Profiles in Social Work

Helping Terminally Ill Elderly, Teaching Social Workers about Aging
Dr. Tracy Schroepfer, MA, MSW, PhD

After receiving her MA in Gerontology from the University of Arkansas at Little Rock in 1989, Tracy Schroepfer, MA, MSW, PhD, began teaching research and statistics and gerontology to social workers. "Once I started teaching, I knew that was what I wanted to do," she says. "I love teaching." However, her experiences in the classroom raised concerns about the future of geriatric social work. "I had social workers in my classes who had little experience in aging," she notes. "I was concerned that as the aging population grew, there weren't going to be enough skilled practitioners to care for the elderly."

Dr. Schroepfer decided to earn an MSW and a PhD, which would enable her to both care for older adults and teach future social workers. After continuing in her teaching position at the University of Arkansas for several years while her son finished high school, Dr. Schroepfer enrolled in an MSW and double-PhD program in social work and sociology at the University of Michigan, Ann Arbor.

At the University of Michigan, Dr. Schroepfer became involved in a number of research projects, including investigating how to control aggressive behavior in nursing home patients with dementia and exploring the caregiving issues that older couples face. She also developed a personal interest in issues surrounding death and dying. This stemmed from experiences with deaths among family and friends as well as encounters with death and dying as a nursing home volunteer.

This interest in end-of-life care led Dr. Schroepfer to a position as a medical social worker for an Ann Arbor hospice. In her work with dying persons and their families, she noticed that the issue of who should have control over the dying process kept recurring. After reviewing the literature and talking to practitioners, Dr. Schroepfer wrote a book chapter entitled "Facilitating Perceived Control in the Dying Process." The chapter discusses ways in which caregivers can reduce stress for terminally ill elders by increasing their sense of control over the dying process, including giving them opportunities to participate in decision-making about their care, estate planning, and funeral arrangements.

This paper led directly to Dr. Schroepfer's choice of topic for her Hartford-supported dissertation, entitled "Terminally Ill Elders Speak Out about Their Consideration to Hasten Death." Curious to explore what factors--including perceived control--lead terminally ill elders to seek a hastened death, Dr. Schroepfer interviewed 96 terminally ill older adults She found that 19% were considering hastening their deaths. Those with poor social support or who felt they had little control over their fatigue levels were more likely to consider a hastened death. Neither pain intensity nor perceived control over pain were significant factors in attitudes toward death.

Dr. Schroepfer believes these findings have important implications for end-of-life policy, care, and research. "Currently the focus is on relieving pain," she points out. "This is important, of course, but my study found that psychosocial issues seem to be what is really important. I feel that palliative care programs need to take a more holistic approach."

Dr. Schroepfer credits the Hartford Doctoral Fellowship with speeding the progress of her studies. "The Fellowship allowed me to quit several jobs I was holding and to concentrate on finishing my dissertation," she says. "I can't say enough about the program. It was one of the best things that ever happened to me." Dr. Schroepfer particularly appreciates the crucial information the program provided on career development issues, such as interviewing, networking, and publishing.

Now finished with her doctorate, Dr. Schroepfer intends to continue her research on the dying process in her new role as Assistant Professor of Social Work at the University of Wisconsin. She plans to continue studying terminally ill elders' attitudes toward a hastened death and measure how and why those attitudes change from week to week. She also hopes to further explore the topics she researched during her doctoral studies, including issues with dementia and caregiving, as well as an earlier interest in homeless elderly. She will also have ample opportunity to reconnect with her first love: teaching. "I hope that by teaching I can encourage more social workers to go into aging," she says. "I want to raise their level of enthusiasm, to show them that aging can be a challenging and rewarding field."

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