I chose the specialization of gerontology. So I've always liked older people. Tthey're my people. They're so smart and funny and just real. Lots of realism. What about you? What was your journey like to seniors care?

Tiffany: So I can't say I always wanted to work with seniors, more because I don't think I realized the field was there. I was gung-ho on helping children or people with various needs, or even working with athletes. I took the therapeutic recreation and business double degree, and I don't even know what I was going into to be quite honest with you. I just made it work and I loved it.

I graduated, and like most people I was like, “What do I do now?” I was in that stunned phase and I fell upon working in long-term care. I have a great-grandma and grandma and grandpa. It'd be like hanging out with them, but a lot more of them. And that was 12 years ago. I've progressively moved from long-term care, to assisted living, to now retirement. 

The funny part is, I am also an old soul. My family constantly tells me that we could be anywhere in the world and I will instantly make a friend with the senior, whether it'd be to start up a conversation or help them carry a bag. So, I definitely connect with them quite well. 

Rebekah: Yeah, that's interesting. I forgot to mention that my grandparents.  I was also very close to my grandparents. So much of my motivation, or my feeling — I guess, sense of duty in a way too —came from my relationships with my grandparents. They lived on a farm and my grandpa was diagnosed with dementia quite young. So it was really interesting to go to school and learn about how health care and social care support somebody with dementia and the care partner. 

My grandparents lived on a farm in a rural setting. So my grandma and I would email almost every day, about all kinds of stuff, but certainly what was going on with my grandpa and she had questions about things that I was learning. So the close relationship with them really motivated me as well.

Tiffany: Absolutely. I think you'll find that a lot in the industry. You have the people that have that close relationship, who totally get it and want others to have that relationship. Or you have the ones that didn't have that relationship and have gotten into seniors care because they had this need they never actually realized they were missing. 

Rebekah: Yeah, that's a good point. Before this role that I'm in now, I used to manage an interagency friendly visiting service in downtown Toronto, and that's probably the number-one reason we had volunteers come to the program. Because they didn't have the connectivity with their grandparents they wish for. So they were looking for it in that volunteer space.

Tiffany: So tell me, you work with seniors, what do you love about it? Or what's your favorite part about it?

Rebekah: I think in the earlier days, I had a lot of satisfaction of doing good assessments, those sorts of things — like having good clinical acumen, saying things that made sense, and having the right sort of charting or scores that would resonate with what they need (or what a system thinks they need). 

I think now at this stage in my work, what I really like is being able to have a respectful engagement with the person across from me. It hopefully meets needs and wishes they have, which is super important to me. And I want to discern between what others think they might need and what they want for themselves. And that's a fundamental point of social work, right? To respond to the individual’s expressed needs and figure out how you can support them in achieving those aims. So, I like that I can have a respectful engagement with somebody and then I can share information — even if it's information they don't necessarily want to hear — in a way that is kind and consistent and informed. That's what I like the best, that relational piece. 

Tiffany: Remind me what you do. Who do you do all this for? 

Rebekah: I work for a level of provincial government where I do in-home assessments, usually for older adults, who live in a triangle of concerns: polypharmacy (prescribed with a number of different medications), cognitive impairment and mood disorder or mental illness (history or newer onset). 

So a lot of the people I see, they have a lot of pretty serious issues. And the acuity — which means how sick they are right now, today — how acute versus chronic the illnesses is, it’s usually pretty significant. A lot of the times they're quite stressed and family members are stressed and there's a lot of confusing things happening with brain changes and their behavior. And that's why I like being able to respect them and still share information about what they need. Tell me more about your role and what you like about it.

Tiffany: So I as I mentioned, I started in long-term care. I was what they call a recreation assistant. I think a recreation role has about 18 different names in our industry. So,, I went from being a recreation assistant to recreation manager, then assisted care and now I work in retirement independent living as a living well manager. All the same role, just so many different names for it across the board. 

I essentially plan our residents’ monthly calendar, their day-to-day activities, fitness, excursions and events. I absolutely love it.  

