Interview with Charis Stiles, MSW on Geriatric Social Work

About Charis Stiles, MSW: Charis Stiles is a Friendship Line Manager at the Institute on Aging (IOA), where she focuses on suicide prevention services for older adults. At the IOA, Ms. Stiles supervises volunteers and staff, writes grant reports, meets with funders, creates training materials, and implements policies and procedures. Outside of her day-to-day work, she also co-facilitates periodic expressive art workshops that have focused on grief and working with vicarious trauma. Prior to working at the IOA, Ms. Stiles held numerous roles at Odyssey Hospice, including Medical Social Worker, Manager of Volunteer Services, and Bereavement Coordinator. At Odyssey Hospice, Ms. Stiles provided biopsychsocial support services to hospice patients and their families, completed regular needs assessments, engaged in educational programming, managed volunteer initiatives, and facilitated the bereavement program. Her numerous roles at Odyssey hospice focused on supporting patients suffering from terminal illnesses and their families, training volunteers, coordinating and supervising grief groups, and working with an interdisciplinary team to ensure quality of care.

Ms. Stiles earned her Bachelor’s degree in Psychology from the New College of Florida in 2006, and received her MSW from UC Berkeley in 2010 with a concentration in Gerontology. After her undergraduate degree, Ms. Stiles took two years off in between school to work in Child Protective Services as a case manager, and subsequently in AmeriCorps with the City of Los Angeles Department of Aging. During those two years she also volunteered in hospice settings and earned her certificate in expressive arts therapy. Charis Stiles was compensated to participate in this interview.

[] Can you please give an overview of your core responsibilities as a Friendship Line Manager at the Institute on Aging?

[Charis Stiles, MSW] The Friendship Line at the Institute on Aging provides suicide prevention and trauma grief support to older adults and adults with disabilities. It’s a 24-hour hotline that operates from 8am to 8pm in the office and after hours remotely. Callers are primarily over the age of 60 and are dealing with isolation, loneliness, depression, grief, and illness. Many have mental health conditions, some treated and some untreated, and many also have a history of trauma. We have between 50-70 volunteers who are the primary hotline counselors. Volunteers consist of students, professionals looking to switch careers and gain experience in mental health, and retired professionals. Staff include many former volunteers; we have an administrative coordinator who coordinates the schedules for the volunteers on their four-hour shifts, one volunteer coordinator who recruits and onboards new volunteers, and four volunteer supervisors who are either MFTs or MSWs.

As the manager, I oversee staffing and the overall program functioning. I assist in organizing and leading the volunteer training, which is a total of 24 hours of training covering active listening, suicide assessment, ageism, and traumatic loss. I also am in charge of all the reports for our many grantors, which includes data analysis (demographics of callers, call volume, etc.), and program evaluation (quality assurance measures, consumer satisfaction surveys, volunteer evaluations and compassion fatigue surveys, etc.). I’m really the go-between between senior management and our staff, often acting as an advocate for our program as well as an interpreter for higher-up decisions and policies. Some days I am solely focused on HR issues or facility concerns, and some days I jump into complicated client issues. But, a typical day includes a mixture: attending multiple meetings about program planning, funding, and supervision with staff; reviewing and compiling data about call volume and client demographics into charts and graphs; assisting staff and volunteers with complicated client issues; and preparing reports or documenting.

[] In what ways is geriatric social work different from other fields of social work, in terms of the skills it requires and the people and organizations you must interact with to ensure patients’ well-being?

[Charis Stiles, MSW] Older adults face many of the same concerns and issues as any adult–limited resources, mental health issues, substance abuse, history of trauma, systemic racism, homophobia, classism, etc. What makes older adults “unique” is that they are dealing with these concerns with the added pressure of ageism (discrimination against people based on their age) and ableism (discrimination against individuals with disabilities), as well as potential physical health changes and accumulated losses. Many older adults talk about internalized ageism and feel a decrease in their self-worth as they get older. Many also talk about the overt ageism that limits their ability to find employment, housing, and companionship. Moreover, many have had to deal with loss after loss, including deaths of loved ones such as their parents, spouse or partner, friends, siblings, and other peers. Other losses can include retirement (loss of role, loss of income in some instances), independence (may have to move into assisted living, may have to stop driving, may have to caregive for a spouse/partner), physical health (may include cognitive changes, diminished stamina, hospitalizations), and so on.

With this in mind, the interventions offered are fairly typical of what a social worker would provide to clients of any age. Counseling and case management are the primary forms of intervention as well as life review, grief support, and bibliotherapy can also be helpful. Life review is essentially actively listening to individuals tell the stories of their lives; many older clients do not get to share the wisdom and lessons they’ve learned over the decades. Many clients, like clients of any age, need to tell the stories of their experiences in order to integrate and explore themes, come to new insights, and better understand the path they have taken. As mentioned earlier, older adults face a great deal of loss and sometimes the best place to start in working with a client is to provide base level grief counseling. Sometimes no “work” can get done until the client is allowed space to grieve and mourn what they have lost and what they have been through. I think many practitioners forget this. Lastly, bibliotherapy is a common practice of utilizing books, articles, and quotes as tools to help the client feel a sense of commonality. I have found that this is a technique especially used in gerontology, especially in grief counseling settings, and it’s very effective. An example would be to provide copies of poems about loss or the changing of the seasons to a client grieving.

