LeadingAge Magazine · January-February 2020 • Volume 10 • Number 01

The Blessing of Meaningful Work

January 17, 2020 | by Gene Mitchell

A conversation with LeadingAge Chair Carol Silver Elliott, at the beginning of her term.

Carol Silver Elliott, president and CEO of the Jewish Home Family, based in Rockleigh, NJ, begins her 2-year term as board chair of LeadingAge in January 2020.

Carol Silver Elliott
Carol Silver Elliott

Silver Elliott joined the Jewish Home Family in 2014, after serving as president and CEO of Cedar Village in Cincinnati, OH.

She is a board member and former chair of the Association of Jewish Aging Services; she was a board member of LeadingAge Ohio and joined the LeadingAge New Jersey board in 2015; she is on the board of the Visiting Nurse Association of Central New Jersey; and she has been on the LeadingAge board since 2012.

She is the recipient of numerous state and national awards for innovation and leadership. She also writes a biweekly blog for The Times of Israel.

LeadingAge interviewed Silver Elliott to learn about her priorities and concerns as chair.

LeadingAge: How would you describe yourself to those members who don’t know you?

Carol Silver Elliott: First and foremost, I am an individual who is passionate about the care of older adults. I began my career working in acute care—and really, I worked in acute care longer than I have worked in long-term care.

When I got into this field, I realized almost immediately that I had found the place I was meant to be. I had the opportunity to work with elders, to learn from them, to connect with them, to develop relationships, and to do whatever I can to enhance their lives. This work speaks to me both personally and professionally on every level. My commitment is always to enriching and enhancing the lives of our elders, and I am thrilled to be playing this role for LeadingAge, and to have the opportunity to take that commitment to a national stage.

LeadingAge: Where did you get your start, before coming to older adult services?

Carol Silver Elliott: I was a specialist who became a generalist. I started out with undergraduate degrees in television and radio. I went to graduate school in communication arts, and my first job was as the first director of public relations for a small hospital.

I am grateful that they saw potential in me and sent me to graduate school for a second time, to get a master’s in health care administration. So, I worked in public relations, strategic planning, and development for a lot of years, and then left health care for about 5 years to become CEO of an organization that did outplacement and career development.

I found that I love being a CEO (on most days), and that I don’t have the same passion for helping people find fulfillment in their work lives, as important as that is, that I do for human services. The opportunity to move into independent living and assisted living, and then shortly thereafter into the full continuum of services, was, in many ways, coming home for me.

LeadingAge: What drives you to do volunteer work in our field—serving on the LeadingAge board, on other boards, and being active in your state association? Why is that so important to you?

Carol Silver Elliott: I've always believed that you have to be connected on levels outside of your own organization. There's so much out there that we can learn from.

In long-term care, the opportunity to be a part of LeadingAge really began for me in 2008, with LeadingAge Ohio. The organization that I joined in Ohio had dropped out of LeadingAge, and the CEO of LeadingAge Ohio came to visit me. It made sense to me that we needed to be part of the state association and a national association, that we needed that advocacy clout, that we needed the education and the support. So, I re-upped us for LeadingAge Ohio, and probably a year or so later went on the board there.

It's so important, I think, for all of us to go beyond the walls of our institution and improve our field. Too often we get locked into the crazy, busy lives we lead every day, and the multiple commitments and all of the demands. But the reality is that we have to also remember that there's a bigger world out there, and that we have to be a part of that bigger change and bigger vision if we're going to be effective.

LeadingAge: You’re embarking on a 2-year term as chair; what are your priorities?

Carol Silver Elliott: One of my hot-button issues is ageism. I truly believe ageism underlies so many of the issues that we have, and that older adults have in this country, and I don't believe that ageism exists in the same way across the globe. I think it is a phenomenon that we see, particularly in the United States, where our focus on youth culture has become […] not just strong, but also has become something that marginalizes and minimizes the older adult, and that's not right.

We see ageism play out in so many different ways. Some of them are social, in the way older adults are spoken to, and the language that we use. But way beyond that, I think, ageism underlies funding issues. It underlies the lack of opportunities for older adults. It’s an element in our workforce issues. The idea of working with older adults should be appealing, as a place to connect with individuals who have great stories to tell, and wisdom to share, and who give love to their caregivers and our professional staff every single day, and yet, people see working with elders as sort of the low level on the totem pole, and that's wrong. That’s ageist.

I think ageism underlies elder abuse and the lack of interest in this country about the victims of elder abuse. There are millions of victims of elder abuse every year. And yet we as a society don't pay attention to that, we don't value them, [and] we're not bringing attention or funding or renewed efforts to prosecuting the abusers. I think ageism is a big elephant in the room, but you’ve got to eat the elephant one bite at a time.

“Too often we get locked into the crazy, busy lives we lead every day, and the multiple commitments and all of the demands. But the reality is that we have to also remember that there's a bigger world out there, and that we have to be a part of that bigger change and bigger vision if we're going to be effective.”

The elder justice issue is huge for me. And another, of course—and they're related but they’re not related—is workforce. I truly believe that our attention as a field has to be continually focused on workforce development, on bringing new people into the field, and growing people’s skills. We've all seen the terrifying statistics of how short we're going to be in terms of caregivers to meet the needs that we face as a society. It’s real and it's out there: There are not going to be enough caregivers to provide the services people are going to need. And we need to grow our workforce initiatives; we need to be looking at all of the innovative things that we're already looking at with public policy, but also to continue to be creative, to find new ways to connect young people with the work that we do, to give them a sense of why it matters to work with older adults, and that there are rewards and benefits to working with older adults. It's got to be attacked on every front.

