Wednesday, March 31, 2010

Karisha networking - Blogs, Newspapers, Brief Reports, Websites ...

I know that I will change careers many times in my life just as you will. One major thing that has changed for me & you is that my next job will not be determined by the health care that I can receive. You can now follow your dreams with out the extra concerns!
I have continued to follow my interests in other ways besides my career. You should do the same to keep narrowing down on your talents and spreading the word about what you can offer as a gerontologist.

A few ways I network:
I wrote my thesis on an interest of mine (that made it a lot more fun to complete)
Check it out on a website that I like to chat and see what is new in the field
Creating Aging Friendly Communities .

I also write anything I can related to aging in place, universal design, livable communities, interior design, architecture, products and of course relate it to gerontology. You have to put effort into networking and that does not stop because you have a job.

Another way I have tapped into my interest is through a blog called Homebody.
Homebody
It is a blog that shows people how they can have stylish and functional homes. You really need to check it out.

Here is a brief report I co authored:
Scripps Gerontology Center Brief Report
Livable Communities: Helping Older Ohians Live Independent and Fulfilling Lives

Below is an article in the local paper about my thesis project



I am also a member of Linkedin. This web based networking is like the career related facebook where you post your resume and interests.

At this time I can not afford to attend conferences with out the student rate so
I am always looking for new ways to network. If you have any ideas please let me know!

Note: Always be true to yourself and treat people the way you want to be treated
Send a thank you note (not an email or text but a hard copy card)to each person that has helped you along your journey and your kindness will be repaid in untold ways in the future.

Case Managers working with Contractors- Karisha

When I first started working as a case manager I agreed to help my supervisors create a training binder for all case managers. As I learned something new I wrote it down anyway and put it into a binder as a reference for everyone else. This helped everyone compile needed information in one spot and to create new documents where there were none. For example, it was very confusing for the case manager to work with the contractors when doing home modifications because our relationship is different than if the contractor was working for the client private pay. I created the documents below to help the contractors understand the role of the case manager and they all appreciate having this.

Environmental Modification Guidelines for Contractor and Case Manager/ Client
1. Determine client need for environmental modification
2. Case manage contact the doctor to have a script written stating the need for the environmental modification
3. Client to choose 3 contractors from the Pick List and put them in order by choice.
4. Case manager determines the needs of the client and with the clients input decides on the design of the construction to be done.
5. Case manager calls contractor asking to send information to their business if they are interested in the environmental modification job
6. Case manager sends a fax including
o Drawing outlined by the case manager and client
o Check list of what to bid on
o Case managers responsibilities and contact information
7. All contractors are to bid on the same job/materials needed to complete the home modification


Contract between Case manager and contractor

I __________ agree to communication with the case manager ___________________ who is representing the needs of the client _____________. I understand that no deviations from the drawing presented for the bid can be made unless discussed in detail with the case manager. All bids that do not follow these guidelines will be dismissed from the bidding process. All communication from the contractor is to go through the case manager and will be discussed with the client. I understand that all code requirements and permits are the responsibility of the contractor that bid the job through Area 9 Agency. If any sub contractors are working under the main contractor the contactor signing this agreement is held responsible. A satisfaction release form will be signed by the client.


Name:_________________________ Date:______________________________

By signing below you acknowledge that you have read and understand the relationship between the client, case manager and contractor.

1. Case Manger will assess individual and determining need for service and environmental modifications
2. Case Manager will develop Plan of Care
3. Case Manager will be determining the cost effectiveness of environmental modification
4. Case Manager will ensure use of Person Centered Planning in having the environmental modification fit the needs of the individual being serviced
5. Client and Case Manager will determine the environmental modification that will be done
6. Case manager will submit one drawing to the 3 selected contractors
7. No deviations are to be made from the drawing by the client or contractor
8. Case manager is acting as the advocate between the client and contractor
9. No additions by the client or contractor to the environmental modification are to be made after the construction has started unless discussed with the case manager
10. Any additional construction being done to the home must be completed separately from the approved bid.
11. Case manager and supervisors will be reviewing all bids from contractors and selecting one to complete work
12. Case Manager will be explaining to client services that will be provided
13. Case Manager will be supervising implementation of construction for the client
14. Case Manager will be advocating on behalf of the clients’ interests and having all decision making communication with contractors
15. Case Manager will be monitoring the quality of HCBS and ensuring that POC objectives are being met
16. Case Manager will be performing record keeping of all construction activity
17. Case Manager will reassess POC to determine need for additional modifications
18. Case Manage and contractor will ensure confidentiality of individual information
19. Case Manager and contractor will maintain the highest professional and ethical standards