Since we've been younger, we have this misconception of what a senior is: they use a walker, they use a cane, they have to have white hair. They wear really big baggy clothes. They truth is, my seniors are sometimes — most of the time — more fashionable than I am. I have a whole slew of them currently that have this purple shade and their hair because it's super trendy. Honestly, they are just like you and I, they just have a lot more years of experience than us and could tell us how to run the show.

That's what I love. You are chatting with them. You're laughing with them. I mean, they'll make crude jokes with you. It's just like talking to your friends. And, like I said, they have a lot more years, generations of experience, on us and you can learn so much from them. For me, I really just enjoy what I do because of what I get from this. 

Rebekah: Yeah, I couldn't agree more about the wisdom. I mean, one of the things that they teach you in life course theory, in gerontology, is the timing and sequence of events. So as any of us age, we're trying to figure out: “This thing happened to me at this point in my life. What does that mean?” And usually we're so busy experiencing it and living our lives, we don't have a lot of opportunity to reflect. But I think older adults have that special characteristic, the wisdom that comes with time. And they feel, in my experience, that they need to share it with you. You know, parenting tips or fashion tips, what's classic versus trend, there's all kinds of different pieces. 

I couldn't agree with you more that they're just as diverse, funny, smart, observant as any sort of age. I think one thing that really stuck with me is the definition of ageism, which is discrimination based on age, whether that's too young or too old. So the assumption that someone can't or can do something because of their age. As a burgeoning professional in gerontology, understanding that really helped me. Because I'm so young. They're not going to take me seriously. But ageism is discrimination based on age either way. So I respect you, you respect me.

Tiffany: You just treat them like a person, you don't treat them like a child. They are respected. It's funny you say that about ageism because often here, things go misplaced and it's like, “Oh, you don't want to get to my age.” And I say, “I misplace things all the time. Have you never watched me walk down the hall, stop in my footsteps and be like, what did I come here for?” It has nothing to do with your age. It's just what's on your mind and ageism is totally a misconception that people don't actually understand. I'm glad you highlighted that.

Rebekah: Totally. Something it made me think of is that there are so many stressful transitions, which can stimulate a chaos. That will cause anybody to forget things, right? I was just thinking about how stressful it is when you first move out of your parents’ home and you go off to school and you're figuring out: Where am I going to live? Where am I going to buy my groceries? How am I gonna get to appointments? Those are actually very similar issues to what a person might think about later in life when they're downsizing or changing their living environment.

Tiffany: …Or they can't drive their car anymore. Absolutely, I totally get that or see that constantly. 

Rebekah: I think that definitely brings us to something that we were gonna touch on as well. What are some of the challenges in our sector? And I think one of them is bearing witness to what we call the cumulative loss. You probably came across this as well in you’re studies — it’s when you have multiple different types of loss as an older person. Changes in health care, your social situation. If your friends or family passed away, changes in your ability to do things. I think it can be very rewarding for someone to reflect back on their life and their accomplishments and their achievements. But it is a little sad too. And it's hard to observe that, to bear witness to that with people sometimes.

Tiffany: Absolutely. And this goes back to that whole wisdom piece. Like what do you say to someone that just recently lost their spouse, or their child? They've probably been through this so many times and all you can do is really console and comfort. You're not there to provide anything more, and it's sometimes tough because you want to do everything you can to make them feel better. That's definitely a challenge I have seen quite often. 

I think another challenge in the field, especially in retirement — actually let's just go with the senior living industry entirely, especially after the pandemic. We are seeing loss in numbers of employees. Unfortunately, and this is a systemic issue,  it’s not really a big paycheck that you get when working on the frontlines. At some point, working with seniors and the passion you get from your day-to-day, unfortunately doesn’t outweigh the amount of work that you're doing. 

There are masks and you're testing every day just to keep yourself, your family, residents or staff safe. I think that's one of the challenges we're currently seeing, to this day. I am not sure how it's going to change but there are a lot of special people out there who will deal with that challenge. At the end of the day they get to go home and they get some contentedness. They feel good about what they did for the day. And for them, that happiness balances out the paycheck, in a sense. I mean, you need what you need, but it balances it out to make your personal stress level low, which can help a lot mentally.