And then, I think the 3rd priority is to continue our advocacy to work toward getting regulation to be more equitable and, in some ways, better under control. It is not a positive thing when we say, with all honesty, that long-term care is the second-most heavily regulated industry after nuclear power. So many of the regulatory efforts that are underway are targeted in the wrong direction. They're looking for issues, for problems. They're not focused on the positive things that are going on. There's a constant environment of witch hunt […] that we see in the media all the time. They show terrible people doing terrible things, but we are not doing terrible things. There are, as in any field, people who are doing good and people who are not.

The 4th priority is to increase our visibility as a field. How can we take control of the message, how can we tell the positive stories? Not to sugarcoat the negative, and not to be unrealistic—there’s no Pollyanna in any of this—but we have to take a stronger approach when telling our own stories. We have to toot our own horn more, and we need to do that both at the individual provider level and at the association level.

It is long overdue for us to be on the offensive rather than the defensive when it comes to talking about the work we do, and the importance of the work that we do.

LeadingAge: Regarding that 4th priority, you clearly see a strong role for LeadingAge national on that topic, but is there anything that you would like providers themselves to be doing better?

Carol Silver Elliott: We could help people develop the tools to find those positive stories and know what to do with them. I think a lot of smaller organizations don't have a marketing person who is going to be able to put this together, but maybe we can help create toolkits our members can use to tell those stories, and maybe we can funnel those stories up and tell them on a statewide or an association-wide level.

There's a big pipeline of stories out there that could be used in 100 different ways. And, you know, I would rather see us bombard the news media with positive stories than constantly be apologizing for things that happen in isolated cases.

I wonder if we should even walk away from [our] terminology. “Nursing home” has this negative connotation: It's the end of the line; it's where you go to die; it's where terrible things happen to you. But the reality is that good nursing homes, like the one I'm sitting in right now, are places where people are living really expanded lives, where they are participating in enrichment every single day, where they are stimulated and have opportunities to do amazing things.

I don't know if destigmatizing nursing homes is going to take a whole identity shift, but certainly it's going to take a lot of work to change the image that’s in [people’s] heads into what many of us, particularly in the nonprofit world, see and do every single day.

LeadingAge: Are there any particular threats to our field that keep you awake at night—issues that you think need to be better addressed?

Carol Silver Elliott: There are a lot of threats to our field. If you ask any CEO what keeps them up at night, workforce is probably number one, and there is regulation, reimbursement, all of those things. There's a tremendous consolidation of health care organizations, and acquisitions by for-profits.

Governance, I think, is another challenge—the fact that many of us have governance structures that are not nimble enough to be able to adjust and flex to meet changing demands. Particularly from the standpoint of some of our smaller providers, it's very difficult to keep up with the pace of change. And I think it makes it increasingly difficult for people to survive.

We know, based on what research is out there, that there will be a tremendously large number of people who need care as the baby boomers age out. We know this is going to happen, but I worry that some of our of our providers are not going to be able to hang in there and prepare for that next wave, because what that next wave wants is going to be quite different than what exists today.

LeadingAge: Do you have any asks for LeadingAge members?

Carol Silver Elliott: I think I would ask a few things. First, I would ask that each of our members think about their role in changing the image of our industry, that they think about ways that they can square their shoulders and take a stronger stand to tell their stories and support the work that we do with older adults.

I would ask that our members not only continue, but also increase their support of all of our advocacy efforts. We need their participation; we need them to be involved and engaged, especially when we’re asking for their advocacy. Their voices matter tremendously, and I would hope that we'll see even more renewed effort from them.

And I would ask that in the area of ageism, that we start to call ourselves on it, that we look at who we are and how we speak and what we say and the way we address things, and the messages that are out there. We need to recognize ageism and call it when we see it. We spend a lot of time in this organization—and we are far from perfect—talking about how our words matter. And there is a difference between calling someone by their name, and calling them Dearie, or Mama, or Papa, or any of those terms of endearment that are inappropriate. It’s the difference between talking about someone who wears disposable undergarments versus an adult needing diapers. Diapers are for babies, not older adults.

“I would ask that in the area of ageism, that we start to call ourselves on it, that we look at who we are and how we speak and what we say and the way we address things, and the messages that are out there.”

We had a physician here talking to us, seeking some business from us, and he kept talking about people who are demented. You know what? People are not “demented;” we have persons living with dementia, and that's a major difference in terms of the way we look at people and the way we see them. I think we have to have our eyes open and our awareness raised.

Last but not least, I would hope that all of our members, at some point or another, could really educate themselves on the issues surrounding elder abuse. I think this is a problem that is under-recognized and under-reported and under-cared for. I have the privilege of having been involved now with my second elder abuse shelter. It is critically important work. But, even for those people who don't have, for whatever reason, the ability to open a shelter, educate yourself about the warning signs, about what to do, about ways to help older adults. [It’s] taking the issue of elder abuse out of the closet and making it as visible a part of our discussion with older adults as child abuse is when you take your child to the pediatrician and they have a black eye. We need to elevate the level of conversation about elder abuse in this country. You don't have to open a shelter to do that. You can be an advocate for these elders, you can be a person who looks for those warning signs. You can be a person who takes a stand against elder abuse, as well as a stand against ageism, as well as a stand in favor of raising and improving the image of the work we do with older adults.

On a personal note, one of the things that draws me to this work, that I didn't realize at first, is being the child of older parents. My parents married late in life. My dad was 50 when I was born and I was the oldest. So, I never had, as a child, the grandparent experience, and we lost my parents when my brother and I were quite young. For me, the opportunity to be a part of the lives of these older adults gives me a whole other level of meaning and experience that I wouldn't have had any other way. These are folks with so much to give, and so many opportunities to grow. What a blessing it is for those of us who can be a part of that!

Gene Mitchell is editor of LeadingAge magazine.