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Long Term Care Advances
Topics in Research, Training, Service & Policy
Vol. 8, No. 1, Winter 1996
Duke University Center for the Study of Aging and Human Development
Long Term Care Resources Program,
Box 2920, DUMC, Durham, NC 27710
(919) 660-7542

Leadership in an Aging Society Program:
Celebrating Divesity and Positive Outcomes

Jennifer B. Hoffmann, MPP, Issue Editor


For the fourth year, we are pleased to present the annual Leadership In An Aging Society Program issue of Long Term Care Advances. This issue, which is edited by our colleague Jennifer Hoffmann who coordinates program activities, features the experience of the current group of Leadership Program awardees. The 1996 Leadership Interns illustrate once again the diversity of characteristics, particularly the interdisciplinary and interinstitutional nature, which are the strengths of the Internship Program. Also highlighted are the initial outcomes of that program. From the beginning, we have made a specific effort to take a continuing interest in the careers of former interns, particularly in the internship as a resource in their subsequent development. Early on, many of the interns were still in the educational process. But at this four year milestone, we have enough information about the career paths interns are taking to share some preliminary outcomes. We are very pleased.

This issue also features another initiative of the Leadership In An Aging Society Program, the Glaxo Wellcome Long Term Career Development Awards Program, which supports young leaders in the field of long term care research. The 1996-97 recipients of Glaxo Wellcome Awards and their research topics are highlighted.

For both the Internship and Glaxo Wellcome Programs, we ask you especially to note the mentors who give of their time to foster the careers of these young leaders. Without these substantial contributions of mentoring time and additional resources from sponsoring organizations, including, increasingly, matching funds for stipends, the Leadership Program would not be possible. We thank them, as well as all the academic programs and institutions which cooperate with us for recruitment of interns. The Terry Sanford Institute of Public Policy at Duke has been particularly helpful.

We also draw your attention to the announcement in this issue of LTC Advances of a new leadership initiative for mid-life and older adults in North Carolina. Since its inception, the Leadership Program has served this group with ad hoc programming and, now with advice from our Leadership Advisory Group, of experienced professionals and policy makers, this new initiative is being launched in early 1997.

George L. Maddox, Ph.D., Editor Sandra Crawford Leak, MHA, Associate Editor


1996 marks the fourth year of the Internship Program of the Leadership in an Aging Society Program and the fifth year of the Glaxo Wellcome Career Development Awards. Through these two programs, the Leadership Program has supported a truly diverse group of 22 students this year. Among the 22 students featured in this issue of LTC Advances, there are 13 females and 9 males; 3 students of African American heritage, 2 Asians and 1 Canadian. The students represent 9 universities and colleges and 13 academic disciplines. This diversity is characteristic of the Leadership Program throughout its five year history. Over the past five years, the Leadership Program has collaborated with a total of 15 colleges and universities and attracted students from 23 distinct academic disciplines (see Exhibit 1).

Exhibit 1
Leadership in an Aging Society Program

Diversity in the First Five Years (1992-1996)
Interdisciplinary and Interinstitutional Characteristics

Universities and Colleges

Academic Disciplines**

Duke University (27)*
UNC at Chapel Hill (13)
Appalachian State Univ. (1)
Brandeis University (1)
East Carolina University (1)
Emory University (1)
Lenoir-Rhyne College (1)
Meredith College (1)
N.C. Central Univ. (1)
N.C. State Univ. (1)
Princeton University (1)
Temple University (1)
Univ. of South Carolina (1)
Wake Forest University (1)
Wright State (1)

Biology (2)
Business (2)
Economics (3)
English (2)
Gerontology (1)
Health Behavior and Education (1)
Health Policy & Administration (7)
History (1)
International Development (1)
Law (3)
Liberal Studies (1)
Medicine (3)
Nursing (1)
Physical Therapy (2)
Psychology (5)
Public Administration (1)
Public Policy (15)
Regional Planning (2)
Religion (1)
Religious Education (1)
Social Work (6)
Sociology (14)
Spanish (1)

* The number in parentheses represents the total number of Leadership participants in each of the categories listed.

** A number of the Leadership Interns have double majors or are involved in joint degree master's programs. In those cases, we have listed both academic disciplines. Consequently, there are more disciplines represented than there are participants.

The Internship Program. The most visible component of the Leadership in an Aging Society Program is the internship program. Since its inception in 1993, the internship program has supported a total of 53 upper-level undergraduates and graduate students in mentored internship placements with national and state organizations working on issues related to aging and long term care policy. Students also participate in an intensive seminar which provides them with an introduction to the "territory of aging" and leadership concepts before they are placed with a site.

The Glaxo Wellcome Career Development Awards. Promoting and stimulating interest in research on issues related to long term care for chronically ill or disabled adults is the focus of the Glaxo Wellcome LTC Career Development Awards. Every year since 1992, this program has supported between 3 to 5 young researchers (graduate, professional or doctoral students) with seed grants to implement long term care research. This year, 3 Duke students received Glaxo Wellcome Awards and their research projects are highlighted in Exhibit 2.

