Guided Practicum in Administration of Human Services

Cultural Immersion and Agency Assessment Report

Jaquaya Thomas
August 17, 2014

Population Served by My Agency:
The Little Sisters of the Poor, Jeanne Jugan Residents currently consists of 78 residents.
The total occupancy is 80 and the residents do not have to be Catholic in order to live at the
home. The age range for the residents are 70-90 years of age with the exception of Father who
just recently turned 101 years old. There are 65 females who are Caucasian, 8 males who are
Caucasian, 3 females who are Afro-American, and 2 females who are Filipino. The residents
have to be 66 or older and of low income, meeting the current poverty guidelines according to
the Federal Government. They must go through an application screening process and interview
to insure they are the right fit for the home. The home prides itself on being known as a nursing
facility and is not an assisted living facility. Every resident has to come in as an independent
resident when accepted into the facility. If the residents grow to need some extra care, they are
housed in the nursing side of the facility. This side only takes care of minimum needs for the
residents that include feeding, pushing them in their wheelchairs, and some lifting. If a resident
needs feeding tubes and or ventilation machines, they are transferred to another facility because
the agency is not equipped to handle that form of care.
Population Selected for Cultural Immersion:
The population selected for this Cultural Immersion are Caucasian elderly women living
in poverty. Little Sisters of the Poor serves a high population of Caucasian females living in
poverty. They come from many different states and cities. Some of the women have family near
and the others who do not, rely on the Sisters to help them out. I have never worked with senior
adults and working at Little Sisters of the Poor was my first experience. I had a slight fear of
working with the elderly because I did not know what to expect. I have worked with your for
about twenty years and that job comes second nature to me. I know how to relate to them and I
also know how to understand what they need and want. I initially thought working with seniors
would be very hard because I thought I could not relate to them. I found this to be untrue early
on in my internship. Working with seniors was not hard and I found that I could relate to them
in more ways than one. They have a voice and they want to know that it still matters. I was
under the impression that they are all set in their ways and there is no room for change. This was
not true and in addition to having an abundance of knowledge they also wanted to learn new
things. The men are not as talkative as the women and it took them some time to warm up to me.
Through daily interactions and friendly gestures, the male residents began to open up and
communicate with me.
Populations History and Major Milestones:
Caucasian elderly women make up 81% of the population at Little Sisters of the Poor.
According to Jasmine Tucker, the gender gap in poverty for older women and men reflects
earlier disparities. The typical woman working full time, all year, earns just 77 percent of what
her male counterpart earns. In addition, womens lifetime earnings are reduced because they are
more likely to take time out of the workforce, or work part time, to provide unpaid care for
children or other family members. As a result of their employment patterns, elderly women in
2009 received a 23 percent lower average social security benefit ($12,012) than their male
counterparts ($15,588). Additionally, elderly women typically have fewer pension assets and
income as compared to elderly men. With the poverty rate so high among women who are
nearing retirement age, smaller social security benefits and the lack of other retirement income
means they will likely spend the rest of their lives in or on the verge of poverty. According to
the US Censes Bureau the elderly population is growing at a moderate pace and we will grow to
have an abundance of elderly than we will of fourteen year olds.
Assessing the Field Work Agency:
Little Sisters of the Poor is located at 185 Salem Church Road in Newark, Delaware
19713. It is directly across the street from Christiana High School, next to an apartment complex
called the Villas, and next to a community for elderly adults.
Agencys Community:

Access:
Little Sisters of the Poor is located off of Salem Church Road, in Newark Delaware. The
agency is across the street from a bus stop that is within walking distance. The residents live at
the agency and do not need to have transportation. There are some residents who have cars and
they park them in designated parking spaces at the nursing home. Surrounding the nursing home
is a high school across the street, an apartment complex to the right, and an elderly community to
the left. There is a shopping center one light up from the nursing home and it contains a Dunkin
Donuts, Dollar General, local bar, Mings Kitchen Chinese restaurant, a laundry mat, a
barbershop, a nail salon, Dominos Pizza, a middle eastern restaurant, and a Wawa. The closest
shopping mall and supermarket with reasonable prices is ten minutes away. The residents who
do not drive have access to transportation through the home. Volunteer drivers are used to
transport residents to appointments. The Activitys Director plan weekly outings for the
residents to go to various shops in the surrounding community. Residents who drive have the
freedom of going to the stores on their own time.
Receptivity:
When you first enter Little Sisters of the Poor, you walk through two sets of sliding glass
doors. The first set of sliding doors lead to a foyer area where there is a little bench area. The
second set of sliding doors leads into the lobby area. In the lobby area you will find the
receptionist and her desk area, a set of couches and armed chairs, some tables, a sign-in and sign-
out stand, a television hanging on the wall that shows pictures, some windows and decorations
placed around on the tables. In the lobby area, everyone is required to sign-in and inform the
receptionist why you are in to the home today. Once you speak with the receptionist, she will
issue you a badge and you can go to the designated area or wait for someone to take you back.
Administration and Staff Training:
Mother Joseph is the person in charge of Little Sisters of the Poor. She insures the right
people are hired for the supervisor positions to run the daily operations of the agency. The
supervisors report to Mother Joseph any concerns they have and anything they need for the
operation of their area. Mother insures the staff are following the policies and procedures
through meetings and trainings. The agency has annual in-service trainings for supervisors to
follow up with any changes being made with the agency and to keep them up to date on all
operations of the program. During the trainings the staff receive CPR/First Aid, trainings on
how to work with the residents on making sure their needs are met, and trainings on safety
(environment and physical). Little Sisters of the Poor utilize members of the population to work
in the nursing home. Their work consist of them running the store, working in the laundry room,
working in the kitchen and cleaning the chapel. These are all volunteer based jobs and the
residents sign up on their own.
Funding:
Little Sisters of the Poor is funded through Bequest, Memorials/IHO, Church Collections,
Employee Matching, Regular Donations, United Way, Fundraising, Grants, Foundations, and the
Begging Nun. This organization does not get any funding through the dioceses or the
government. Each year they have annual sporting events; such as, the Nun Run and golf
tournament that raise money for the specific needs of the agency and residents. This years Nun
Run is being held to raise money for new beds for the residents. The amount of money raised
last year for this even was about $18,000 and this year the goal is to double that amount.
Staff Sensitivity:
In my experience at Little Sisters of the Poor, the staff are very respectful to all the
residents. They care for the residents as if they were a member of their family. The residents are
all addressed by their names and when the staff are talking about them as a whole they refer to
them as the residents. The residents who have restrictions, the staff are all aware of these
restrictions and they make sure everyone around knows. The staff meet the residents at their
level of need and this has created an environment of family in the nursing home.
Agency Programs and Services (Effort):
The Little Sisters of the Poor Mission is to offer the neediest elderly of every race and
religion a home where they will be welcomed as Christ, cared for as family and accompanied
with dignity until God calls them to himself. Their Vision is to contribute to the culture of life
by nurturing communities where each person is valued, the solidarity of the human family and
the wisdom of age are celebrated, and the compassionate love of Christ is shared with all. Their
Values are reverence, family spirit, humble service, compassion and stewardship. Reverence is
for the sacredness of human life and for the uniqueness of each person, especially those who are
the poorest and/or the weakest. This is reflected in their care that is holistic and designed to fit
the needs of the individual person. Family spirit is a spirit of joyful hospitality embracing all
with open arms, hearts and minds; fostering participation in the life of the home and rejecting all
forms of discrimination. Humble Service is the desire to raise others up and to put their needs
before our own; an appreciation of simple, everyday tasks, experiences and being humble means
accomplishing our work. Compassion is empathy for sharing the weaknesses and sufferings of
others; eagerness to relieve pain in all its forms and to make the elderly happy. Stewardship is
the recognition that life and all other goods are gifts from God and should be used responsibly
for the good of all; trust in Gods Providence and the generosity of others to provide for our
needs; just compensation for our partners; a spirit of gratitude and sharing (2014).
Little Sisters of the Poor is uniquely structured in a way that I have never seen a human
services program operate. They do not have a Board of Directors and operate with only an
Advisory Committee due to the fact that they are a Provincial Organization. This means that
they handle everything that they need within the organization and rarely go outside of the