Rebekah: Definitely. I remember thinking earlier, when I was starting my career: “Well, that's so sad.” Because a lot of older people, they die, and I thought, “Oh, that's so sad.” 

But it's an extremely natural thing — as natural as birth is, so is then death right? I think one of the most rewarding things you can have as a professional in the in this sector is bearing witness to someone as they're living some of their last days. Having those conversations about, you know, what were the nuggets for you? What were the things that make life worth living? It really is an extraordinary honor to be with someone when they're in that stage. And most of my patients, my clients, they feel peace with it. It’s a really nice, special place. It's not all bad. It actually resolves something I think in me certainly. 

Tiffany: I think it actually puts life into perspective a little. So in my first job, I was what maybe 23, 24 and I was with a couple in long term care. We were celebrating their 65th or 67th anniversary together. I was so excited for them. But then I did some math and for anybody my age to be married 67 years, they would need to get married today and have to live till at least 100 to be able to reach that milestone. We see some milestones with seniors that I think a lot of people could never imagine. It's probably like people who see babies being born. But like you said, it comes with challenges and sometimes the journey to that moment, as I'm sure you see a bit more often than I do, can be very emotionally draining and exhausting for families or care providers.

Rebekah: Yeah, it can. There's a lot of acceptance, like an ongoing basis of constantly [asking], “What am I facing today?” Just living for the day, being present for the day, never knowing what's going to happen next. 

I’m heart focused and very, I hope, emotionally intuitive. But I think one of the more pragmatic things I’ve done was when thinking about what a good career is to join. I considered what sectors are going to be growing or booming, what type of industry is going to have good traction for a career. Some roles certainly don't pay a lot, but there's a lot of opportunity for growth when it comes to seniors care. People are living longer than they ever have before, right? Blown past 100 and still doing all kinds of things. So longevity is increasing, our aging population is growing. Folks who enter senior care will have a job for a very long time, should they choose to stay in that sector. I don't know what your thoughts are on that point?

Tiffany: You’re absolutely right. During the pandemic, while everybody was working from home or unfortunately getting laid off, I went into work for 365 days of the year. Because we couldn't just leave all our seniors here and work from home. It’s definitely is growing. It's still growing. We haven't even touched the boomers. 

Everything in life I do have to have some flow. Challenges have got to meet enjoyment. And I think that's where senior living, for me at least, fits in. So there is a lot of flow because I have this balanced lifestyle that I would have never learned about if I wasn't [working in this area]. 

Rebekah: I can I can relate to that. Because a lot of the times like when you're having those supportive conversations with someone, right, they're helpful for me. So I'm like, “What are you doing to take care of yourself? Be a little self-compassionate with that.” And then of course as you say that, if you're not walking the walk, no one's going to believe you. And older people see right through that in a heartbeat. They're like, “Okay, lady, you're full of crap. You're full of baloney.” It's like, oh well, I’ve got to practice what I preach.

Tiffany: Absolutely. Well, the joke around here is that I put fitness on the calendar every day. And I'm like, “I wouldn't get up at 10 o'clock to do fitness when I'm your age, let alone now. So if you don't want to show up, don't. I'm not here to force you to do it.” 

Rebekah: And it's such important work. I have so many clients in retirement living who their lives [revolve around] that schedule. Like they really do center most of their days, and a lot of their fulfillment and their friendships and relationships, around what's going on in the community. They really do follow that calendar very closely. It’s on their table, almost all of them, it’s on the table on their wall. It's important.

Tiffany: So I know we both have a bit of a business background. Care to share?

Rebekah: Sure, yeah. I do have a company, Green Care Farms, and it’s a social enterprise that provides an operational day program for people with dementia on a farm. There are thousands of this type of care model across Europe, particularly in the Netherlands. When my grandpa was going through his journey, we were trying to find appropriate programs for him, and we really struggled to find something that was nature-based, focused on outdoor engagement. Because he was an outdoors person, very much dedicated to nature and being outside, he didn't really like a lot of the indoor programs. So when I learned about this care model, I thought, how can I make this happen in Canada? And the most effective way so far, I think, has been to start a business. 