Exhibit 2
Leadership in an Aging Society Program

Glaxo Wellcome Career Development Awards for Chronic Illness and Long Term Care

Marc Musick is a doctoral candidate in Duke University's Sociology Department. Recently, Marc's research has focused on examining the relationship between religion and health, especially among the elderly. Based on this research, he has become increasingly interested in the relationship among beliefs, social support, religious participation and well-being. His Glaxo Wellcome research project focuses specifically on the impact provision of support has on personal well-being among the elderly. Marc expects that elderly individuals who are able to give help to friends and family will actually benefit both physically and mentally from such activity. His research mentor is Professor Linda George.

Gregory O'Neill is a doctoral candidate in Duke University's Sociology Department interested in the demography of aging and intergenerational transfers. His dissertation examines generational transfers of money, household assistance, and personal care from adult children to their aging parents, using data from the Health and Retirement Study (HRS). Specifically, his research examines the extent to which time and money transfers to parents vary by family structure, gender, race, socioeconomic position, parent needs, and the competing demands and resources of adult children. He is especially interested in how competing demands on the time and financial resources of middle-aged children such as work, their children's tuition, and other caregiving obligations, compete with claims from frail elderly parents. Furthermore, Greg is interested in how changes in the demographic structure of the family affect intergenerational resource transfers. In particular, he is looking at how the age-distance between generations affects transfers from middle-aged adults to their parents. His study also investigates the role of reciprocity as a motivation for parent care by examining the effect of prior parent-to-child money transfers on current child-to- parent time transfers in the form of providing help with personal care tasks. His research mentor is Professor Linda George.

Dan Yoder is a third year medical student in Duke University's Medical School with interests in clinical epidemiology and outcomes research. The focus of his research is to identify effective ways to use educational interventions to supplement clinical interventions in the management of low back pain. Working with Dr. Lloyd Hey in the Center for Clinical Effectiveness, Dan hopes to measure the impact that patient education has on outcomes such as patient satisfaction, understanding, confidence, worry and compliance with the prescribed treatment


The goal of the Internship Program was not for all interns to go into careers directly related to aging but rather for potential leaders in their chosen careers to "know the territory" of aging. The initial outcomes indicate that interns are clearly moving into such career paths and several are working with key national or state level aging organizations (see Exhibit 3).

Exhibit 3

Leadership in an Aging Society
Preliminary Program Outcomes
Career Paths of Leadership Interns

Aging Policy/National Level (3)
Aging Policy/State Level (2)
Aging/Direct Service (4)
Aging and LTC Research (2)
LTC Administration (1)
Health Policy/National Level (3)
Health Policy/State Level (1)
Financial and Business (7)
Doctoral Students (4)
Graduate/Professional Students (13)
Undergraduate Students (7)
In Transition (6)

Highlights include:

  • Three former interns are working with national organizations on policy issues related to long term care: the Alzheimer's Association, National Coalition for Nursing Home Reform and the Policy Institute of the American Association of Retired Persons.

  • Two former interns, who are graduates of the Sanford Institute of Public Policy at Duke, are employed by the Duke Long Term Care Resources Program and are working on long term care infrastructure development in North Carolina.

  • Four former interns are working directly with older and disabled adults in the following North Carolina service and care organizations: Orange County Department on Aging, Sunrise of Raleigh, John Umstead Hospital and Jewish Family Services. Another intern with a Master's degree in Health Administration is working as a nursing home administrator in rural North Carolina.

  • Two former interns are working on re-search related to long term care in the following institutions: Edmund S. Muskie Institute of Public Affairs at the University of Southern Maine and the Veterans Administration Medical Center in Durham, NC.

  • Three former interns are working with national organizations on health policy issues: American Society for Internal Medicine, Group Health Association of America and Birch and Davis Associates, Inc. Another intern is working with the North Carolina Department of Insurance on managed care issues.

  • Seven other former interns are working with financial and business entities, including Chase Manhattan Bank, Arthur Anderson and Deloitte and Touche.

On November 7th, a Leadership Convocation was held to recognize the contributions of the Leadership Mentors, Interns and Glaxo Wellcome Awardees. Jim Bernstein, Director of the North Carolina Office of Rural Health and Resources Development, was the guest speaker for the evening and gave the students some insights on making a life and career in rural health policy.

The vignettes that follow highlight the experiences of the 1996 Leadership Program participants.

Stephanie Batchelor, B.S., Biology, Duke University
Mentor: Brenda Porter, Program Director
The Setting: Alamance ElderCare, Burlington, NC

The Experience: Stephanie Batchelor worked side by side with Brenda Porter, Program Director of Alamance ElderCare in Burlington, North Carolina. Alamance ElderCare is the central point of contact for information and referral and access to services for older adults and their caregivers in Alamance County.

