Shapiro Assignment 1

I am currently working at J-ADD, which is short for The Jewish Association for Developmental Disabilities, located in Hackensack, NJ for my field placement this year.  So far it has been a wonderful experience that I look forward to sharing with you.  The population that I work with involve those who suffer from a developmental disability and are over the age of 18.  In our agency, we currently have nine group homes sporadically located in Bergen County.  I have been assigned to four of the homes, where I visit with the consumers on a weekly basis.

J-ADD is a small but efficient agency providing an essential service to those who need extra help.  The consumers are usually referred to us, but some are placed in our agency by their families or removed from the street when conditions are unsafe.  J-ADD provides a safe shelter, food, clothing and any other essentials that our consumers need.  The staff at J-ADD work hard to place every person in the home that best meets their needs.  Each home is distinguished by the abilities of those who live in it.  For example, some of the homes occupy people who are immobile or unable to speak, while others are extremely high functioning.  J-ADD also has several apartments for those who are able to care for themselves but need a little supervision and guidance.

The staff in the J-ADD office are highly trained and well prepared for the unexpected types of situations.  Every staff is licensed in CPR and first aid and have attended classes in abuse and neglect, medication, and overview of mental illnesses.  Most of the staff that work in the "office" have PHDs and at the very least a MSW and LSW degree.  Those who provide the direct care for the consumers do not need any special degree but do undergo training.

I  meet with a variety of consumers weekly.  In one home,  which only has 6 men residing there and is considered one of the higher functioning homes, I visit with one specific client  twice every week.  For confidentiality purposes, I will refer to this client as Bill.  I do carry out activities with all who live in that house, such as cooking and arts and crafts.  I recently made home made pizza with this home, which was a great activity to get everyone to spend time together and share what they are going through each day.  In the second home I visit, there are 5 consumers living together, 3 men and 2 women.  In this home, there is only one person who is verbal, but her needs are very complex since suffers from paranoid schizophrenia and an intellectual disability.  I meet with her once a week as well where we always do an activity such as coloring or go out shopping.  For confidentiality purposes I will refer to this person as Amy since I will be discussing her again soon.  The third house I visit is one where  4 consumers live.  All but one are non verbal making discussions extremely difficult.  For this purpose I am constantly baking and doing puzzles with them to engage them.  The one consumer who is able to speak has conversations with me very frequently.

During the initial phase of this assignment I wanted to focus on Amy, who has many identifiable behavior patterns that need attention.  Amy is a 55 year old female who has been living with her step mother for as long as she can remember.  She suffers from paranoid schizophrenia and an intellectual disability.  She is accustomed to spending her entire social security check on scratch offs and Dunkin Donuts.  Her and her mother were forced to sleep in chairs because their apartment was infested with bed bugs.  Amy was removed from her home by social services, where the placed her with our organization.  She is very resistant to being in her new group home and is constantly causing arguments because she wants to return to her home with her step mother.

Amy craves attention, and will do or say almost anything if she is being ignored.  It has come to my attention that Amy can remain calm until someone new arrives and then she likes to "put on a show".  Similar behavior occurs when she arrives at a new place, for example, when Amy comes home from her workshop, she always has a meltdown.  She will enter the house screaming and yelling, throwing her stuff and anything that is around her on the floor while cursing at whom ever is closest to her.  Despite that she actually had a decent day, has positive things to say about it later while in a calm state of mind, and stayed out of trouble, this is part of her disability.

After speaking with my supervisor, I was persuaded to stray away from my original plan to change or interfere with Amy's behavior patterns, because it would be better to focus on someone who has a goal they want to change.  I agree with this due to the fact that it is a great deal harder to make someone participate in a change that involves them self when they don't want this change.  In Amy's case, she doesn't understand what I want from her either.  After much collaboration with my supervisor and staff from another house, I have decided to focus on Bill for this assignment.

Bill is in his late fifties.  He too suffers from paranoid schizophrenia and very mild retardation.  He is physically fit and healthy otherwise, who understands what is expected of him and is willing to help others.  To briefly mention his history, he lived with his family up until approximately five or six years ago when his father passed away.  His mother had passed away when he was much younger.  I believe that both parents died from a cardiac related illness.  He has a brother who does not visit often.  He misses his parents greatly and is able to express his emotions clearly.  In relation to his disability he has constant thoughts that people around him don't like him or are not his friends.  He sometimes has trouble internalizing an idea, for example, if the staff gives him advice (that can be very useful to him) he won't be able to apply it to himself.  He can repeat back to you what they said, but does not realize this information can be useful to help him.  Bill does not like to socialize with the others from his house and can not take the initiative.  Although this is rare, Bill is sometimes able to initiate a difficult conversation with heavy prompting and guidance, or be present in a common room with others in his house.  Some of his goals included becoming more sociable, since this is an area he lacks in.  His feelings are easily hurt and his rage can easily get out of control.  He has never expressed will to harm others, but has mentioned ideas of hurting himself.

After speaking with the manager from his home and my supervisor, we all agreed that it would be most beneficial not only to me, but a great deal to him as well to focus on his desire to socialize more for this assignment.  The main factor for this decision is due to the fact that this is something he wants to accomplish, and we are not asking for an unreasonable demand.  I still need to sit with the manager a bit more to discuss what will be the best way to carry out this task, but we have thought of a few simple changes in my routine.  From now on, when I visit weekly, we will all do an activity together, rather than me spending time with him for part of my stay and then with the rest of the residents for the remaining portion of the time.  I will attempt to organize a group activity involving cooking, a discussion, and arts and crafts in order to include everyone.  In addition, when I take Bill to our weekly volunteer program, which I am the leader of, I will guide him in initiating conversation with others.  I will formulate a way to keep track of his accomplishments, such as a chart, with the help of the staff in the home during times that I am not present. In addition, I will discus with his every week how he feels about what he has accomplished, or lack thereof to make him aware of his current progress.  Any mention of progress will act as a motivator for him and will help with this process and change.  I will monitor his progress over the next three weeks and will keep you posted as to my progress in addition to periodic updates.