We had our first year of operation this summer. Probably my number-one gripe with social work is why don't we have accounting classes? We need a finance class. I remember so many social workers [saying], “I'm in social work, I don't do math.” Guess what: you probably will need to do math in some way, shape or form if you are in social work, whether that's budgeting or having financial discussions with people — whatever. 

Tiffany: Your personal budgeting as well. 

Rebekah: Oh, yeah, I mean, good luck in life if you don't budget. You need to at least have some wherewithal of what's going in and out, right? So what I did to build up some business acumen, because I really didn't have a lot of that for my degree…. Although funny, I didn't mention this before — I started out in a dual major, business and social work program. I took microeconomics and was terrified. So I dropped it. Dropped the double major and then came full circle after school. I wish I had stuck it out. I didn't. So, I took project management professional training. I took three courses before I wrote my Project Management Professional designation. That gave me enough business acumen to start the business. But what about yours?

Tiffany: So, I started with the double major. I did stick out microeconomics. Okay, it might just be the macro. We had the choice.

Rebekah: Well done.

Tiffany: And I finished with the double degree. So business and therapeutic recreation, and to be quite honest, that business portion absolutely gave you a different outlook on your day-to-day job. So yes, you're completely focused on your residents, or your clients, or whoever you're dealing with. But you also can see the business aspect of it, and how your actions can actually impact the business as a whole. To some people it's not interesting. To me, that was completely interesting because my family had a small business as well that I helped with, so it gave me a look at the other side. 

I actually just graduated in July from my MBA. I used all the downtime during COVID to create a higher education opportunity. So with that, I'm not really sure what's happening next. I always have a nice business idea in the back of my mind. And like I said, I do really enjoy what I do. So who knows, maybe I'll stay here and do something else on the side. Really, I have no clue at the moment, but I think that's where everybody is when they graduate from any program — undergrad, high school, higher education. And I think I've come to the terms that that's quite normal.

Rebekah: Oh, it's not normal to think you have everything figured out. You're immediately setting yourself up for disappointment when things don't go the way you thought, or when you have expectations that exceed what's possible. COVID is a great example that threw everybody for a huge loop. Similar to the comments that you're making about flow, I like that there's a balance between active and passive effort. It always makes me think about that gerontological life course theory because a lot of the timing and sequence of events in your life are wildly out of your control, like hugely. You could get hit by a bus, you have no control over that really. If there's a healthcare event or emergency in your personal family, or for yourself — there's all kinds of stuff that is hugely out of your control. So one of the things I like to think about… It's good to have dreams, to have goals, aspirations, professional development pursuits. But there's a balance between active effort, which is where you're diligently completing those applications and submitting them and signing up for things and doing work. And then there's passive effort, which is a quieter space in between all of those milestones. It allows for relationships to develop, or opportunities to present themselves. It allows for some personal sanity so that you have enough energy to respond to all those achievements. 

Tiffany: You're absolutely right. Because sometimes, you work, work, work, work work. But you're missing out on a few little things in your peripheral. As a young university student, I didn't really understand the healthcare industry. I did placements in high school. There were nurses, there were doctors. There were a bunch of other technicians in places. But recreaction therapy, social work, working with seniors — that was never on my radar. And in some ways, I wish someone was out there giving me the lists of thousands of jobs that I could possibly do. Because you don't think of healthcare as senior living, you don’t think beyond very much of the regular, typical medical terms or positions that are just rolling off your tongue.

Rebekah: I mean, age is not a disease in itself, which is where I think we went wrong, you know, “This person's got all these chronic health care issues. It's age related.” Aging is not a disease. I mean, that's somewhat contentious in some circles, but from my perspective, it's a natural process. 

I was totally the same as you in school. How all-encompassing or how widespread is seniors care? It's so nebulous. I learned so much — I'm sure you did too — about the different levels of government. Municipal, provincial, federal — they all have their own responsibilities. One of the difficulties right now when it comes to streaming funding at a provincial level is that we don't have a healthcare arm that encompasses seniors. They're very much focused on the body parts. So you have arm specialty, legs specialty, head specialty. You don't have a seniors care stream in itself, which makes it difficult to focus on that as a social and healthcare issue. 

