Aging gracefully

Indiana State’s gerontology certificate is changing lives.

No one wanted to care for Donald Graybill, a World War II veteran with blue eyes. He grunted, groaned and struck out at nurses. Like his comrades housed on the total-care floor at the Indiana Veterans’ Home in West Lafayette, Donald could no longer talk. Daily, he battled with pain and lacked the ability to speak of it.

The administration at the home followed a powerful, golden rule about human dignity: Each day, all residents got dressed and out of bed. This meant the former soldiers housed on Donald’s wing as well.

At that time, Tina Kruger, now an assistant professor in the department of applied health sciences at Indiana State University, served as a certified nursing assistant (CNA) on Donald’s floor. Since Kruger was the newest hire, she was often assigned to work with the most challenging patients. Even though Donald was known as a difficult patient who sometimes yelled at or tried to strike his caregivers, Kruger forged ahead and paid attention to the gruff old man.  While dressing him that first morning, she placed his arm in a shirt and noticed he winced.

“Essentially, the CNAs were hurting Donald and not communicating with him,” Kruger said. “So, I began talking to him and telling him what I was about to do and apologized if it hurt. I think this comforted him. He never hit me or yelled out. I worked with Donald my first week. When I returned on Monday, I discovered he had died over the weekend. That was really hard. It is so important to pay attention to older adults in these situations. The last few months of that man’s life could have been so much better. I want someone to be there for me in my last days. Not because it’s a job, but because she gets it. Because she wants to make my life better.”

Not long after receiving her PhD in 2011, Kruger was hired to develop a gerontology program at Indiana State. Lynn Duerr, associate professor of applied health sciences, and Kruger joined forces to grow this essential certificate program.

“From the onset, support from the university has been astounding. Many departments recognize the value of this interdisciplinary program, not just academically, but also its value personally for students,” said Kruger.

The certificate’s 12 hours of coursework address the merits and pitfalls of the social, mental and physical development of aging adults. Understanding damaging stereotypes, having knowledge of chronic diseases and health issues, investigating appropriate health care options and helping older generations live an active, balanced lifestyle are key components of the program. “Indiana State has been positioning itself as a wellness-oriented university, and the gerontology certificate fits into that vision quite easily,” Duerr said.

“It’s the little black dress, the blue blazer. It goes well with anything,” said Kruger of the certificate. “It is definitely a great complement to any degree program.”

“America is aging, and no matter what field students go into, they will encounter older adults and the issues surrounding them,” said Duerr. “Since older adults are going to permeate any field of study, our program graduates will have an edge over other job applicants. Although hiring organizations and agencies may not advertise as such, a gerontology certificate will be viewed as an asset.” Duerr thinks that many employers are now seeing issues with their older adult clients, and these employers will value an applicant who can tackle these issues on a professional level.

In the health fields, the benefits of understanding aging within the contexts of public health and psychology allow practitioners the ability to identify specific problems more readily. Yet, this certificate is also valuable to those going into nutrition, built environment, interior design and even art.

Climbing stairs. Something, many of us take for granted, but when designing a house for the elderly, it means focusing on concerns, like physical agility, that a typical home builder might not consider. Art therapy has been proven to help stimulate neural activity in those with dementia. With a keen knowledge of issues facing older Americans, students undertaking the gerontology certificate gain specific tools to enhance their abilities in their particular career.

For Tracy Keith,‘13, a human development and family studies major, the certificate meant the ability to employ her newfound knowledge in an activities department at a senior living facility in Terre Haute. As part of her 120-hour internship, she managed facility residents’ daily activities. She coordinated and led older adults in morning exercise, baking, journaling, bingo, bus rides and games.

“I currently work with children in the mental health field,” said Julie Wright, ’13. “Some of the children I work with are living with grandparents and great-grandparents. When they have questions or make comments about their older relatives, I feel extremely well-equipped to point out positive traits in older adults instead of focusing on the negative, which some of the children are prone to do.”