Older adults are just the same as us, only older. There may be generational considerations when offering interventions, just as there are often cultural and gender considerations. It’s important to treat each client as an individual and to ask them respectfully before assuming their value system. Remember the social work value of autonomy and self-determination; these clients are adults who have been making their own decisions for decades!

In many cases, gerontological social workers work closely with medical professionals and many clients come to mental health services through their medical team. I’ve also worked closely with APS, adult protective services, as many of my clients have been victims of self-neglect, financial abuse, or even sexual abuse. In very few instances I have also worked with conservators for clients with advanced dementia. Large, public programs that gerontological social workers will most likely come in contact with include Medicare, Medicaid, IHSS (in-home supportive services), Social Security, SSI (Supplemental Security Income), and HUD (United States Department of Housing and Urban Development). Each city/county also has a Department of Aging, which is a useful resource for aging services–get to know your branch and what services they offer.

[] In addition to working individually with hospice patients, elderly individuals, and their families, you have also taken on several leadership roles, including, not just your current role at IOA, but also your positions as Bereavement Coordinator and Manager of Volunteer Services at Odyssey Hospice. What did these roles involve, in terms of daily and long-term responsibilities, and what motivated you to transition from direct clinical work to program development and administration, as well as staff training and advising?

[Charis Stiles, MSW] I naturally jump into responsibility, which I think is a common trait among social workers. I’m also a natural extrovert with an urge to improve processes, so the step into leadership roles happened without forethought! I would not recommend this same “falling upwards” strategy to other social workers–talk with your friends in other roles, do informational interviews, really consider the choice before moving up the ladder and away from clients.

Each of these leadership roles involved different things dependent on their position in the hierarchy of the organization. At the IOA I was involved in hiring and disciplinary measures with staff, completing staff evaluations and so forth. As a volunteer manager, I did “hire and fire” volunteers and did many of the same tasks just with volunteers. For these type of manager responsibilities I had zero training, and that has for sure been a deficit.

Each position has held a lot of responsibility. Especially at IOA, I am in effect the program director and I am the primary contact for every funder, every outside agency, every staff member needing guidance, and every emergency or crisis situation. I am responsible for a 24/7 program in every way, and that was not what I had anticipated.

I do miss client interactions and I find my typical manager tasks drain me without fulfilling me, unlike client work. I am considering moving back to client-centered work and taking a break from management.

[] What have been some of your most rewarding experiences in geriatric and hospice social work? On the other hand, what have been the most challenging aspects of your career in this field? How do you recommend students who wish to enter geriatric social work prepare themselves to face these challenges and hardships?

[Charis Stiles, MSW] I have had so many rewarding experiences with clients–so many frail, dying individuals I’ve had the honor of working with and being present for, so many people I’ve been privileged to advocate for when they were not able to speak for themselves, so many grieving families I’ve been able to comfort and counsel. It’s been really incredible how many clients have really touched me.

Many of the challenges I’ve faced with clients are primarily due to longstanding, often untreated mental illness that clients have been dealing with for decades. Often there are systematic issues like generational poverty, lack of services in the community, and a general lack of concern for older adults unless in a medicalized setting.

For new social workers, I recommend keeping perspective and understanding the limitations placed on people in this profession. Many issues an older client is dealing with are issues they’ve been dealing with for decades; we cannot solve family discord, we cannot solve poverty, we cannot solve regrets or mental illness or a lack of services. This is incredibly difficult and takes years of practice and self-reflection. Remember that older adults have the right to self-determination and autonomy and we must respect their choices, no matter how much they may be hurting themselves.

[] For MSW students who are interested in becoming geriatric social workers, what advice can you give them about optimally preparing for this field while pursuing their degree?

[Charis Stiles, MSW] I highly recommend taking whatever gerontology-focused classes your program offers. A basic course in death and dying is a wonderful asset, even just for you personally. I recommend reflecting on your own attitudes toward older individuals and being honest with yourself about your assumptions about the later stages of life. Many of us have some degree of internalized ageism even if we don’t recognize it and this exploration will help us in any field we go into. Realize that while many of us may not explicitly choose gerontology, we will encounter older adults in our work and our personal lives; and as much as we don’t think about it, we are aging all the time! If you can find a placement with older adults, I highly recommend it. Adult day health care is a good first placement because you will get to interact with a large variety of older adults. Volunteering in settings like hospice, senior centers, or even the library may also be a good introduction to this population.

Thank you Ms. Stiles for your time and insights into geriatric social work.

Last updated: April 2020