So, what does government do at different levels? It does different things for seniors at all different levels. So you've got different designations for financial options, pensions, related things like that. For seniors, you also have different options for health care, like depending on their issue, and housing. So all of the big things are spread for all of us, but I think especially for seniors. It can be hard to navigate.

Tiffany: Oh, absolutely. I mean, I'm currently having an issue with transportation. And, I mean, housing is a huge issue. Just understanding the senior living industry. 

I hate to go back to COVID again, but I didn't actually realize how different parts of each government reflect back on us. Some will say one thing, but this part can say another. And one doesn't talk to the other. It's a huge minefield to understand and have a really fantastic advocate for all of us at the top.

Rebekah: I'm sure you read these articles, I do as well because they're interesting to our sector — future innovations in in aging, or what's coming up next for seniors care, things like that. Everyone is very excited about digital services, apps, devices, online health care, virtual care platforms — you name it. I am interested to see how this goes. If someone's looking at a career now, what might they select? I think there's a real opportunity for a hybrid with business UX and UI, so user interface and design professionals, people who have some computer acumen paired with seniors care acumen. That's one of the future trends. I don't know of you have thoughts on where you think careers might change. 

Tiffany: Actually, that’s something I have brewing in my head currently. But you see right now because seniors are aging, and they're living much longer, you have about 20 to 30 years of seniors that are embracing technology. I have people walking around here with their iWatches, and their FitBits, and using them regularly, probably more than I do. And then you have the other extreme, which is like, “Can we just do this on paper and pen? Why do we need to use the virtual presentation or sign up on an iPad?” We are definitely seeing this gap slowly encroach from technology-driven older adults just entering the industry. It is going to change. Definitely. It’s just a question of how well it will be adapted by the [tech-averse] seniors.

Rebekah: And that's where I really can appreciate the wisdom, and also the ability to choose. The ability to choose something that either they like or they don't like. I mean, that's why starting the farm was so important to me. Because a lot of older adults really used to thrive in an outdoor-based environment, or loved gardening, loved being outside, loved touching things with their fingers (especially earthy green things). It's such a soothing place, so good for our mental health. A lot of folks did not have access to that anymore. A lot of the interventions planned for them — sometimes digital — are not necessarily what meets their needs, and I found that to be quite sad. 

Tiffany: It’s the touch and the smell that you’re losing in that digital aspect. But, I mean, the way that the digital world is going, I’m sure that we’ll have something that will provide that sense of smell and touch eventually. Just not in the next few years, but it will come — just considering how quickly people are trying to get into this industry.

Rebekah: Right, or VR, virtual reality. Especially for our folks with dementia. It’s not necessarily safe, depending on what state. Yeah, I mean, there are so many opportunities. I think, probably what always resonates with me when I’m talking to students, and then mentoring, is just that we need all the ideas. We need all the passion and the smart thinking. We need it all for this sector.

Tiffany: There is no bad idea. That is absolutely true.

Rebekah: Yeah, no bad idea. There's enough of a population segment, there's enough of a market for everything to at least be tried and tested. And we certainly need more people in it. Similar to what you're saying before. A lot of my colleagues went into fields with children and that was very much what they were focused on. They knew from day-one, I'm interested in kids and working with kids, supporting kids. Kids are lovely, nothing against children. I love children too. But not as many people think that way about older adults. And I think that's a lot of the stigma we're still working on, even though you and I know that older folks are great. Many best friends that are older people, but you do too.

Tiffany: That’s very true. We don't think about them the same way that we would think about children, and it's not to make them synonymous. It's just more to understand that there are a generation of people just like children and teenagers and adults. And they have needs and wants just like you and I so

Rebekah: So it's a safe place to work and because there's so many people and opportunities. 

Tiffany: Oh yeah. And it’s definitely more fun than most people know.

Rebekah: Yeah, like you can have literally any career you could have and then specialize in seniors, whatever it is. You could teach, you could do health care, you could do finance, you could do law. Tons of jobs there….