While Stephanie was involved in the daily activities of the agency, including attending county planning and interagency meetings, her main responsibility was to organize six health promotion and disease prevention programs for older adults throughout the county. Each of these programs included information on medication management, questions to ask your doctor, legal issues, and other community resource information such as handouts on how to make your home a safer place. Each program also had on- site, a pharmacist, nurse, a retired physician, and a community representative to answer questions that participants may have from the information presented to them.

Stephanie was also been involved in helping collect demographic and functional status information on the older adults that are served by Alamance ElderCare and the types of services they receive. These data are complied on a regular basis to provide Alamance ElderCare with useful information that helps them target their resources and plan for service use.

Tamara L. Box, B.S., Biology, Duke University
Mentors: Heidi White, M.D. and Ellie McConnell, Ph.D.
The Setting: Veterans Administration Medical Center, Durham, NC

The Experience: During her ten-week internship, Tami worked with Heidi White, M.D. and Eleanor McConnell, RN, Ph.D., on a project which focused on the issue of reducing social isolation among the elderly. In a feasibility study, Drs. White and McConnell used current computer technology (the Internet and electronic mail) as an intervention to social isolation. Among continuing care retirement community residents, participants who learned to use the Internet and e-mail, had a statistically significant decrease in depression and loneliness compared to a control group. Tami's internship centered on extending this research to a broader group of older adults.
Specifically Tami was responsible for three main areas: continuing the training of new participants at the project site, completing follow-up interviews with previous participants, and helping to forge new avenues for the expansion of the project, particularly in the VA hospital. She prepared a new training manual on general computer use and how to navigate the Internet and e-mail and trained 16 new participants. At the VA hospital, she conducted a needs assessment in the long term care section and gave presentations for numerous staff members to foster ideas and support for a VA project extension.

Tami reflected that while her internship afforded her many obvious rewards, such as the immediate thrill of watching an elderly person receive his/her e-mail from a friend or relative, there were also other, more subtle, benefits. Namely, she was impressed to witness the more subliminal, yet decisive connection between social intervention and overall health. She observed,

"When high-tech medical cures fail, as is often the case among the elderly, it is every bit as vital to implement social interventions such as the Internet Project, which has the potential to improve quality of life and decrease social isolation."

Peter Brown, Graduate Student, Public Policy, Duke University
Mentor: Theresa Forster, Minority Staff Dir.
The Setting: US Senate Special Committee on Aging, Washington, DC

The Experience: Peter Brown's internship with the Senate Special Committee on Aging provided him with the opportunity to work on issues that directly related to his area of policy interest; that is, health policy as it relates to the aging population. Because the Senate Special Committee on Aging is charged with the responsibility for studying any matter pertaining to the problems and opportunities of older people, he was able to work on a variety of timely issues focusing on different areas of aging policy. Specifically, he worked on four Committee hearings, in which he drafted statements and witness questions for Senator Pryor (D-AR), the Committee's Ranking Minority Member. The topics of those hearings were: 1) Suicide and the elderly; 2) Social Security Disability Insurance; 3) The growing need for more geriatricians in the medical community; and 4) Increasing the funding for medical nutrition therapy.

Some of the other "hot button" issues that he worked on during his internship included: health care insurance and Medicare reform and the restructuring of Social Security. While these two issues received widespread media coverage, Peter reflected that, "It is almost certain that Medicare reform will not be addressed legislatively this summer because it is a controversial issue in an election year."

In addition to expanding his knowledge of the problems that are facing our nation's aging population in future years, Peter also reported that his internship helped him gain a better understanding of the legislative process and allowed him to interact with knowledgeable and influential people in the area of aging policy.

Colin Clode, Senior, Health Administration, UNC-CH
Mentor: Leslie Jarema, N.H.A.
The Setting: The Forest at Duke, Durham, NC

The Experience: As a health policy and administration undergraduate, one of Colin Clode's specific areas of interest is retirement homes. Consequently, he was placed with The Forest at Duke, a nationally recognized and accredited Continuing Care Retirement Community (CCRC) that offers its 350 residents independent living, assisted living and skilled nursing care.

Leslie Jarema, The Forest's Nursing Home Administrator, designed Colin's twelve-week internship around the AIT (administrator in training) model, which involved spending a week in every department of the CCRC including administration, activities, nursing, environmental services, dietary and marketing. Using this format, Colin was able to see first-hand how to manage a successful program in each department and work alongside the person in charge. He was also able to participate in a variety of meetings including the meetings of the health maintenance committee, health care directors committee and the resident's association. This helped expose him to a cross-section of the retirement community business from different perspectives. According to Colin, "By talking to the residents, I got to hear their opinions, which kept my mind open to everyone, not just the administration."

In addition to participating in the day-to-day activities of running a CCRC, Colin's mentor made sure he was exposed to some of the policy issues related to operating an long term care facility such as the certificate of need process, health care power of attorney, DNR orders and Medicare issues.

