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Internship Paper
- 1. Internship Paper Michelle Weber Dr. Bourassa Summer Internship GRN301 August 14, 2009
- 2. When I first started my career at Shippensburg University, I knew one thing: I was a Political Science Major who wanted to work for the government. Never would I have guessed that my entire track would change after a single class that was required by the university. My grandparents were always a huge influence in my life; whether it was in my attitude, character or as my role models. After I took the Introduction to Gerontology course, it clicked that maybe I could connect my love of politics with the love I have for older adults. Within the last four years at Shippensburg, many ideas of how to apply these two passed through my head. After working at an assisted/independent living center in the summer of 2008, I was attracted to the admissions office. I wanted to learn more about how the people I spent hours learning about got into this specific facility. With many failed attempts of finding an internship that could provide a well rounded experience of admissions, finally came the opportunity to do so with LifeQuest Nursing Center in Quakertown, PA. I learned more than just how to sit at a desk, but to apply my knowledge of the Gerontology minor to every aspect of the role of admissions director/coordinator. There were five specific concepts from several areas within Gerontology that stuck out to me; ageism, abuse/neglect, financial exploitation, and cultural competency. This minor is more in depth than just learning about the habits of old people as many Americans call the aging population. The first thing that I learned was about the concept of Ageism. This term was given to me in my first Gerontology class, Intro to Gerontology. Ageism is a pre-determined stereotype given to the elderly in which can be either negative or positive. Negative ageismhas such connotations as poor, frail, powerless, asexual, and valueless; while positive ageismassumes they are knowledgeable, cute and adorablei. This concept I was not aware of until after this course. As I walked around campus, the comments about older adults
- 3. and how my generation referred to them became more offensive. By break that year, I started to correct my family and friends when they referred to the aging community as old farts, geezers, and grandpa/ma (when referring to a slow driver). While at my internship, the ageist comments were limited. There were times however that I did catch some of the family members making remarks about certain individuals, whom are not their family, by describing them as a waste of space. As soon as these comments were noted, the staff did correct them immediately by trying to explain their situation without violating HIPAA (Health Insurance Portability and Accountability Act). Many people do not understand how ageismaffects older adults; in fact some might believe it doesnt affect them at all. At LifeQuest, there were several residents whom Diane, my advisor while there, felt it was okay to talk with openly. When I asked how they felt about the way they had been treated once they reached the age of 65, retirement age, the general consensus agreed that there was a drastic change in the way they were treated. One gentleman was a marine for 30 years, lived on his own, and was very active until he had to get his knee replaced. He says now, even after 3 months of rehab and at about 8 out of 10 on a recovery scale, he notices that people assume he cant do things himself because of his age; Even before this knee got bad, I use to get young fellas asking to mow my lawn. Every week Id say no, I enjoy mowing my lawn. Unfortunately not everyone can be taught about ageism, but little corrections here and there can make a difference. Abuse and neglect are another part of this minor that stuck with me throughout the years. The idea of someone hurting an older adult, as seen in Adam Sandlers movie Happy
- 4. Gilmore, makes my blood boil. While at my internship an opportunity presented itself in which I went to a seminar dedicated to educating those working with older adults about ideas they might not be aware of. The WilliamJ. Neff, SR Symposium on the Prevention of Crimes Against Older Adults focused on two main areas which I will break into two sections. The first one is by the Area Agency on Aging Services (Bucks County), on abuse and neglect; both physical and financial. The other, which I will go into detail later, is the idea of cultural competency. When talking about abuse and neglect in the spectrum of older adults one cannot assume it is always physical. Abuse is an actual physical or mental action in which inflicts harm, or punishment. When a family member intimidates an older adult by saying that they do not love them unless xyz, that is abuse. If an older adult is moving at a pace which the caregiver is not happy and rushes them, that is also abuse. Although abuse and neglect seemsimilar, they are different. Neglect can range from family members or caregivers refusing to help them with simple ADLs (Activities of Daily Living) such as toileting, dressing or even eating. As morbid as it sounds, its true that some family members refuse to feed their aging family member. Another way that neglect can be understood is refusal to give medications. Some seniors rely on specific medications to help regulate their body; heart, blood pressure or even arthritis. Worse than physical or mental anguish and pain is the financial exploitation of older adults. At the seminar, Dennis L. Houser, CPA a Forensic Accountant and Fraud Examiner reviewed several ways that older adults could be financially exploited. If an older adult and their child or another individual have a joint account, and the child or other individual begins to withdraw money from this account (checking, savings, money market, etc) it is not a civil matter
- 5. and has quickly become the newest form of theft from an older adult. Also power of attorney is another way for a family member to take money. There are four specific statements that should be included in order for it to less likely be violated. These include: 1. I shall exercise the powers for the benefit of the principal. 2. I shall keep the assets of the principal separate from my assets. 3. I shall exercise reasonable caution and prudence 4. I shall keep a full and accurate record of all actions, receipts, and disbursements on behalf of the principal. Number four is the one that is most likely to be broken. Many families see as if the money is now theirs since they are taking care of the older adult. In Death and Dying, Dr. Drenovsky often talked about the ways that even after death, families would fight over the wills and if the child with POA (power of attorney) got more, then the rest of the family would accuse them of exploiting their deceased relative and making them sign it this specific way. Cultural competence is something not many people think of when thinking about older adults. Culture is the last thing on the mind of caregivers, when in fact it should be the first. Different cultures have different expectations of their children. For example, in Asian cultures it is expected that the children take care of the parents as they age. Most often the children will move their parents into their home as a way to bring them closer. This is different than our traditional culture, which is to take care of them until we feel we cannot anymore, and then let them choose
- 6. their final home which is usually an assisted living, independent living or nursing home. At the seminar, The WilliamJ. Neff, SR Symposium on the Prevention of Crimes Against Older Adults, the woman who spoke of cultural competence, Susan Casta単o, did something very similar to one we did in, I believe it was Aging or Death, which was talking about the Cultural Umbrella. She had everyone stand up with the different cultures in which we associate ourselves. In the end we saw we all were associated with each other in many ways. While interning there came a resident on the Sub Acute unit and this idea came into play front and center. There was a resident who was Hispanic and only could speak Spanish. The one nurse who knew Spanish became the link between the administrative side (Kristen) and the nursing side (Joy). The nurse could translate that there were certain things that nursing wanted to do, such as testing and moving, that would be against their culture. Cultural competency also includes gender roles. When it comes to staffing at a LTC (long term care) facility, gender becomes a huge factor. If you have a frail woman in her upper 80s or low 90s and you try to schedule a six foot one tall, very muscular man with a bald head, it will end up in disaster for the next shift. In most cases when this happens the woman feels as if the man is too dominant and will rough house her; even if the man is as soft as a teddy bear. On the flip side, if you have a younger woman, say in her mid 20s, who has a fuller upper body and pair her with a man in his upper 80s or low 90s there could be even more problems.
- 7. The men can get grabby or there is a potential for them to push their boundaries and those nurses are less likely to report it, because they do not want to lose the resident. It is important as an administrator to understand this concept. After this internship I learned that even in the most obscure placement everything I learned in Gerontology is applied. Every day I was to learn more about Medicare and other insurances as well. After my day of being the admissions director I realized that this is what I want to do. I found confidence knowing that not only did I learn from this minor, but I understand how to apply every aspect of it to my future career. No longer do I feel lost, but instead empowered knowing that this minor is allowing me to enter a field in which I can truly change a field of study. i Markson, Elizabeth W. Social Gerontology Today An Introduction. Boston: Roxbury Company, 2002, p. 166