"You know, Mr. X was in the emergency room again last night," they would say—doctors and nurses and social workers doing their rounds at the Veterans Administration (VA) hospital. Although the identity of Mr. X changed from day to day, the expression became the refrain of Maria Carpiac-Claver’s internship there: Providers were concerned "that certain older vets would show up in the emergency room a lot," she says. They wondered, "What might we be missing in terms of medical or psycho-social needs?" There was a sense, Maria says, that lack of social support was a contributing factor—"that the men were anxious and didn’t have anybody else to call."

At the time, Maria and another intern responded by developing a monthly comprehensive care clinic for some older veterans who were frequent ER visitors. Participants found it "comforting to know they were coming here once a month," she says. Although the interns wrote a journal article about the clinic, no attempt was made to learn whether veterans who used the clinic were less likely to seek help at the emergency room. Maria was still completing her master’s degree in social work.

Some time later, however, when she was thinking about her doctoral research, the VA experience came to mind, and "my dissertation topic was born," Maria says. Not being a full-time employee of the VA, she had no access to hospital records, so Maria gathered a theoretical sample of veterans through contacts she had made during her internship with doctors, nurses, and other care providers. In the end, she talked to 30 elderly veterans—both frequent and infrequent ER visitors with both large and small support groups—and her findings contradicted the social support theory: Frequent ER visitors "were using the emergency room quite appropriately," Maria says. "They’re just really, really, sick, and they have difficult-to-control and -manage chronic health conditions," for example, congestive heart failure. The role of their social support network was more complex than she had expected—in fact, "their primary care providers were a significant source of social support," she says. "They seemed to have good relationships."

Maria’s conversations with ER staff members brought a different conclusion: They thought the men they saw frequently—many of them homeless and with drug or alcohol issues—"didn’t have a lot of social support or don’t know how to use the health care system." Both findings could be correct—Maria has no way of knowing whether the men whom staffers talked about were participants in her study. It’s her hope to follow up with a study in which she can ask providers about the specific veterans she’s interviewing. She’d also like to do a randomized clinical study to see if a comprehensive care clinic would reduce ER visits, and she’s interested in older women veterans, particularly those from the Vietnam era.

Indeed, the endless opportunities—a research agenda with plenty left to explore—was one of the reasons Maria was attracted to geriatrics. Also, she has a history of good relationships with older people and feels comfortable with them. "I was never afraid of growing old," she says. "It’s always been more a thing to look forward to." Finally, Maria grew up "kind of knowing I wanted to be in the helping professions in some way."

As she finished her bachelor’s degree in psychology at UCLA, however, Maria still hadn’t figured out just what that way would be. "I knew what kinds of things I wanted to do," she says, "but I had no idea what job title was attached to that." She spent a year teaching third grade and then a year with Americorps as an instructor in first aid and earthquake preparedness—not surprisingly, perhaps, she often worked at nursing homes. Little by little, she discovered that social work offered a combination of "the things I’m passionate about." She liked the fact that social work dealt with individuals holistically—as part of their family and community environments—and that it offered opportunities in different walks of life, from teaching to clinics and hospitals and even political office. The "diversity of opportunities at UCLA" drew her back to her alma mater for graduate studies.

This fall, Maria launched her career: a one-year appointment at Whittier College, teaching "Introduction to Social Work"; an assignment at UCLA teaching a year-long freshman honors course, "Frontiers in Aging"; and a part-time research position at the VA. Her extensive experience at UCLA—including her own seminars on "Policies and Programs in Aging" and "Death and Dying"—"gave me the skills and the confidence to go out and teach other places," she says. "I love introducing undergraduates to social work and aging, to open their eyes to the fact that if they were to choose to get into this field, the opportunities are endless."

She also filed her dissertation this fall, having spent the summer in the throes of writing and preparing to defend it, placed on "a social diet" by her adviser, Assistant Professor Lené Levy-Storms. For the time being, she’s reduced the time she invests as an animal activist and volunteer mentor for at-risk high school students. Although the long-time Bruin is married to a Trojan, they share their dedication to community action: "He has his causes, and I have mine," she says.

Clearly, helping older adults—and informing those who deal with them—is one of those causes. Whittier has shown an interest in developing more courses on geriatrics with their newest faculty member. "The fact that I’m being called an expert in anything is wildly entertaining to me," she says, "but when we sit down to talk about aging, I am the expert."

Published in Fall 2006, Graduate Quarterly