Careers Working with the Elderly

In 1992, only one state (New York) reported the healthcare and social assistance sector as their largest employer. The rest of the country was dominated by manufacturing and retail jobs. By 2013, however, health care and social assistance was the biggest employer in 13 states. What changed? In short, people got older. Baby Boomers – those born in the 1940s and ‘50s – began to retire and experienced health challenges as they aged. As a result, millions of new jobs were needed to take care of this aging population.

Despite the huge numbers of people employed in elder care positions, demand for workers is still higher than supply. Five of the 10 fastest growing occupations from 2016 to 2026, according to projections by the Bureau of Labor Statistics, are in health care. Better yet, they’re at various skill levels. Those who enter the field today should have plenty of job security, especially as they build their skills and acquire new credentials to move up the career ladder.

The fastest growing jobs in the industry include both entry-level positions requiring minimal formal education, such as home health aides, and high-paying positions for master’s degree holders, like physician assistants. Those new to the field may find entry-level jobs provide a good opportunity for discovering whether they enjoy elder care.

The rules of old age are being rewritten. By roughly 2050, over 15 million people will be over the age of 85, according to the Association for Gerontology in Higher Education and The Gerontological Society of America. And they’re not all going to be in poor health. There are opportunities to work with both active and vulnerable seniors to help make their later years golden. And since the U.S. doesn’t have a blueprint for working with an older population, you can be a pioneer in crafting innovative programs and services.

There’s a lot more to working with the elderly than checking vital signs or being a home health aide. Recreational therapists use art, music and sports to improve the physical and emotional wellbeing of patients with disabilities or illnesses. Similarly, fitness trainers are increasingly marketing their services to the elderly. Fitness can be a great area to work in because many older people often have the time and money to dedicate to exercise, but their physical needs differ from those of young adults. But jobs aren’t restricted to health and fitness. As people live longer, their retirement incomes have to stretch further. Careers in the finance sector are becoming more specialized to accommodate seniors. Real estate agents also work with clients who need homes with elderly-friendly features, such as railings, ramps and easily-accessible showers. Members of the National Association of Senior Move Managers help clients downsize their possessions to move into smaller dwellings, such as retirement communities.

An estimated 48 million Americans suffer some degree of hearing loss, and unsurprisingly, older populations are more likely to need hearing aids. Audiologists examine patients with hearing problems.

Degrees/certificates that prepare you for this career: Doctorate in audiology, plus state licensure.

Something to think about: An audiologist needs four years of education beyond an undergraduate degree to earn a Doctor of Audiology (AuD).

Forty percent of nursing assistants work in nursing homes, where they take care of patients’ basic needs, including helping with bathing and eating, moving patients, and taking vital signs.

Degrees/certificates that prepare you for this career: State-approved program, plus certification through an exam.

Something to think about: Many elderly hospital patients cannot bathe or use the bathroom on their own. Certified nursing assistants must be prepared to deal with bodily fluids.

Since diets and lifestyles have changed from the meat and potato days of the ‘50s, many older people need nutritional advice to help them fight diabetes, cut their risk of stroke or just feel energetic in general.

Degrees/certificates that prepare you for this career: Bachelor’s degree in nutrition (some states require certification or registration).

Something to think about: Populations aren’t just getting older – they’re also becoming more diverse. Nutritionists must recommend foods that are culturally appropriate for their clients.

Fitness instructors lead group classes or provide personalized training to help people meet their health goals. Because many older people have limited physical movement compared to young adults, instructors working with older clients have to design unique routines that help their clients lose fat and/or gain strength and stamina safely.

Degrees/certificates that prepare you for this career: Certification from an organization such as the National Academy of Sports Medicine (NASM) or American Council on Exercise (ACE).

Something to think about: While top earners can pull in more than $70,000 a year, fitness training pays only a bit more than the national average. That said, extensive formal education isn’t always required, depending on the employer.

Social workers help people experiencing difficulties in their lives. In the healthcare setting, they often help elderly adjust to growing old, work with them to transition out of a hospital and form support groups to help them manage disease, disability or feelings of loneliness.

Degrees/certificates that prepare you for this career: Bachelor of Social Work (BSW); clinical social workers require a Master of Social Work (MSW).

Something to think about: Robin McHaelen, executive director of True Colors in Hartford, Connecticut, notes that “the range of responsibilities for social workers continues to grow exponentially.” There are diverse opportunities for growth, but the job can be very demanding so there’s a high risk of burnout.

Home health aides work in the homes of the elderly, where they assist with daily tasks like bathing, housekeeping, cooking and driving. In some states they also monitor health (e.g., taking temperature and pulse) and help clients take medications.

Degrees/certificates that prepare you for this career: Although home health aides typically only need a high school diploma or GED, attaining a certificate provides more routes for employment, as agencies that receive Medicare reimbursements require it.

