Aids Those Ailing and Alone : Social Worker to the Aged Does Battle With System

Dianna Guinyard, a social worker who makes house calls in the most isolated parts of the nation’s capital, parks her four-door burgundy Honda in the hazy sunshine, enters an old apartment building and takes the stuffy elevator to Edward Green’s cramped fifth-floor apartment.

Green, a 69-year-old black man who retired from a restaurant dish-washing job in 1980, is living alone, wheelchair-bound. He greets her in blue shorts, white shirt and running shoes and produces a stack of medical bills he is unable to pay: $25.65, $35.76, and so on, until the total passes $200.

High blood pressure, diabetes, stroke all have afflicted him, he says. “I got every bad thing a person could have and still live.”

And he is sick and tired of some voice on the telephone trying to collect a $428 doctor bill. “She was a foreigner,” he tells the social worker. “She tried to run over you the way white people do.”

Guinyard, who also is black, soothes him, promising to pursue Medicaid to see that the bills are paid. “My God,” she says, “when they see all these bills, you’ll get help right away.”

Green is the first of several clients whose homes Guinyard will visit today. All will have something in common: They will be elderly, ailing and alone.

Guinyard, one of the legion of workers in Washington’s bureaucracy, is a supervisor for a program run jointly by the city and a hospital foundation. As such, she may seem to outsiders to be merely part of “the system”--but that is not the way she sees herself.

“One city bureaucrat had the nerve to tell me I’m doing too much for my clients,” Guinyard fumed. “My clients can’t come out and fight the system. I have to do it.”

That means, among other things, standing in long lines at Social Security offices for the needy people she assists, telephoning other social service agencies, arranging transportation and meals, finding housing and tracing lost or stolen checks.

“Sure you get weary, but you know if you don’t do it no one will,” she said.

Snakeskin Eyeglasses

Guinyard, a slender woman in low-heeled black shoes who usually dresses in muted, modest styles--except for her eyeglasses with snakeskin frames--is one of seven social workers at the Greater Southeast Community Center for the Aging, a nonprofit agency.

She works in the public housing developments, apartments and houses of southeast and northeast Washington, a mostly black area that is largely poor, crime-ridden and cut off from the rest of the city by the Anacostia River. It is where tourists never go. Black Washingtonians call it “Far East.”

Is she afraid? “I would never allow fear to become a part of my life,” Guinyard said, walking with brisk confidence through a housing development’s deserted yard. “Can you imagine how that would intimidate me?”

But, if she isn’t frightened, she isn’t crazy, either. So, although she takes clients’ telephone calls at all hours of the night and weekends, she admitted that she would never walk alone at midnight through some of their neighborhoods. And, she said: “One thing you always do is lock your car.”

Her days are filled with staff meetings, telephone calls and paper work, and with visits to little stale-smelling homes with pictures of Dr. Martin Luther King Jr. and Robert F. and John F. Kennedy on the walls. The home visits have made her more adept at navigating Washington’s rambling streets than most cabbies. She must write narratives about each visit, each contact with “the system.” And she dispenses as much psychological help as any other kind, becoming a surrogate daughter to the old people who are her clients.

The people she sees each day are part of “the other Washington.” Their problems are so profound and so basic that they often pay no attention to the worldly concerns that so preoccupy official Washington and its hangers-on. At one home, a televised “special report” shows President Reagan speaking. No one watches. Someone turns down the sound.

Being black is an asset to Guinyard. It has helped her gain the trust of many black people whose only experiences with “the system” have been bad ones. “Washington is 70% black,” she said, “and when I took this job I knew most of my clients would be black. They feel more comfortable sharing feelings with me.”

Guinyard, who is deeply religious, has integrated her church life with her work. Often she rises at 5 a.m., takes tea and attends an hourlong prayer session at her church before making it to the office--about two miles away--by 8 a.m.

She participates in an “adopt-a-senior” program to help elderly church members. And, on her visits to homes, she often tries to enlist members of clients’ churches to help them--using the “church network,” Guinyard calls it. Sometimes she sees herself almost as a minister.

“I’m meeting the needs of people,” she said. “That’s what ministers do.”

But, if she is religious, she’s not sanctimonious. She loves sewing, tennis, roller skating, basketball and a good laugh. She noted that “a lot of seniors work well into their 70s,” adding: “Look at our President.”

Close contact with old people and new technology has inspired two Guinyard maxims:

-- “Don’t be anxious about anything.”

-- “Computers will take over everything but the human touch.”

Social work called Guinyard years ago. As one of 12 children growing up in St. Matthews, S. C., she used to watch television and fume whenever she saw fictional social workers “raiding their clients’ closets, looking for evidence of a man. I said, ‘One day I will be a social worker, and I will never do that to my clients.’ ”

She received a master’s degree in social work at the University of Georgia in 1980 and worked in several other programs for the elderly before joining the center a year ago. As a director of case assessment, supervising other social workers in addition to ministering to her own caseload of 28 clients, she earns $25,000 a year.

When she was a youngster in South Carolina, she said, she lived in a neighborhood called “the senile farm” because so many old people lived there. “From a child, I learned to respect my elders.” She was especially close to her grandfather, who died at 89. He was “a sweet man,” she said, known as “Praying Joe” for his religious fervor.