Upon completing his internship Colin concluded that he learned more about the health care field and aging issues by working in the retirement home; observing daily activities; listening to staff and residents; and studying policies, procedures and regulations than he could have from course work.

Ellen Condelli, Junior, Social Work, Meredith College
Mentor: Marlene Chasson, Executive Director
The Setting: Friends of Residents in Long Term Care, Raleigh, NC

The Experience: Ellen Condelli's internship with Marlene Chasson, Executive Director of Friends of Residents in Long Term Care (FOR) began on a part-time basis in January 1996 and continued on into the summer and fall. Over this period, Ellen followed proposed legislation for long term care reform on both the state and federal levels. Federally, she tracked proposals for changes in Medicaid and its implications for regulating nursing homes. At the state level, she tracked legislation related to improving safety and the quality of care delivered in rest homes in North Carolina.

The highlight of her internship experience was observing the process of setting public policy by a committee appointed by the Governor of North Carolina. The appointment of Ellen's mentor, Marlene Chasson, as co-chair the Governor's Ad Hoc Committee on Rest Home Reform, provided Ellen the opportunity "to observe first hand the way consumer advocates work with long term care industry representatives and elected officials to promote positive changes in policy affecting residents in long term care facilities." The Committee was formed in response to a fire in a rest home that resulted tragically in the death of 8 residents and was charged with making recommendations to the Governor in an effort to deter similar tragedies form happening in the future. Ellen attended all three of the day-long committee meetings, read material distributed by the various stakeholders and learned about the "incremental nature of progress."

Ellen's internship with FOR helped her gain insight into the widespread problems facing residents in long term care. She concludes that residents' biggest need is representation, "With the ever increasing numbers of frail elderly needing care by the growing long term care industry, it is clear that advocates must unite to help empower our most vulnerable citizens and their families."

Yoko Crume, Graduate Student, Social Work, Univ. of North Carolina at Chapel Hill
Mentor: Erdman Palmore, Ph.D.
The Setting: Duke Center for the Study Aging & Human Development, Durham, NC

The Experience: The goal of Yoko Crume's internship was two-fold: 1) to learn the ABC's of conducting a comparative study through field experience involving the issues of long term care in the United States and Japan and 2) to learn how two different societies with rapidly aging populations approach and plan for the needs of older adults. She was particularly interested in the different directions these two countries seem to be headed in financing long term care programs (i.e., the private sector approach in the U.S. versus the public financing approach in Japan.)

"Both in the U.S. and Japan, the goal is no longer the creation of an ideal system. The real issue today is to build a sustainable system which will withstand the pressures from the ever shifting dynamics of population and economy." Yoko Crume, Duke Center for Aging

To fulfill her goal, Yoko worked on a part-time basis with Dr. Erdman Palmore at the Duke University Center for the Study of Aging and Human Development. Under his guidance, she initially focused her attention on learning about the methods of comparative studies and relevant long term care developments in the U.S.. Next, she spent three weeks in Japan learning about Japanese long term care programs, paying special attention to a proposal for establishing a publicly-financed long term care insurance program.

While in Tokyo she had the opportunity to meet and interview experts in the field of long term care policy, insurance executives, medical doctors and the staff of a skilled nursing facility. She also visited a variety of long term care settings including an adult day care center, an assisted living facility, a group home for older adults with dementia, a hospital for the aged, a skilled nursing home and an intermediate care facility.

Yoko describes her internship as "valuable and instructive." Her internship experience helped her "see the nature of the challenge of an aging society more clearly. Both in the U.S. and Japan, the goal is no longer the creation of an ideal system. The real issue today is to build a sustainable system which will withstand the pressures from the ever shifting dynamics of population and economy."

Debbie Grammer, Graduate Student, Public Health Education, Univ. of N. C. at
Chapel Hill
Mentor: Gina Upchurch, R.Ph., M.P.H.
The Setting: Senior PHARMAssist, Durham, NC

The Experience: As a health educator, the intent of Debbie Grammer's internship was to develop "an intervention" to address the problem of how medication information is communicated to older adults with low literacy skills who receive their medications through Senior PHARMAssist (SPA), a pharmaceutical assistance program operating in Durham County. To design this intervention, Debbie worked with Gina Upchurch, Senior PHARMAssist Director, to conduct a focused needs assessment to determine the extent of the problem: explore what has been done regarding literacy efforts for older adults; interview older adults, health care providers and literacy workers to determine what they think could be done; and suggest ways to monitor and evaluate the proposed solutions. Debbie noted that the community was responsive to her inquires and proposed "interventions" that addressed multiple levels of the problem. (Note: It is estimated that up to 20 percent of SPA clients can not read medication labels.)

As a result of Debbie's recommendations, SPA will increase referrals to literacy programs, conduct a literary workshop for pharmacists, expand community outreach, obtain feedback about health information handouts from adults with low literacy skills, and promote accurate directions on medication labels.