Something to think about: The responsibilities of home health aides are somewhat like parenting. However, the pay is lower than other healthcare professions, so many home health aides work part-time work while they pursue a Certified Nursing Assistant (CNA) credential or another degree.

Fifty percent of LPNs/LVNs go on to work in nursing facilities or home healthcare, where they monitor their patients and help with basic care. Unlike CNAs, they play a role in administering basic health care, but under the direction of a doctor.

Degrees/certificates that prepare you for this career: Certificate or diploma and state licensure.

Something to think about: Practical/Vocational nursing is a good transition point on the way to becoming a registered nurse. But most will still have some overlap with CNAs.

Alzheimer’s, osteoporosis and cancer are all related to growing old. Medical researchers look for the causes of these diseases and work to develop therapies to treat them.

Degrees/certificates that prepare you for this career: PhD in biology or another life science.

Something to think about: Medical scientists may enter the field hoping to cure cancer, but individual clinical trials take years and lead to yet more clinical trials. Researchers should be prepared to spend years on incremental advances.

Occupational therapists work with people with injuries, disabilities or illnesses to improve their ability to function day-to-day. They develop individualized treatment plans with specific exercises or tasks that help the body recover, adapt or strengthen.

Degrees/certificates that prepare you for this career: Master’s degree in occupational therapy, plus state licensure.

Something to think about: Occupational therapists often work in hospitals and nursing homes, so they should be prepared to deal with bodily fluids. In outpatient settings, they might have to deal with wound care. Moreover, occupational therapists may find themselves working with patients who won’t improve, no matter how much therapy they get.

Patient advocates — many with a background in nursing or social work — help the elderly navigate the complicated healthcare and insurance industries. Patient navigators cover the same ground, but work within a hospital setting.

Degrees/certificates that prepare you for this career: The National Association of Healthcare Advocacy Consultants provides recommended credentials, but these aren’t necessarily required to work in the field. Although formal education isn’t required, some colleges do offer programs that are related to the career, such as Sarah Lawrence College.

Something to think about: Many seniors may not see the value of paying a consultant to help them with their healthcare and insurance concerns. And because patient advocacy is a relatively new field, wages are highly variable.

Like home health aides, personal care aides work with people in their homes, but they don’t do any medical tasks. Instead, they may keep their older clients company, cook and clean, and drive them places.

Degrees/certificates that prepare you for this career: High school diploma or equivalent.

Something to think about: Salaries are relatively low, but being a personal care aide can provide valuable experience and income for someone pursuing a CNA credential.

Like occupational therapists, physical therapists work with people who have injuries or disabilities. They tend to play a greater role in diagnosing problems but also get hands on in treating the underlying problem.

Degrees/certificates that prepare you for this career: Doctor of Physical Therapy, plus state licensure; physical therapist assistants need an associate degree.

Something to think about: Physical therapy can be both emotionally and physically demanding. PTs work with people with serious physical challenges. Work may involve lifting people out of wheelchairs, for example.

Recreational therapists move beyond physical wellbeing to address the emotional and social wellness of patients. When working with the elderly, recreational therapists plan activities to keep them engaged with their community – everything from bowling and hiking to chess tournaments and movie nights. Many also use physical therapy or counseling techniques.

Degrees/certificates that prepare you for this career: Bachelor’s in recreational therapy; some states require licensure, and most employers prefer employees to hold the Certified Therapeutic Recreation Specialist credential.

Something to think about: Recreational therapists spend a lot of time on their feet. After all, the goal is to keep people active.

Geriatric nurses monitor older patients’ health, administer treatment, perform tests and collaborate with doctors.

Degrees/certificates that prepare you for this career: Nursing diploma, associate degree in nursing or Bachelor of Science in nursing (BSN).

Something to think about: Many nurses work 12-hour shifts and have to care for multiple patients simultaneously. They must be on their feet all day and be able to shift gears from patient to patient.

Rehabilitation counselors help elderly clients manage the effects of diseases and disabilities. The role blends psychological counseling and support with advocacy and referrals.

Degrees/certificates that prepare you for this career: Master’s degree in rehabilitation counseling, plus state license.

Something to think about: The career is more a labor of love than a lucrative occupation. Rehab counselors who work in nursing facilities take home around $30,000 a year on average, which is below the U.S. average of $37,000.

Though best known for their work with children, speech therapists also work with elderly stroke survivors and people with Parkinson’s disease. They help patients strengthen the muscles used to swallow and may suggest ways of communicating without the spoken word.

Degrees/certificates that prepare you for this career: Master’s degree in speech-language pathology, plus state licensure or registration.

Something to think about: In many cases, speech-language pathologists are working with adult patients whose health is declining. Unlike kids, who want to communicate, older adults may not be motivated to do the work necessary to get them back to 100 percent. Moreover, older patients may lack social interactions that could help them practice what they learn in a session.