Provisionally Approved 6/18/02
INTERVENTION WITH ELDERS IN INSTITUTIONAL SETTINGS
Level III
RATIONALE: Working with elders involves a range of tasks and activities carried out in a variety of settings, each defining a specific role for the worker. There are two major categories of settings involving direct care with elders—community-based settings and institutional settings. Intervention with Elders in Institutional Settings encompasses a broad range of institutional settings where elders may reside long-term or for shorter stays. (Students have an opportunity to address community-based settings in the demonstration of the competency Intervention with Elders in Community-Based Settings.) With both intervention competencies, the student needs to be aware of his/her personal values, assumptions, biases, and the potential impact of these on intervention decisions. In addition, each of the intervention competencies is intended to be an individual rather than a group demonstration. It is important, therefore, for those seeking to work with elders to gain experience through direct-service with elders, and often their family members, who may be facing a variety of challenges. This competency relies strongly on the participation of an agency partner that will provide on-site supervision to the student and a CPCS faculty member who has agreed to evaluate the student in cooperation with an on-site monitor. Whatever the setting or task, effective work with an individual elder, an elderly couple, a family which includes an elder, or a group of elders requires knowledge of the aging process, the societal perceptions of elders, the network of services available for elders, and intervention strategies.
COMPETENCY: Can act purposefully with, or on behalf of, an individual elder, elderly couple, family or group of elders, to effect positive change in their lives.
CRITERIA:
1. Negotiate a supervised placement within an institutional setting that will allow you to provide direct services to an elder resident.
2. Describe the institutional setting and the resident base.
3. Describe your assigned role, placement expectations, and goals.
4. Select one to two residents and develop case studies that:
a. Describe the resident and his/her reason for seeking help
b. Negotiate/establish a contract with the resident(s) that specifies the nature and frequency of contacts
c. Discuss your role and your responsibility to the resident(s)
d. Describe an intervention method that you have chosen, including a justification for this choice
e. Describe interactions with resident(s)
f. Identify other resources that can help the resident(s)
g. Plan and execute termination strategies
h. Discuss the effects of field supervision on understanding and working with each resident
5. Using a theoretical base from literature drawn from gerontology, social welfare, and/or the health sciences to support assumptions, assertions, and intervention decisions made, evaluate your strengths and weaknesses in relation to working with the resident(s) and provide overall reflections on the extent to which expectations were met and placement goals achieved.
PORTFOLIO LINKS: You are expected to use the Level III Communications Portfolio writing standards as guidelines for the essays required by this competency. At a minimum, writing should demonstrate Level II Communications Portfolio standards.
STANDARDS:
1. For Criterion 1, the placement must be for at least one semester (14 weeks, 6 hours per week). This setting can be a hospital, clinic, overnight respite facility, or other institutional long-term care setting. The placement will be for direct intervention with elders (individuals, couples, families, or groups). The student will be assigned residents or resident groups (“types” may vary by problems presented or by resident composition—individual, couple, family, or group; gender; chronic condition(s), or referral sources). The supervisor must be an agency designee or a CPCS faculty member.
2. For Criterion 2, your description must discuss the setting’s mandate, mission, and authority, and the expectations these engender; describe the setting’s resident base, staff, and their operation, including the organizational hierarchy and flow of command; and place the unit where you will be working within this larger organizational context.
3. For Criterion 3, the description must include a discussion of the responsibilities and the relationship of your assigned placement role to the purpose of the unit and organization. The responsibilities must include direct intervention with elders. The student must maintain a journal as separate from the case studies, of all encounters with agency personnel. With the supervisor, you must:
a. negotiate/establish an agreement for the supervisory relationship;
b. discuss your role and that of the supervisor; and
4. For Criterion 4, you must write up case studies for at least three residents, meeting these standards:
a. Description of the resident and reason for seeking help must be consistent with generally accepted parameters of needs assessments or intakes.
b. Contact should be established with each resident once a week. Each contact should be between 50 and 90 minutes. Student should see each resident at least six times.
c. Parameters of placement plan must be made within agency policy/practice, including confidentiality.
d. Intervention method(s) must be presented to supervisor with supporting documentation, sanctioned by the organization, and implemented consistent with measurable outcomes. Specify other resources that may help the resident.
e. You must discuss how societal factors such as race, class, gender, age, ethnicity, and sexual orientation may have impacted the intervention.
f. You must discuss the planned termination strategies developed in cooperation with the field supervisor.
g. You must discuss the effects of field supervision with the field supervisor in understanding and working with each resident.
5. For Criterion 5, you must prepare an overall discussion of your strengths and weaknesses in working with elders:
a. Relate your personal observations to theory and case studies provided in the gerontological, social work, and/or health sciences literature.
b. Be aware of your personal values, assumptions, biases, and the potential impact of these on intervention decisions. Include observations of your communication skills, interaction style, biases, and values and assess how these observations may have impacted your intervention decisions.
c. Discuss how feedback from your field supervisor affected the work and relationship with the resident(s) and its impact on your understanding of the case/care planning.
EXAMPLES OF DEMONSTRATION:
1. Prior Learning: A student who has had extensive work experience in an institutional setting, meets competency requirements based upon documentation of prior experience. The student presents that documentation to a CPCS faculty evaluator who assists the student in identifying where criteria have been met and where additional documentation or work may be needed.
2. Independent Learning: A student already employed in an agency providing direct services to the elderly arranges to be assigned residents who meet the competency criteria and standards. The student negotiates an independent learning contract with a faculty member who approved the workplace setting, identifies appropriate literature, meets regularly to monitor progress, and agrees to evaluate work when completed.
3. Course: The student registers for and attends a course designed to address this competency. The student satisfactorily completes the assignments and meets the course requirements.