Guinyard’s childhood clearly pointed her toward her present work. Roberta Greene, staff director of family programs at the National Assn. of Social Workers, said positive childhood experiences help people realize “that growing old is a natural part of the life cycle” and become an impetus toward a career in helping the elderly.

Now 31, single and living the dream she had as a child, Guinyard is able to give back to elders some of what she received from her grandfather: time and compassion. “I always wanted to help people,” she said. “What better way to do it?”

Help is needed. In Washington, 24,000 people age 60 and over are using agencies like Guinyard’s to get food stamps, legal counseling, housing, Social Security and other assistance, such as electrical devices that can summon emergency help at the touch of a button. As the population ages, the number of the elderly poor is rising, reflecting a national trend.

The Commonwealth Fund, in a study entitled “Old, Alone and Poor,” has reported that, of 8.8 million elderly people living alone, 1.7 million are poor. “Over the next 25 years,” the report says, “the number of elderly people living alone will continue to rise.” The financial picture is bleakest among minority members: The poverty rate for nonwhites is 43%, compared to 35% for Latinos and 16% for whites.

For Guinyard, the numbers come to life daily.

On this day, she receives a telephone message of distress from Beatrice Plummer, an 81-year-old woman whose Supplemental Security Income check is past due. To trace the check, Guinyard goes to a neighborhood Social Security office in the Capitol View Plaza--a gloomy mini-mall with a few small shops. A clerk, unimpressed that she is a social worker with more homes to visit today, says sharply: “You’ll still have to take a number.”

“This has taught me patience,” Guinyard sighed, settling among a dozen people in metal chairs in the little overheated room. “I take it one step at a time.”

‘A Little Darling’

Ten minutes later, she gets the tracer form she needs, fills it out and takes it to Plummer’s apartment for signing. Plummer, who has been unable to walk for the last 10 years, said: “Sometimes I feel sorry for myself. You lie here in the bed and you feel nobody’s coming. But she’s a little darling. She was really a big help in getting my husband in a (nursing) home.”

Life in a nursing home, or “a home,” as many of the elderly here call it, is the most fearsome prospect known to the people who seek help from Guinyard. A major part of her job is to keep them functioning in their own homes. Finding city-paid homemakers, getting hot lunches delivered and keeping their aid checks coming are all part of that.

Experts estimate that only 5% of the elderly nationwide live in nursing homes, which, they say, cost far more than other alternatives.

But money is not the only price elderly people pay for life in a nursing home, Guinyard said. “Many just go down,” she said. “They look at a nursing home as a place where people go to die.”

Plummer, whose city-paid homemaker spends the day with her, may be able to stave off a move to a nursing home if her daughter retires and moves in with her. But that is some time away, and Guinyard suggested that she allow a 19- or 20-year-old to move in with her. “Yes,” Plummer agreed, “if it’s a quiet young person.”

As for going to a home--no way. “I cry,” she said. “And I don’t eat. Even when I go into a hospital, I don’t eat.”

‘They’re Human Beings’

Guinyard likes to try to give her clients an option, perhaps by finding someone to live with them, even when it seems that going to a home is all that’s left. “If you make that decision for them and things don’t work out, then they’re going to blame you,” she said. Besides, she added: “They’re human beings, and they have rights.”

And, often, they have humor, which sprouts like exotic flowers in a harsh desert.

Late in the afternoon, Guinyard rings a doorbell and waits. After a minute or two, Madie Haith, an 84-year-old widow, answers, apologizing for the delay, explaining that “my chariot needs repairing.”

It’s a light-hearted way of dealing with a serious matter; her wheelchair control mechanism is damaged, and she desperately needs her “chariot” to move around her home. Confined to the chair, her limbs twisted by arthritis, Haith needs a full-time homemaker also.

Her body is failing, but her memories flourish. She directs a visitor to a photograph of a woman in a bathing suit. Atlantic City, 1959. “I used to be straight,” Haith said proudly. Curvy, actually.

Guinyard said she sees no problem in getting Haith a homemaker. Getting the wheelchair repaired may be tougher, though, because it will mean convincing the bureaucracy that the repair is an expense that should be covered.

Will to Survive

Spending time with old people can educate. Guinyard is amazed by her clients’ will to survive, despite their infirmities. “If they give up,” she said, “if they don’t have a reason to live, you’ve got a big problem” helping them.

But spending time with people who are old and ill can take a lot out of you. At the very least, it makes you acutely aware of your own mortality. “When you’re young, you don’t think about growing old,” Guinyard remarked, obviously not speaking for herself.

There is danger of overexposure to other people’s pain. “I realize my limits,” she said. “I’m not a little superwoman. I’m there to help and enhance their life styles as much as I can, but I know my limits.”

When she reaches those limits--when the social worker needs a social worker--she and colleagues, like her office mate, Joyce Thompson, swap stories and “just ventilate,” Guinyard said.

‘Compassion Fatigue’

She seems in no danger of suffering from “burnout” or “compassion fatigue,” common afflictions among social workers. But what if?

“If I ever wake up in the morning and don’t want to come to work, I’ll take up sewing,” she said.

And, if she should marry? She’ll not lose her taste for intense social work, she insisted, she’ll just become more inspired.

“I have become very conscious of living each day to the fullest,” she said, “but I also know there is a tomorrow.”