An element that makes the certificate special stems from Indiana State students wanting to give back. While many receive financial aid and more than 50 percent receive Pell Grants, students are keenly aware of the gifts they receive. It’s no surprise that according to the Washington Monthly’s 2013 study of 281 schools, Indiana State ranks number one in terms of community service.

Many students come from Terre Haute and stay after graduation, so they give back directly to the local community. Aware of this, the department of applied health sciences wanted the certificate to mean something in cities and towns across the country, but also specifically to Terre Haute. For the creation of the certificate, Kruger reached out not only to university faculty but also to members of the community by interviewing a host of aging services’ providers to learn exactly what potential employers wanted to see in graduates.

Michelle Graham, coordinator of the Area 7 Agency on Aging and Disabled in Terre Haute, emphasized the need for graduates to have a rudimentary understanding of the highly complicated Medicare program. With the recent passage of the Affordable Care Act, students need to understand Medicare now more than ever.

With input from the community and Indiana State faculty, in just two years, the gerontology certificate was not only designed, but the first certificate graduates crossed beneath the arena lights to receive their diplomas on the Hulman Center stage.

Not every one of the students in the certificate program necessarily knew gerontology was in their cards.

 All students need an upper division integrative elective course to meet foundational studies requirements, and several take a gerontology course. Many arrive with distorted and even humorous views on aging, and Kruger noted that these students get an eye-opener. “A good number of them believe that 50 percent of the population over 65 years of age resides in nursing homes,” said Kruger. “The reality is that around 4 percent of the older adult population lives in residential care facilities.”

Once students begin to explore the data, engage in community-based projects and learn about the aging process in real-life situations, a change occurs. “Students discover not only that the field is fascinating but any fears they had about old people were silly. Then, they want to take another class,” added Kruger.

However, like Kruger, other students have long known they wished to work with older adults. Some have been CNAs like Kruger. Others have experienced close relationships with grandparents or elderly friends.

Sometimes, working with children can lead students to change career paths. After a practicum or internship with a key population, some students realize this is not what truly interests them, but working with the elderly does.

Wright has enjoyed the company of older adults, but it wasn’t until she took a class on aging as part of the major requirement for her degree in human development and family studies that she became interested in the gerontology certificate. She acknowledged Kruger as an inspiration, “Her knowledge and enthusiasm for gerontology made me even more interested than I already was.”

It is often something beyond the coursework that draws students to the program, and this spark stays with them. Kruger understands this because she felt strongly about her career path despite some opposition. “When my family, friends, even grandparents, learned I wanted to go into the gerontology field, it was met with repugnance. But I knew I wanted a CNA like me to be knowledgeable and caring during my last days. Many of my patients passed away, and I was there for them,” said Kruger.

Duerr also pointed out that personal connection. “Students benefit personally because they are most likely going to be part of a sandwich generation where they may be raising a family while trying to address issues with their parents and grandparents. It will be important for these students to gain some idea of how to handle those issues.”

Keith needed to know how to care for her mother, who was diagnosed with stage four pancreatic cancer two and a half years ago. “I gained the knowledge about valuable resources available for caregivers. I learned about coping strategies, home health, hospice, support groups, websites, Medicare, end-of-life decisions and the stages of dying. The classes at Indiana State helped me tremendously in being my mother’s primary caregiver,” said Keith.

During Keith’s internship at the local senior living facility, she said, “I found that helping older people make their day better in turn provided me with gratification.  My desire and ability to work with older adults increased after my internship.  Helping older adults receive the best quality of care became my passion.”

Dave Malone, GR ’94, is a freelance writer in West Plains, Mo.  


  1. I received a masters in Sociology from ISU in 1982 with an emphasis in gerontology. I did an internship at a local nursing home and went on to become an administrator and regional for a nursing home chain in California and I am now the director of a state ran va facility in Alabama. What a rewarding career. I got involved on a bet that I would never go back to complete by PhD in sociology. They were so right. I started as a teacher in high school biology and changed to sociology for my masters. It was the best thing I ever did.

    Kathy Voll

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