Client ___________________________________________ Date: ___________
Case Manager:_____________________________________ Date:____________
Contractor:_________________________________________ Date:___________

Salary and Benefits for Case Managers

Oh I almost forgot the niddy griddy:

Case Manager salaries range from $25,000- 40,000
Supervisors $35,000 - 45,000
Administrators $45,000- 65,000

I work for a University so I have really good health care benefits and 6 weeks of vacation a year.

I have the opportunity to attend lots and lots of continuing education seminars ranging from domestic violence training, eating healthy, wheelchair evaluations, dealing with difficult clients, elder fraud and abuse...

The best part of my job is the flexibility. I work 40 hours a week. We are not allowed to go into overtime. If I have a late visit with a client I leave early on Friday or come in late the next day. I independently monitor my hours and can work out during my lunch break or not take one and go home early.
I would not want it any other way.

Friday, March 26, 2010

Karisha explains how to do a wheelchair ramp

This is an example of a ramp drawing. If the modification is over $1,000 the cm has to obtain 3 bids from separate contractors. I have found the more detailed and accurate the drawing is the easier it is to communicate with them and the quicker you get their bid back.

Thursday, March 25, 2010

How a mentor can help you find a job- CM Karisha

Check out this Podcast about mentoring.

Having a mentor can help guide you in your career search. I have had several mentors help me on my career journal and when I switched paths I ended the mentor relationships in that field and built new ones to help me find my way. I am currently thinking about doing the national home builders association kitchen and bath design courses to become a certified bathroom and kitchen designer and I will be searching for a mentor to take me to the next level in my career.

Do you have a mentor?
Joining an organization like OAGE can help connect you with the right dependable professionals in the field of aging.

Karisha and Environmental Modifications

One of the favorite parts of my job are the home modifications. Each client that is on Medicaid has a life time cap allowance to have modifications done to their home to meet their needs. Most of the modifications case managers do are bathroom modifications, widening doorways and ramps.

These are need based modifications that need to be authorized by the state (because the state aka tax payers are paying for them)

Authorization of Environmental Modifications
A. Environmental modifications are minor physical adaptations to the home, as required by the individual’s Plan of Care/Cost Comparison Budget (POC/CCB), which are necessary to ensure the health, welfare and safety of the individual, which enable the individual to function with greater independence in the home, and without which the individual would require institutionalization.

Purpose of environmental modification:
• Necessary
• Access
• Function as independently as possible in home

B. A lifetime cap of $15,000 is available for environmental modifications. The cap represents a cost for basic modification of an individual’s home for accessibility and safety and accommodates the individual’s needs for housing modifications. The cost of an environmental modification includes all material, equipment, labor, and permits to complete the project. No parts of an environmental modification may be billed separately as part of any other service category (e.g. Specialized Medical Equipment). In addition to the $15,000 lifetime cap, $500 is allowable annually for the repair, replacement, or adjustment to an existing environment modification that was funded by a Home and Community Based Services (HCBS) waiver.
Cost:
• Material
• Equipment
• Labor
• Permits

Permit requirements to be determined by contractor depending on location and scope of job.

Here are some of the things I look at when I assess the client for their modification-

Environmental Safety
• Antiscald devices
• Hand held shower head
• Grab bars for bathroom
• Can remove
o Tub
o Toilet
o Sink
• Can install
o Roll in shower
o Grab bars
o ADA toilet
o Wall mounted sink
• Can install
o Floor if necessary
• Widen doors for access
• Completion of the medication, painting, wall coverings, door trim, flooring etc.. will be matched to the degree possible to the previous color/ style/ design

Wednesday, March 24, 2010

Incident Reporting by Case Manager Karisha

A Case Manager monitors and assesses ongoing services in the home. We also "monitor" what is going on with the client and anything out of the ordinary is to be reported to the case manager. If an incident occurs the person (aide, home maker, meals delivery) that discovers the incident has to report it with in 24 hours of the incident. Since the case manager has a history of the client we get to do the incident report follow ups. Our case notes are entered into a system that allows all the other case managers, supervisor in all offices and the state to review.