According to Debbie,

"Helping a community to raise its voice and make decisions is the role of a health educator, and it was rewarding to play a part in linking existing networks in the community for change."

Under the mentorship of Gina Upchurch, she gained valuable insight into the perspectives of older adults, the need for a statewide pharmaceutical assistance program, the way a community-based program works, and the role of public policy in health behavior.

Stephanie Green, Senior, English, Emory University
Mentors: Lori Owen Smetanka, J.D. and Lisa Woodruff
The Setting: National Citizens Coalition of Nursing Home Reform, Washington, DC

The Experience: Stephanie Green's main project at the National Citizens Coalition of Nursing Home Reform (NCCNHR) was compiling an information packet to celebrate Residents' Rights Week, which included a special section describing the value of resident councils, how to start one and the Briggs Resident Rights Form. The packet also featured projects that resident councils could establish to involve themselves in the community, suggested ways to involve children in the lives of older adults and contained voter education materials. Supplementing these materials were original works of arts produced by residents of long term care facilities, such as poems and pencil sketches. NCCNHR will distribute this packet to ombudsmen working in all 50 states and market it across the country.

Under the guidance of Lori Owen Smetanka and Lisa Woodruff, Stephanie also prepared rough drafts of consumer fact sheets on abuse and neglect, restraint reduction, and issues related to transfer and discharge of nursing home residents. In addition, she shadowed her mentors to various meetings on Capital Hill and attended two conferences, one on "Quality Assurance" and the other on "Improving the Quality of Life for Nursing Home Residents," sponsored by the Health Care Financing Administration in Baltimore.

Stephanie described her internship as an "exceptional experience." She described her mentors as "dedicated, inspiring and wonderful role models for anyone interested in making a difference." Not only was she exposed to a variety of long term care issues, but she was introduced to the field of health policy, an area she is considering focusing on in and after law school.

Demario Hayes, B.A. Psychology, Lenoir-Rhyne College
Mentor: Gina Shell, M.P.P.
The Setting: NC Association of Area Agencies on Aging, Hickory, NC

The Experience: During his summer internship, Demario Hayes had an opportunity to be involved in a wide variety of activities of the Western Piedmont Area Agency on Aging. His mentor, Gina Shell, is also serving as the President of the NC Association of Area Agencies on Aging (NC4A), so he was involved in a number of major initiatives being organized by the Association as well. One of his responsibilities was to assist in the planning of the 23rd Annual Southeastern Association of Area Agencies on Aging Training Conference which was held in Charlotte, NC, in October of this year. He also helped the Association to develop an implementation plan for a set of standards that will be used to assess the performance of North Carolina's 18 Area Agencies on Aging.

Other activities included participating in several meetings with members of the North Carolina Association of Areas Agencies on Aging, distributing fans for needy seniors, visiting senior nutrition sites and updating the waiting list survey for home and community- based services. Demario also met with members of the local business community to discuss issues of eldercare and the demands made on caregivers who work in full-time jobs.

After completing his internship, Demario entered graduate school to study industrial/organizational psychology. Being a part of the aging network helped him to explore the issues that older adults face in different environments such as the work place, long term care facilities and in their own homes. With his exposure to the territory of aging and his advanced training, Demario believes that he will be more sensitive to the challenges that occur in later in life and he will "attempt to implement policies and procedures that are beneficial to older adults and their caregivers in the work place."

Lan Liang, Doctoral Student, Economics, Duke University
Mentor: Frank Sloan, Ph.D.
The Setting: Duke Center for Health Policy Research & Education, Durham, NC

The Experience: As a doctoral student in health economics, Lan Liang's interest in aging issues related to the economic aspects of acute and long term care for the older adult population. Consequently, Lan spent the summer working with Frank Sloan, Ph.D., Health Economist, at Duke University's Center for Health Policy Research and Education, an interdisciplinary research center on health related issues.

The focus of Lan's work during the summer was research on the issue of breast cancer and aging. To gain a basic understanding of the topics she was researching, Lan conducted a literature search and compiled a reading list on health and aging issues and researched basic clinical aspects of breast cancer. Equipped with this background knowledge, she was prepared to assist with the more sophisticated analysis of the research project. For the rest of the summer, Lan analyzed data from the National Long Term Care Survey (NLTCS) and Standard Analytical Medicare Data linked to NLTCS, and completed some basic economic modeling on the choice of treatment and usage of preventative care by Medicare recipients.

According to Lan, "The internship experience strengthened my interests in medical care utilization of the older people and economics of aging in general." She was especially grateful for the opportunity to practice and enhance her research skills, to work with large databases (NLTCS and Medicare), to apply her economic and statistical modeling skills and to work side-by-side with the researchers at the Center for Health Policy Research and Education.

