Social Workers: Giving Voice, Navigating the System, Reclaiming Lives

"I think of my job as giving voice to people who have none," says Sherri, a social worker. As the former baby boomers turn 65, who will be there to assist a generation through a milestone?
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At age 86, Cleo L. is a survivor. She has outlived three children and her husband. She has beat back a drug addiction and remains clean and sober. She has been in and out of the hospital more times than she can count and, about as many times, has come down to her last dime.

Today, she lives in an apartment on Roosevelt Island and stays out of the hospital. She pays her bills on time and has even managed to save a little money. She has also, for the first time, gained peace of mind by planning for the future -- she's even organized pre-paid burial arrangements that include a plot beside her parents down South and a limousine to take her body to JFK Airport for the final flight home.

This turnaround is thanks in large part to Sherri Zabko, who has been called a miracle worker and an angel. But as far as she's concerned, she's just doing her job. Sherri is a social worker -- one of approximately 650,000 men and women across the country who are becoming known as the "unsung heroes" of our health care system -- connecting individuals and families in need to resources that create real change in real lives.

"I think of my job as giving voice to people who have none," says Sherri, who works for VNSNY CHOICE Health Plans, the managed long-term care plan offered by the Visiting Nurse Service of New York. Sherri's clients range in age from 55 to 102 years old and she is part of a coordinated care team that includes nurses, physical therapists and home health aides who work to ensure that each client lives with dignity and independence in their own home as long as they wish and safely can. As the Boomer population ages, managed care programs like our CHOICE Health Plan are fast becoming the way of the future. "I'm an advocate for people who don't know how to go through the system," Sherri says. "I help people break through the obstacles that could keep them from getting things done and help them negotiate to get what they need."

Needed: Social Workers for an Aging Population
This year marks the year Baby Boomers begin turning 65, a milestone that at once heralds an upcoming boom in the senior population and redefines what it means to get old. By 2030, one in five Americans -- or, 70 million -- will be over 65, more than double the numbers in 2000. The vast majority of these seniors will age in place, in their homes and/or in the community. Experts estimate that we are falling exponentially short of our current need for 60,000 to 70,000 social workers with an expertise in aging; just imagine what this might look like as we approach 2030. Clearly, social workers specializing in the needs of our aging population will continue to be in demand as this fast-growing profession expands to meet the needs of a generation defined by its hard-won independence.

Social workers like Sherri help seniors navigate their entitlement benefits; secure affordable housing; gain access to the physical and mental health care they need; manage their finances; find translators and transportation and connect to community resources such as senior centers, religious charities, or community centers that can empower and enrich their lives.

Many of Sherri's clients have very little in the way of family support and while some do have families nearby or at a distance, they need extra help navigating and accessing health care and community resources. In addition to assisting single Boomers, social workers can ease the burden for adult children who are looking after their aging parents. They can provide an array of services, from Meals on Wheels, to someone to help manage bills, to counseling for anxiety and depression.

When Sherri began working with Cleo in 2000, Cleo had just moved into stable housing after a life on the streets and was facing complex challenges, including significant physical and mental health issues and overwhelming debt. "She had no family, no support system and no back-up plan," says Sherri, who worked with credit card companies to reduce or eliminate debt and who visits Cleo once a month to help her pay bills and gain control of her finances. "I try to get her to live within her means, rather than buying on QVC for the instant gratification. For someone who's had no control of money her whole life, saving up to purchase something she wants is a new concept."

Many Cultures, Many Languages, Many Needs
In New York City, seniors -- particularly those from other cultures -- often find themselves aging alone in their apartments, limited in their mobility, estranged from their children, whether by proximity or by the younger generation's busy schedules and long work hours.

Johnny Hsu, a social worker with VNSNY, connects elderly Chinese-Americans to services by helping them translate and understand mail regarding their benefits, advocating for them if something goes wrong and helping them cut through the red tape that can accompany social services. The barriers may begin with language, but they don't end there. "Even though the HRA is trying to print benefit literature in Chinese, many of my clients grew up in a culture where they didn't go to school, so they don't read Chinese," he says. "Or they speak a different dialect. And even if they understand Chinese, they don't understand the system."

Government agencies often provide field translators, but for those who speak no English, the process of connecting to someone who speaks your language can be daunting. "There are so many options before you get to a representative who speaks Russian," says Luba Dvirts, a VNSNY social worker in Brooklyn who works with immigrants from the former Soviet Union. "So I'm always next to my clients when they make the call."

Social Worker Eva Rivera helps Spanish-speaking communities in the Bronx navigate not only the language barrier, but an even "stickier" obstacle as well: human nature, sometimes better known as procrastination. Eva's clients often know they need to recertify their Medicaid, keep meaning to complete a housing application, or need to find transportation to the doctor's office. But life intervenes. "They'll put things off, like we all do -- 'I'm going to do it tomorrow,' they tell me; or they need help with transportation, but they're preoccupied about how sick they feel," Eva says.

Isolation often follows immigration. Johnny provides counseling to seniors suffering from depression, an all-too-common outgrowth of aging, illness and isolation -- a condition that, for many of his clients, comes with a cultural stigma. "A lot of Chinese, especially that generation, don't want to go to a counselor or psychiatrist," he says. "They don't want to feel mentally ill." Day by day, week-by-week, he talks and listens, helping his clients with their benefit services, translating their mail, explaining their entitlements -- slowly, but surely, establishing and building up trust.

Johnny tells the story of one client, who, when they first met, was depressed, anxious, unable to sleep. "She worried a lot, about finances, about her children. She sat alone all day and just worried -- she was in bad shape," he recalls. "I went to her home and spent time with her, talked to her, helped take care of her needs and she started to trust me. Once someone starts to trust you, they'll listen to you." Eventually, Johnny's patient got counseling and some medication from a psychiatrist and things improved for her dramatically.

Shedding Pounds, Embracing the Future

One of Sherri's success-stories-in-progress is 74-year-old Janet, a Queensbridge widow whose serious chronic health problems -- including arthritis, cancer, obesity and depression -- kept her from leaving her apartment, which itself was a minefield of buckling floors and lack of adequate heating. Sherri helped connect Janet to a weight management program at Brookhaven, where she lost almost 100 pounds and has kept it off for almost a year. It was Janet who dubbed Sherri a "miracle worker."

"Before I met Sherri, I could barely make it to the bathroom," says Janet. "When I needed help, I'd bang on the walls to get my neighbor's attention. Sherri and her team have brought me back to life."

For those who are aging alone at home, depending on neighbors or family members may not be enough. If someone you know is becoming more and more isolated, if your your aging parents or spouse need more help than you are able to provide, ask a doctor about help from a social worker. Chances are, you'll soon be singing the praises of your own "miracle worker."

Have you been fortunate enough to find an unsung hero who changed your life, or the life of a loved one? Share your story below, or let us know if you have questions about how social workers might be helpful for your situation.

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