It is especially important to have a history of case notes when an incident report is made. When something happens to the clients such as theft, fall, or nursing home placement an incident report must be made to the state for review.
The following information must be added:

Cite the date
Identify the people and relationship
Identify the type of contact – face to face, phone conversation, etc.
Describe the event
Recount the transaction
Demonstrate how the contact relates to the ISP
Describe how the issue was resolved and/or next steps



Incident Example:

03/22/2010
Case Manager went to clients home on 3/22/10. While visiting the cm noticed a large bruise on clients right arm. Client is an 89 year old female with hypertension, diabetes, macular degeneration and amputation of both legs. Client lives in a one bedroom apartment with her daughter and her autistic 8 year old. The client said that her LPN dropped her while getting out of the bath tub a couple of days ago. The client did not want the LPN to get in trouble so she did not tell anyone. The home was neat and clean. The client was dressed in clean clothes and had good personal hygiene. CM followed up with unit manager at Sunshine Valley Care and Nurse Suzy will speak with LPN Brandy today at 2:00pm. CM will follow up with client and Nurse Suzy for further information regarding incident.


Follow up:
Nurse Suzy followed up with LPN Brandy on 3/22/10. Brandy said the bruise was on clients arm already when she came to give her a bath. Brandy asked client about bruise and client said she hit it on the kitchen door. Brandy noted that client has had other bruises on her body during the last 3 months but did not know she had to report it because the client told her not to. CM contacted Adult Protective Services to report bruising. APS went into the home on 3/25/10.

Follow up required in 7 days
Follow up 2: 3/28/10
Case manager followed up with APS on 3/25/10. Client was very hesitant and fearful to admit that daughter does "push her around". Client does not want to leave her home. Nurse Suzy has educated LPN on signs of abuse and how/when to report an incident. Case Manager has added respite hours for the daughter to get away and have some time to herself. The client is not pressing any charges against the daughter. The daughter has agreed to attend a caregiver workshop to help her deal with caring for her mother.

4/15/10 Case closed


All follow ups are required to be filed by the cm. The first person to see the incident is to be the first to report. Since the cm only goes into the home every 3 months we do not do all the initial reports but have to follow up on all the reports made for our clients.

Tuesday, March 23, 2010

How to do an eligibility screening- Case Manager- Karisha

When a case manager goes into the home (after receiving a referral and on all visits) they are checking to see if the client is still eligible. A lot of what you learn in your biology, sociology and psychology classes comes in handy for your assessment of the client. Going through the gerontology program allows you to analyze the client on a different level than someone with out your extensive background.
Here is an Eligibility Screen check list:
INFORMATION TO INCLUDE
• DATE
• Reason for visit
• Travel

S.O.A.P.S – SUBJECTIVE
What the client says
Ex: I have been fine and do my own bathing and meal preparation

O – OBJECTIVEWhat you see (appearance, cleanliness, visually, smell…)
Ex: The client does not look like she has bathed in weeks, there is food on her clothes and the countertops and tables are cluttered with paper, food and bills.

A – ASSESSMENTFacts
Ex: The client is in a wheelchair and can not bend to clean the kitchen floor

P – PLANWhat the case manger is going to do about it
Ex: The case manager may suggest homemaker, personal attendant and bill payer assistance

Back up Plan – 911

CCB:
• Call Provider and check PA hours
• Call Provider and have them fax 485 orders for their PA
• Call Provider and check number of hours being provided

Here is an example of how you will be thinking

Problem:
87 year old, female diagnosed with

Goal:
Provide case management to monitor and assess ongoing services
Care being provided
Ex: continue respite care for 12 hrs for ______

Objective:
To keep client at home in a safe and feasible home environment and as independent as possible

Monday, March 22, 2010

What to do when ? Case Manager- Karisha

I spend my day either visiting clients in their homes or at my desk typing up the notes about the visit.

This is the process in how the clients obtain services and keep them updated.