Jennifer Maynard, Graduate Student, International Development Policy, Duke University
Mentors: Brenda Summers, Exec. Dir., and Jacquelyn Jones McKinnon, Leadership Dir.
The Setting: NC Equity, Raleigh, NC

The Experience: Jennifer Maynard was one of two Leadership Interns working with NC Equity, a public policy, educational and advocacy organization concerned with the rights and well-being of women and their families in North Carolina. Within NC Equity, Jennifer worked on two program initiatives: the Women of Color Program and issues related to Older Women in the Workplace.

Working with Jackie Jones McKinnon, Jennifer collected, compiled and analyzed statistics on women of color of all ages. With this information, she was able to begin to document the status of women of color in North Carolina. Furthermore, Jennifer used this information as a foundation for a more in-depth analysis she conducted on the issue of older women in the workplace. Specifically, she analyzed the economic opportunities available to older women workers including wage levels and training opportunities, circumstances that hamper their progress and knowledge of legislation that protects their rights.

In addition, to working on these special projects, Jennifer was able to attend a number of committee meetings held in the NC General Assembly, participate in "lobby days" at the legislature and observe her mentor (Brenda Summers) advocating on behalf of the women in North Carolina.

Like many of the other Leadership Interns, Jennifer described her relationship with her mentor as a "thoroughly enriching experience." She "gained much from having met a personality like Brenda Summers, a person who is full of life, vigor and commitment to the betterment of the lives of others."

Elizabeth McCubrey, Senior, Sociology, Wake Forest University
Mentor: Michael McCann, J.D.
The Setting: North Carolina Division on Aging, Raleigh, NC

The Experience: Elizabeth (Betsy) McCubrey's two primary areas of focus with the North Carolina Division on Aging this summer were Elder Rights and Intergenerational issues. Under the mentorship of Michael McCann, J.D., State Long Term Care Ombudsman, she worked on a number of timely projects including writing an issue brief on grandparent visitation rights in North Carolina. She also helped compile a handbook designed to help grandparents caring for their grandchildren.

Her other projects included updating the Adult Care Home and Nursing Home Community Advisory Committee manual and redesigning brochures and creating several new ones related to various aspects of elder rights. Betsy has also had the opportunity to attend meetings, seminars and conferences related to aging, such as the statewide Innovations in Long Term Care Conference sponsored by the UNC School of Medicine and held in Chapel Hill on June 20 and 21.

Reflecting on her summer experience, Betsy was astounded with the amount of information to which she was exposed. Even though she had taken several gerontology courses in college, she noted, "It seems that every day that I come to work I learn something new." She also expressed that her internship "has served to cement my plans to help serve the elderly via a law career."

There is one final thing that Betsy states that she will take away from her internship - Michael McCann's "demonstration of great leadership." She observed that her mentor had the ability to empower the people with whom he worked. He seemed to work with his staff, not over them. Finally, his office door was always open and he was willing to listen to suggestions and answer questions.

Elias Rolett, M.S.W., University of North Carolina at Chapel Hill
Mentor: Lisa Gwyther, M.S.W.
The Setting: Duke Family Support Program, Durham, NC

The Experience: Elias Rolett was placed with Lisa Gwyther in the Duke Family Support Program (FSP), an information and referral, counseling and resources agency which works with individuals with memory problems and their caregivers. During his internship, his time was split between working for FSP and doing research on grandparent caregiving. He wrote articles for FSP's newsletter, provided telephone counseling and I & R services, developed resources, participated in presentations, toured facilities and helped to create a glossary of approximately 1,000 aging terms to be used by professionals in the field. Along with Lisa Gwyther and Edna Ballard, he helped to add case scenarios and examples to the manuscript.

Elias also conducted an extensive literature search on the subject of grandparent caregiving, interviewed a number of grandparent caregivers and professionals on both the local and national level and attended support group meetings. Elias used his research on grandparent issues to create an annotated bibliography and to write a report that summarized the major legal and social barriers that impede grandparent caregivers to obtain socio-economic support.

Both of these related experiences helped to strengthen his conviction to continue working in the field of geriatric social work. His FSP experience allowed him to gain significant practical experience through the provision of direct services and the creation of resources for both clients and front line workers. Conducting research allowed him an opportunity to see how a relatively new problem is recognized, viewed and dealt with on the local, state, and national level. He considers both experiences to have been extremely valuable and to have increased his social work skills as well as his understanding of these important issues.

Jennifer Sanderson, Graduate Student, Social Work and Public Health, University of South Carolina
Mentor: Constance Rinehart, M.S.W.
The Setting: South Carolina Division on Aging, Columbia, SC

The Experience: Jennifer Sanderson was placed with the Division on Aging within the Office of the Governor for the State of South Carolina. Throughout her internship she worked side by side with Connie Rinehart, director of the Division on Aging. Because of this mentoring relationship, she was able to attend meetings around the state that dealt with various topics in aging, including coordinated transportation meetings, Aging Network leadership meetings, Health and Human Service Coordinating Council Meetings, Adult Day Care Advisory Meetings, Long Term Care Committee meetings, Advance Directives Coalition meetings, etc. By attending these meetings Jennifer was able to see policy-making at its beginning stages.

