My Agency

Assignment #1: My Agency

My field placement this year is at an agency, one I’ll refer to as A.B.C, which is what is called a “guardianship agency.”  It is a nonprofit organization whose clients are normally people who have been declared as “incompetent” by the courts, meaning essentially they are deemed as incapable of caring for themselves and therefore require another to be their guardian.  They do not, however, have any relatives, friends, significant others or spouses who are willing, able and considered fit by the courts to be their guardians, so the responsibility of their guardianship is assigned to an agency such as A.B.C., which is paid by the government for fulfilling this role.  There are generally two types of guardianship services an agency such as A.B.C. can provide for their wards: personal needs guardianship and financial guardianship, which is also called property guardianship.  Usually our agency provides our clients with both types of guardianship, normally by court order.  Sometimes, there are atypical cases where we are a ward’s guardian because he/she felt he/she needed one or both of guardianship and applied to the courts for the service.  For example, we have a client who became an agency ward because, at the urging of her nursing home’s staff, she applied for financial guardianship so that she could get her Medicaid reinstated so her nursing home could get paid for her care/housing. 

Most of our clients are geriatrics who reside in nursing homes.  Almost all of them have dementia and 99% of this group has severe dementia.  My job is as a client caseworker.  I visit my clients periodically to determine whether their needs are being met and that they are not being abused or neglected in any way.  My average client is an African-American nursing-home resident with diabetes, at least one other serious health problem – frequently vascular problems or Parkinson’s – depression, dementia and a “times-two” orientation, which means that the dementia has progressed far enough that he/she no longer has any sense of time but has a sense of place and person.  Many of my clients suffer from psychosis often in addition to dementia.    

 I have one client who would be appropriate as a subject for this course.  I will refer to her by the pseudonym Mary.  Mary is an atypical ward.  She is 72 years old and does not suffer from dementia.  She has health problems but they are less severe than those of my typical ward.  She does, however, suffer from psychological problems that include psychosis, depression and hoarding. (It is relevant to mention here that her facility’s staff has worked with her in a matter that has gotten her hoarding under control.)  She is currently residing at a nursing home, yet my agency feels the home provides a more restrictive setting than necessary given her particular set of mental and physical limitations.

I will be able to see her seven or eight times during the semester.  I am almost sure will be unable to see her any more.  I am, however, attempting to change Mary’s behavior, thinking and feeling in some way.  There is a problem that I have identified that I feel I might be able to effect some change that could serve as a primary focus for my work in this course.  The nature of this problem I will discuss in my next blog posting.