1. Referral from client
(call in or in person)
2. Referral directed to Supervisor
(depending on the service projected to receive)
3. Case manager is assigned referral

Client’s needs are going to determine the steps to follow first
A. Referral – stay in home transition- NH, hospital to bring home

B. On Medicaid Not on Medicaid

1. Phone: Call client to see if they are interested in services
2. Home visit
a. Assessment
b. Eligibility Screen (Will post details later)
c. Application (Medicaid)
d. Application for LTC services Check list of client needs
e. Doctors certification 450B
3. Provider list (client chooses who they want to provide them with the services they need )

Follow up with Client:
1. Quarterly
2. 60 day Assessment
3. Quarterly
4. Annual (reassessment)

That is the basics of how the case manager and the client work together. We see each other every 90 days. I have around 60 clients right now so I go on at least 5-10 home visits a week and then do extensive write-ups to the state to justify that they still quality for services.
Obviously, the home visits are my favorite part vs. the documentation.

Sunday, March 21, 2010

Case manager Karisha shows a bathroom modification


Can you detect all the changes?

This is an example of what a bathroom modification would look like to meet a clients needs. This is a typical modification for a client that is frail. I switched out the tub for a roll in shower, rearranged the sink and widened the doorway to accommodate the walker currently using and wheelchair in the future. Also, non slip floors were added and grab bars on the toilet. Each house is unique and usually does not have a lot of space to work with. Also, each clients need is unique. One client may not be able to use their left arm and will need extra grab bars that would be used by their right arm only.
Another example would be someone who is a total assist (can not use a their arms or legs to use a bathroom) and so they would never use a grab bar but would utilize a ceiling lift.
As I said before the modifications are my favorite part of my job. The design is based on the clients needs so your gerontological knowledge comes in real handy. The products are endless but the budget is not so you have to be thrifty in reusing supplies if you can and picking out products that stick to the budget.

A Typical Work Day for Joanna

As an Engage Life Director, I plan all sorts of programs and activities for residents at Atria Merrimack Place and have three assistants as well as some volunteers to help me! My main responsibility is to plan each monthly activity/event calendar two months in advance in order to ensure I can get colored copies of my calendar printed and delivered to my building prior to the actual month beginning. For example, on April 1st, I will be starting to solidify and confirm all the activities/events/programs (as well as my personal and staff schedule/work hours) for the month of June! Planning this far in advance was a little challenging for me to do at first, but now it's just second nature. To see one of my most recent monthly calendars, go to my community's website and click on "Community Calendar" on the right side: http://www.atriaseniorliving.com/community.aspx?id=1590

This is a job where I (as well as my staff) do not spend most of my (our) time sitting in an office staring at a computer and answering/receiving phone calls and e-mails. Instead, I get to wear many different hats: department manager, exercise instructor, bar tender/waitress, educator, art teacher, photographer, videographer, van driver, counselor, decorator, gardener, computer technician, receptionist, dancer, caregiver, shopper, event planner, tour guide, etc. It's nice because to me my job is fun, rewarding, and dynamic. No day of the week is ever the same. I can honestly say that I never get bored when I'm at work. My building always has activities going on, even on weekends and evenings. My staff and I rotate working the weekends. Being flexible with my work schedule is an important and helpful aspect with this type of work, as special events/parties and emergencies do arise. Emergencies include power outages, floods, fires, evacuations, etc. Sometimes, my staff and I end up helping our other "sister" Atria communities with transportation (we have a 14-seat van) when they experience emergencies.

Below is an example of a typical activity schedule for one day:
9:30 Exercise Class: Weights!
10:00 Play Wii Tennis
10:00 Board Game with Adam
10:15 Shopping Trip: Walmart in NH
11:00 Word Game
11:00 Choral Group
10:30 Store Cart
11:30 & 12:45 Dinner
1:30 Bridge Group
1:45 Communion & Rosary w/ Joe
2:30 Scott Entertains: Piano & Singing!
3:15 Happy Hour
4:15 Trivia
4:30 & 5:45 Supper
6:45 Evening Fireside Chat
7:00 Movie Night
7:00 Card Games

It's important to note that my staff and I are the ones responsible for both setting up and cleaning up all of the activities listed above. And, more importantly, to make sure the activities start on time!! (If you want happy seniors, then you must always start on time, otherwise you may be sorry!) Sometimes it is necessary for my staff and I to remind some residents about events or even recruit residents in order to promote a specific or new activity. Whenever there's a new resident, I take the time to interview them in order to get to know their history and interest/recreation background. Then, I have to see if we currently offer activities/programs that meet this resident's interests, and if we do not, then I have to think creatively and make sure this happens. I need to make sure that there is something for everyone, so our residents can be happily engaged in life at our community.