Within the Division, she was also responsible for helping prepare for and participate in the SC Governor's Conference on Aging and the Governor's Summer School of Gerontology, a week long educational program for professionals and others working with older adults. She also worked with the Advance Directives Campaign held state- wide in June and was responsible for representing the Division on Aging at various health and educational fairs held around the state. She assisted with the preparation of several documents as well, including the Final Report of the Governor's Conference on Aging, the Health and Human Services Retreat Report, the Four Year State Plan for the Division on Aging, and various speeches for the director.

Some of Jennifer's most meaningful experiences were those where she visited aging sites to see services being rendered, including going on ombudsman investigations within nursing homes and residential care facilities throughout the state, attending meal sites in the area and delivering Meals on Wheels.

Jennifer offered the following summarizing comments on her internship. "My summer was an enriching and eye-opening experience that I shall never forget. I absorbed large amounts of information about policy issues affecting older adults (long term care, health care, advance directives, adult protective services, and others) and the services available to older adults.

"I was also able to shadow a very dynamic leader who impressed upon me the importance of putting older citizens needs before the demands of bureaucracy and who marvelously demonstrated how to creatively meet these needs within a governmental setting."

James Sizemore, Graduate Student, Religious Education, Duke University
Mentor: Jack Preiss, Ph.D.
The Setting: PreissSteele Place, Durham, NC

The Experience: Beginning in September 1996, James Sizemore has been working on- site at Preiss-Steele Place, to develop two types of literacy programs for the residents: 1) functional literacy and 2) computer literacy. Preiss-Steele Place (PSP) is an affordable assisted living facility for low-income older adults located in Durham, NC. In addition to providing the opportunity for older adults who may need assistance in the activities of daily living to access personal care services, PSP supplements the basic services with special activities and programs when a need is identified. In this case, the need for a literacy program was identified.

James came to PSP with an extensive background and experience with literacy programs in North Carolina and was aware of and sensitive to the literacy issues related to older adults. Consequently, he began his internship by assessing the willingness and ability of these students to learn to read at this point in their lives. Then he worked one- on-one with all of interested individuals to teach functional literacy (writing a check, reading a prescription and information sheet, reading grocery store sale ads, paying bills, etc.).

For residents with the ability to read and write, James intends to design a program that will teach residents computer literacy skills. Within this program, the residents will be exposed to the computer in a non-threatening, one-on-one tutorial session. The program content will range from the basics of turning the computer on to using the Internet and e-mail to communicate with people outside of the Preiss-Steele community.

Elisa Cook Snowise, B.A., English Literature, Brandeis University
Mentor: Brenda Ginsberg, M.S.W.
The Setting: Jewish Family Service, Durham, NC

The Experience: As an intern with the Jewish Family Service, an agency of the Jewish Federation of Durham and Chapel Hill, Elisa Cook Snowise was responsible for helping to design a study and gather information on the needs of older adults in the local Jewish community. Elisa managed and administered the needs assessment from the beginning to end of the project. Her responsibilities included writing a letter of introduction to the targeted population, scheduling the interviews, meeting with the older adults in the community and writing the final report about the survey.

Throughout her internship, Elisa received technical support from a variety people associated with the Jewish Federation. To fine tune the survey instrument, she first worked with Gerda Fillenbaum, Ph.D. To practice her interviewing skills, she worked with Sharon Wallsten Ph.D., Simone Lipman and Sasha Loring in some role playing activities. Ongoing support was provide by Brenda Ginsburg, Elisa's mentor and the director of Jewish Family Services, who met with her frequently to discuss her observations and findings and answer questions.

The biggest challenges Elisa faced as she worked on the project were convincing older adults to participate in the survey, making participants feel comfortable with her and working with and understanding older adults who are mentally disoriented and confused. According to Elisa, meeting these challenges were the "most significant aspect of the project," because it helped in her "development from a potential social worker interested in the issues of the elderly to a potential social worker dedicated to the aging population."

Elisa's immediate plans are to stay with Jewish Family Services and help in the development and implementation of services that will address some of the needs highlighted in the survey.

Dawn Spencer, Junior, Business Management, NCSU
Mentors: Lousia Cox, AAA Director and Cynthia Davis, Associate Director
The Setting: Bellhaven Senior Center, Bellhaven, NC

The Experience: Dawn Spencer received front-line experience in what it means to run a senior center and the role a senior center plays in the community, especially in rural eastern North Carolina.

During her internship, Dawn acted as the activities director at the Bellhaven Senior Center which serves the area of northeastern Beaufort County. Her daily responsibilities included opening and closing the building throughout the week; developing and coordinating the activities for the older adults who participate at the senior center; and outreach to seniors that reside in nearby rest homes.