organization for ways of running it. The structure is set up with an Advisory Committee with a
President-Mother Joseph, Vice President- Sister Georgia, and Secretary- Sister Cecile. Mother
Joseph is in charge of the whole agency so all the supervisors report to her. The organization
does not get input from the surrounding community about what goes on in the agency. The
residents who live there give input on what they would like to see done in the home and their
input is used to shape new programs for them.
Quality:
The programs and services are evaluated for cultural congruence and sensitivity to the
needs of the population by surveys. The residents are given surveys and feedback cards to give
their input on what they want in the program. The agency is well aware of cultural differences of
the residents who live there. They have created an environment that includes everyone.
Effectiveness:
The residents of Little Sisters of the Poor and given a survey to take during the
admissions interview. This survey gives the agency a view of the incoming residents likes and
dislikes. This information is shared with the Activitys Director and she uses this to plan
activities for the month. The agency gets feedback from the residents on how they like certain
activities and what would they like added to the calendar. The agency serves a high population
of women and they make up the majority when attending the activities planned. The activities
planned are all inclusive so they do not leave anyone out.
Efficiency:
Little Sisters of the Poor has ongoing relationships with different agencies that services
the agencys population. They work closely with Medicaid to insure the care for their residents.
They work with Exceptional Care to pair up the residents with children who are terminally ill to
read to them. RSVP is a volunteer program that they work with to insure seniors are active
volunteer members of the community.
NASW Standards for Cultural Competence:
In Section I-Standards for Human Service Professionals under The Human Service
Professionals Responsibility to Clients, Statement 5 says Human service professionals protect
the integrity, safety, and security of client records. All written client information that is shared
with other professionals, except in the course of professional supervision, must have the clients
prior written consent. At Little Sisters of the Poor, the social worker Carrie is the keeper of all
residents records. When a resident first comes to the nursing home, they go through an
interview with the social worker. Carrie goes over their 3 month care plan, they have a care
conference, they review their medical plan and they complete a mental mood survey for
activities compatibility. Once all this information is collected, the resident now has a file that is
created. This information is never shared with anyone outside of the agency. All staff in the
nursing home work together to help the resident with what is needed for them while they are
living in the nursing home. Also during the initial interview, the residents give the social worker
written permission to be advocate with handling business with agencies outside of Little Sisters
of the Poor. Carrie will write letters on the behalf of the residents to have their bank accounts
changed to Little Sisters of the Poor, so the home can take care of the residents finances. If the
resident has to go into the hospital, Carrie acts as the liaison between the hospital and the
resident. She handles the care for the resident and will help with notifying the family. If a
resident does not have family, Carrie will stand in to make decisions on behalf of the resident.
This is a part of her job this information is discussed during the initial interview once the resident
moves into the nursing home. During my internship, I signed a letter of confidentiality. This
was to insure what information was shared with me during my time at Little Sisters of the Poor,
was not shared with anyone else. If there were instances where I could not be privy to certain
information, I was asked to leave the room. This was to protect the residents privacy and also it
insured the agency stayed within regulations for client privacy. I personally like to maintain a
high level of professionalism when it comes to working with the residents. If they resident
disclose personal information to me, I do not share that information with anyone. I feel like they
must really trust me to share this information and it is my job to keep it to myself. If it were the
other way around and I shared my information with someone, I would not like them telling my
business to anyone else.
In Section I-Standards for Human Service Professionals under The Human Service
Professionals Responsibility to the Community and Society, Statement 10 says Human service
professional are aware of local, state, and federal laws. They advocate for change in regulations
and statues when such legislation conflicts with ethical guidelines and/or client rights. Where
laws are harmful to individual, groups or communities, human service professionals consider the
conflict between the values of obeying the law and the values of serving people and may decide
to initiate social action. In order for Carrie to effectively do her job, she has to know the state
rules and regulations. She has formed working relationships with the state and is in constant
contact with them in regards to the care of the residents. With the rules and regulations are
constantly changing, Carrie has to be on top of knowing them. In order for a social worker to do
his/her job, he/she has to know what is needed and expected of them when serving the clients. I
feel that if you know what you can and cannot do, it can help you provide the best service for the
clients. This information can also help you with completing your job to the best of your ability.
References


(2014, 06 20). Retrieved from www.littlesistersofthepoordelaware.org

(2014, 06 20). Retrieved from www.littlesistersofthepoor.org

(2014, 08 17). Retrieved from
http://www.census.gov/population/socdemo/statbriefs/agebrief.html

Tucker, Fellow, J. (2010, September 22). Poverty among the elderly is a women's issue.
Retrieved August 16, 2014, from http://www.nwlc.org/our-blog/poverty-among-elderly-
womens-issue-0