Friday, March 19, 2010

Introduction from Joanna

Interestingly, I found my way into the field of aging via psychology. I had a very good and inspirational psychology/behavior science teacher in high school who motivated me to start out as a psychology major in college. Because psychology is such a big field, I wanted to narrow it down to at least the population that I wanted to work with. I read a few books about careers in psychology and that's when I read about the Gerontologist. Right away I knew this was it for me! Soon after this discovery, I decided to change my major to Gerontology since I wanted to focus on aging and my other interests related to aging. Of course, having close relationships with all four of my grandparents also strongly influenced and encouraged me to study aging more in depth. I also realized that studying aging is very beneficial since we all age, and understanding it will only help us to better understand ourselves, others, and life in general. (Not to mention there are all those Baby Boomers--my parents' generations--who are retiring and becoming grandparents!)

In May 2007, I graduated from Ithaca College with a B.S. in Gerontology and a Minor in Recreation. I chose Recreation as my minor since my major interest in the field of aging was quality of life and how we are able to improve the quality of life for seniors. After college, I decided to take a break from academics and get some work experience in the field of aging and recreation. So, for the past 2 and a half years I've been working for Atria Senior Living Group, a privately owned assisted living company that has nearly 130 communities located all over the United States. I work at Atria Merrimack Place in Newburyport, MA as the Engage Life Director. This is the same thing as an activity or recreation director. My company chose to call the "recreation" department "Engage Life" because that is exactly what my staff and I do everyday: continually devise and promote a variety of recreational programs in order to keep our senior residents happy, physically and mentally active, and to put it simply, engaged in life! My building has 3 levels of care: independent, assisted living, and Life Guidance (Alzheimer's care). So, it is similar to a CCRC; however, the main difference is that we do not provide nursing care.

Whenever I tell people about my Gerontology B.S. or that I work with seniors, 9 times out of 10 these people automatically tell me, "Well....that must be somewhat depressing, huh?" I simply smile back and say, "Not at all!" Just think of all those seniors I surround myself with and interact with on a daily basis, and if practice makes perfect, then this means I have the great pleasure of spending my 40-hour work week with people who have had the opportunity to develop their sense of humor for over 70, 80, 90+ years! But most people don't think about things like this....do you?

Saturday, March 13, 2010

I never knew what a unit was for case manager

I have mentioned this a little bit in the other posts but I never really knew what a unit was until I became a case manager. Everything and I mean everything we do has to be put in as a unit so that we can bill and get reimbursed for our work. See below how the units are designated into 15 minute time blocks. In a typical day you want to get at least 28-48 units of work done.
Some unit examples (more detail would be added)
Called Ruth to schedule appointment for qtr visit - 1 unit (designated who to bill to)
Travel to and from Ruth's house for qtr visit - 2 units
visit at Ruth's house - 6 units
Case note write up and qtr check list from visit - 2 units
Called meal site to rearrange hot/frozen meals - 1 unit
Adjusted medications for Ruth on assessment page - 1 unit
Copied lawyer information for Ruth per her request - 1 unit
Mailed lawyer information for Ruth - 1 unit

Time Units
15 minutes 1
30 minutes 2
45 minutes 3
60 minutes 4
1 hour 15 5
1 hour 30 6
1 hour 45 7
2 hours 8
2 hours 15 9
2 hours 30 10
2 hours 45 11
3 hours 12
3 hours 15 13
3 hours 30 14
3 hours 45 15
4 hours 16
So you can see how my career is ruled by units. The documentation is tedious at times but when you need to look back at the records to write a report it is easy to compile and remember.

What are Case Management Responsibilties? Karisha

So what exactly what do I do? Well here is a list of the responsibilities I have.

Case Management Responsibilities:

A. Assessing individual and determining need for service
B. Identifying all sources of funding services and supports
C. Developing Plan of Care
D. Ensuring use of Person Centered Planning
E. Reviewing and explaining to client services that will be provided
F. Supervising implementation of services for the client
G. Advocating on behalf of the clients’ interests
H. Monitoring the quality of HCBS and ensuring that POC objectives are being met
I. Determining cost effectiveness
J. Reassessing POC to determine need for continuation or termination of services
K. Performing record keeping and data collection activities
L. Ensuring confidentiality of individual information
M. Maintaining the highest professional and ethical standards
N. Reporting unusual occurrences or incidents

I will post later with examples how I do my job and how these responsibilities guide me.
Note: Some states require you to have a social work degree to be a case manager.

