A care manager in Maryland has spent nearly four decades learning what systems cannot teach: how to make broken things work for people who need them most
The term "feeder/companion" disappeared from healthcare vocabulary sometime in the late 1980s, along with so many other words that once described the intimate, unglamorous work of caring for the elderly. Allyson Stanton remembers it because she was one: a high school volunteer who sat with nursing home residents at mealtimes, helping them eat, keeping them company. She was young enough then that the math seems impossible now. Thirty-eight years in healthcare, and she is fifty-four years old.
Some careers choose their people early, and the chosen stay.
Stanton became a certified home health aide, another phrase that has since been quietly retired from professional use, replaced by newer terminology that sounds more clinical, less direct. But the work itself has not changed: someone must still sit with the person who cannot be left alone, must still know which foods they can swallow and which words bring comfort. Stanton knew, even then, that she had what she calls "an innate calling" to work with older people. It was not a decision so much as a recognition.
She became a social worker. She has remained one for her entire career, focused entirely on gerontology: the study and care of aging populations. It is a specialization that requires a particular temperament. Patience measured not in hours but in years. An ability to see dignity where systems see only expense. A willingness to fight battles that will never be fully won.
The question of what reaffirmed her purpose, she answers easily. The question of what challenged it comes just as quickly, but with more weight.
"As a Social Worker, you are an advocate first and foremost," she explains, "and that can be challenging working within systems and organizations." The understatement is characteristic. There have been many moments of frustration. There are still moments of frustration, even now, with her level of expertise. Things are not perfect. Sometimes systems seem very wrong and fundamentally flawed.
She has learned, and it took a long time, to focus on the solution and not the problem.
This is the wisdom of someone who has stayed long enough to understand that outrage alone accomplishes nothing. That pointing at what is broken does not fix it. That the work requires a different kind of endurance: not the sprint of righteous anger, but the marathon of incremental change. Helping one person navigate an impossible system, then another, then another, until the accumulation of individual solutions begins to reshape the system itself.
When Stanton speaks to students or early-career professionals exploring social work, her advice carries the weight of someone who has seen colleagues burn out, who has watched idealism curdle into bitterness. She tells them to ask themselves why they want to be a social worker and what they want to get out of it. Then: where do you see yourself working, and what will that look like?
"We can be successful," she says, "but it is not a glorious field."
She tells them to be informed about the different types of social work, about salaries and benefits. The big picture. Their future life in the field. To talk with older social work professionals. And then she adds, with the gentle insistence of someone who knows what she is recommending: "Please consider going into healthcare."
Because healthcare social work, more than perhaps any other specialization, exists at the intersection of human need and institutional constraint. It requires people who can hold both realities at once: the person in front of you who needs help, and the system that was not designed to help them in the way they need. It requires people who will stay anyway.
What does being a social worker mean to her? The answer comes in a list, each word chosen with precision: advocacy, guidance, empowerment, support, knowledge. And then, the phrase that contains everything else: "Ensuring someone has a voice, even when they can no longer speak."
This is the work that began in a nursing home dining room when Stanton was still in high school. This is the work that has continued for thirty-eight years, through changing terminology and shifting healthcare models, through frustrations that would have driven others away. The work of being the person who sits with the person who cannot be left alone. Who knows what they need. Who fights for it, quietly, persistently, without glory.
Today, through Stanton Aging Solutions, she continues this work as an independent care manager, bringing decades of expertise to families navigating the complexities of elder care. The practice is an extension of everything she has learned: that advocacy works best when it is personal, when someone who knows the system can stand beside those who do not, translating bureaucracy into care.
When Stanton thinks about the future of healthcare, she does not imagine revolutionary transformation. She imagines something both more modest and more profound: normalizing advance care planning conversations at every stage of life. More resources, more education, more support, so that individuals can feel empowered and proactive in their care. "A stronger focus on life and values," she says, "and less on treatment after the diagnosis."
It is the vision of someone who has spent decades watching people face the end of life without having ever been encouraged to consider what kind of end they wanted. Who has seen the consequences of a system that waits for crisis before asking questions. Who believes that the next generation can do better, not by inventing something new, but by making routine what should never have been rare: the simple, difficult conversation about what matters most.
Allyson Stanton has been doing this work since before the terminology changed, since before healthcare became an "industry" rather than a calling. She will likely continue doing it until the terminology changes again. Somewhere in Maryland, there is someone who needs an advocate, who needs their voice heard even when they can no longer speak it themselves.
She learned how to be that person when she was sixteen years old, sitting in a nursing home, keeping someone company at mealtime.
The term for what she was doing has disappeared.
The need for someone to do it has not.
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