101Careers in CounselingIn this weekly feature, the editors of SpringBoard highlight one career in the health care professions–including a basic description, educational requirements, core competencies/key skills needed, and related web sites and professional organizations where you can find more information!

In addition to counseling geriatric patients in a residential setting, counseling elderly clients in outpatient settings will likely become more common. The retirement age is to be raised from 65 years to around 70 years within a decade, meaning that many senior citizens will be working. It is also likely that seniors will make use of services, and this includes counseling services. While previous generations were reluctant to seek counseling, the late baby boomer generation and those generations coming thereafter do not hold the same stigma toward counseling.

Degree Required
A master’s degree in one of the counseling fields (e.g., mental health counseling, marriage and family counseling, and geriatric counseling).

Issues to Understand
Counseling the elderly will be similar to, though slightly different from, counseling people of other age groups. The elderly will struggle with depression, anxiety, troubled relationships, and so forth just as younger populations do. But the elderly know more than any segment of society that their time in life is running short and they realize a need to make the most of their remaining years. Many elderly will feel disappointed that they did not accomplish what they set out to accomplish in their lives. Others will be grappling with grief as their spouses and perhaps some of their children have died. Then there is the reality that for many elderly people, bodies do not function as well as in their younger years, and this will require many cognitive and emotional adjustments. Then there is the lingering bias by many parts in society that the elderly will not want the same things that most people want, such as an active sex life. Some elderly will have been diagnosed with a terminal illness and many wish to end their life on their own terms by euthanasia. Senior citizens have the highest suicide rates of any age group. There is a plethora of issues for counselors serving the elderly to be prepared to address with their clients.

Best Aspects of the Job
The best part of counseling seniors may be in counseling seniors. What I mean is that many counselors may enjoy counseling people with a lot of life experience under their collective belts. Many elderly people of the age 70 or older likely harbor a desire to discuss existential, meaning-of-life issues with a counselor. Counselors are required to be prepared to address spiritual or religious issues with elderly clients. Counselors who enjoy working with such weighty issues and concerns like these will enjoy counseling this population. In addition, many elderly counselors may very well enjoy the challenge of serving the very population they now represent. In fact, you can expect to see counselors who have reached their golden years being the professionals counseling the elderly.

Challenging Aspects of the Job
There will be many challenges the elderly face: declining physical and cognitive functioning, family relations, isolation, impending death, and reviewing their lives. Many senior citizens will be bitter at life’s disappointments, struggling with depression, estranged from children and grandchildren, in declining health, or angry at a loss of freedom. Young counselors may especially have difficulty bridging this generational gap and empathizing with their geriatric clients. It is also accurate to stress that counseling elderly clients, many of whom may be near death, is not for most counselors.

Occupational Outlook and Salary
The Bureau of Labor Statistics did not yet compile figures for counselors serving the elderly. Also, as counselors cannot yet bill Medicare for counseling services, this also limits the counselor’s ability to counsel the elderly in many settings. But in the near future, say, within 10 years or less, counselors are very likely to be awarded Medicare privileges. Salary for counselors serving seniors in outpatient centers is likely to be comparable with salaries for counselors working with other populations. The current median salary for outpatient counseling is $37,590.


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