What is Case Management (Karisha)

Lets get down to what you really want to know. I am a Case Manager (CM). I manage a case load of about 60 clients. I work with the aged and disabled population. There are 4 CM's in my office and 4 in another office that also have their own case loads. CM's can be used in all types of employment. I am a CM for In Home and Community Based Services (HCBS) for an Area Agency on Aging.

The short version of what I do is
"I monitor and assess ongoing services"

The long version
1. Assessment of an individual to determine the individual’s:
a. functional impairment level; and
b. corresponding need for services
2. Development of a person centered care plan addressing an eligible individual’s needs
3. Supervision of the implementation of appropriate and available services for an
eligible individual
4. Advocacy on behalf of an eligible individuals interest’s
5. Monitoring the quality of community and home care services provided to an
eligible individual
6. Reassessment of the care plan to determine the continuing need and effectiveness of the community and home care services provided to an eligible individual
7. Provision of information and referral services to individuals in need of community and home care services

Next post I will share with you the responsbilities I have as a case manager.

A Little Background from Karisha

If you are reading this blog you are most likely in the aging field as a professional or a student. Everyone has their own story how they found gerontology . Yes, I had a really close relationship with my grandparents and still do with my grandmother who is 91! But, in reality I have always been comfortable and connected to older adults. When I was younger I would ride my bike to the local hospital to volunteer as a candy striper. I had the entire hospital to roam but always ended up on the fourth floor which was the geriatric unit. During my high school years I was involved in student council and other organizations and always incorporated volunteering to rack leaves in the fall and bring flowers to the nursing homes on Valentine's Day. When I graduated high school I went to Tompkins Cortland Community College for an associates degree in general studies. I once again joined the student government and incorporated volunteering with the local area agency on aging to spend time with older adults. I remember having a discussion with a professor who suggested applying to the gerontology program at Ithaca College. I had a major light bulb go off in my head!!! I did not even know you could study aging. So I went to Ithaca College with a major in Gerontology and minor in Health Care Administration.
I got to know myself better and realized I was really interested in aging in place, home modifications and products for older adults. I graduated in the middle of the academic year and was not definite if I wanted to get a job or go to graduation school. So, after graduation I took a year off of school and went cross country with my boyfriend (now husband). I had never been very far from the east coast and the trip out west to Steamboat Springs Colorado was a once in a life time opportunity. We lived in a small ski town that did not even have a nursing home. I ended up working as an Office Manager for a real estate office. After a year I had applied and was accepted with a position as a graduate assistant at Miami University Scripps Gerontology Program.

I knew I have an interest in design and aging. However, I did not want to go back to school from scratch in design or architecture school in order to do what I want to do; aging and design. Unlike most of the other programs I looked at making their student more narrowly focused on policy, administration, biology… Miami University Scripps Gerontology Program appealed to me because they allow you to study what interests you and then you relate that to your required courses and reflect your research. During my Master’s years, I was able to further enrich my interests in aging and design and my intellectual and personal development in the area came out as my thesis.

So here I am- I graduated with my MGS (Masters in Gerontological Studies). Some of my cohort decided to continue on for a PhD in Gerontology. I contemplated that option for about half a year but decided that I have more to contribute to community outreach and working directly with older adults than to academia with doing research and teaching.
Before I even graduated I took a job offer that included a training as an AIT (Administrator in Training). This is required to be a nursing home administrator. I should have listened to my heart and not followed the nursing home path but I learned the hard because my passion is to keep people in their homes. So I did not start my work experience immediately but I am on a path now that feels right because I work to keep older adults in their homes and I get great satisfaction from being able to do that. I am currently working as a Case Manager for In Home and Community Based Services for an Area Agency on Aging. I will blog about my day to day responsibilities of being a case manager. I look forward to your questions and comments.

Friday, March 12, 2010

Welcome from the Gerontology Institute!

Welcome to the new "Working in the Field of Aging" blog, sponsored by the Ithaca College Gerontology Institute. Here you will find posts by former Ithaca College Gerontology/Aging Studies majors and minors who are willing to share information about the joys and challenges of their jobs working with and on behalf of elders.