Dawn observed that one of the challenges confronting a rural senior center was how to provide quality services in the face of dwindling attendance. Consequently, she worked on various marketing strategies such as posting flyers in community businesses, advertising in the local newspapers and running public service announcements on local television stations to increase the daily participation rates at the center. The most successful marketing strategy, however, resulted from word-of-mouth communication.

Adding to the difficulties facing the center was Hurricane Bertha, which left 23 inches of standing water throughout the building, ruined some of the center's equipment and caused the center to close its doors for a over a week. Rather than taking time off, Dawn's mentors, Louisa Cox and Cynthia Davis, included in her in the negotiations with FEMA which added an interesting learning experience to her internship.

Overall Dawn concluded, "My internship experience at the Bellhaven Senior Center was very profitable to me both personally and professionally and I feel that I gained valuable insights from my mentors, Louisa Cox and Cynthia Davis, and the seniors with whom I worked throughout the summer."

Angelique Thomas, Senior, Sociology, Duke University
Mentors: Brenda Summers, Executive Director and Jacquelyn Jones McKinnon,
Leadership Director
The Setting: NC Equity, Raleigh, NC

The Experience: Angelique Thomas was one of two Leadership interns who worked with NC Equity during the summer. Her primary project included researching and writing two articles for the quarterly newsletter for the Women of Color Program. In addition to using secondary research sources such as newspaper and journal articles, she interviewed older black women from a senior day program at a local YWCA and incorporated their stories into her articles. She also used the older women's stories to complement the material she collected to compile a community resource directory. Angelique explained this unique approach to developing a resource directory by saying,

"My purpose was to tell the stories of real women with real problems, but to counter the harshness with hope by providing a list of sources that women with similar problems could utilize for legal, employment, mental health and other services specific to their needs."

In addition to writing the articles, Angelique participated in all the other activities of an advocacy organization. She shadowed her mentors to various meetings outside of the office, observed them interacting with NC legislators and helped to edit the Draft Women's Agenda, which was distributed across the state to local community activists organizing women's assemblies.

According to Angelique, "My work with NC Equity has afforded me the opportunity to expand knowledge of myself and the issues that are important to me as a Black woman and my community. This leadership opportunity has allowed me to challenge and discipline myself with regard to my abilities, assumptions and my work habits."

Danielle Turnipseed, Senior, Public Policy, Duke University
The Setting: Spring 1997 Internship

Danielle Turnipseed, was chosen among all rising seniors in Duke's undergraduate public policy program to receive a 1996 Leadership in an Society Internship Award and her internship stipend will be supported by the Mary Duke Biddle Foundation, which is providing support for an intern for the third year in a row. She also received a Woodrow Wilson Fellowship, a competitive award given to outstanding minority students with an interest in public policy, which required her to participate in a seven week academic seminar during the summer 1996. To enable her to accept the Wilson Fellowship, Duke LTC postponed Danielle's Leadership internship placement until the Spring of 1997.

Teaching Community Update:

Cleveland County: Teaching Communities Expand to the West

October 16, Shelby, N.C. - Dr. George L. Maddox and Sandra Crawford Leak of the Duke Long Term Care Resources Program look on as Sarah Wray, Executive Director of Cleveland County's LIVE! volunteers for the elderly program addresses a large audience at the in-auguration of the Cleveland County Teaching Community. The Cleveland County Teaching Community is sponsored by ACCES (Accessing Cleveland County Elder Services) a vibrant interagency group with a long history of coop-erating on innovative services for older adults. Monty Thornburg, Chair of the ACCES Board and the Executive Director of Kings Mountain Senior Center was moderator for the event.

Next Teaching Communities Inauguration: "The Down-East Teaching Communities Consortium: Enhancing Long Term Care in Beaufort, Hertford, Martin, Pamlico and Pitt Counties" in Williamston, NC on November 12.

Duke Long Term Care Resources Program


  • Exciting opportunities in 1997 to work with key local, state and national leaders concerned about policy issues affecting older adults

  • Stipended internships for both graduate and undergraduate students with an expressed interest in aging issues

  • 1996 interns addressed issues such as literacy, Medicare and Medicaid reform and grandparents as parents

  • Complementary seminar to "know the territory" of an Aging Society

  • Also learn about Glaxo Wellcome Long Term Care Career Development Awards for young researchers

If you want to learn more about Leadership Internship opportunities or Glaxo Wellcome Long Term Care Career Development Awards for young researchers, please contact the Leadership Office at:

Leadership in an Aging Society Program
Duke Long Term Care Resources Program
Box 2920, DUMC
Durham, NC 27710

E-Mail: jbh@geri.duke.edu



The Senior Leadership Enhancement Initiative of the Leadership in an Aging Society Program

  • Flexible leadership development program for mature adults

  • Emphasis on aging and long term care policy

  • Intergenerational connections with Leadership student interns

  • Individualized planning encourages use of a wide range of leadership development resources
Three to five participants will be selected in February 1997. Application information will be available after December 10, 1996, from:

Duke Long Term Care Resources Program
Box 2920, DUMC
Durham, NC 27710


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