Leslie Rubens

As a first-year graduate student at The Jack, Joseph and Morton Mandel School of Applied Social Sciences at Case Western Reserve University, I am pursuing an MSSA with a concentration in Direct Practice and specializing in Aging. Unlike most students, I have been afforded an opportunity to work in two different agencies for my practicum. Whereas my first semester was spent entirely at McGregor PACE, an all-inclusive care for the elderly program, I currently split my time working in Jewish Family Services’ Aging in Place program, which is sponsored by Case Western’s Medical and Nursing School. Similar to McGregor PACE, Jewish Family Services offers the experience of working as a key member in an interdisciplinary team with other healthcare providers to deliver care to a different cohort of older individuals. This second agency experience not only presented the opportunity to work with other students employing a holistic approach, but it gave me the chance to work with a different group of older persons with potential differing needs compared to my caseload at McGregor PACE.

At McGregor PACE, I am working with several clients who require more attention and pose different challenges. With these clients, I am able to identify and address their needs, establish goals, and set intervention methods to best meet these goals. I also have the privilege of working in an interdisciplinary setting, where we collaborate to provide the best care possible. I am able to work with the various social workers daily and attend monthly social work meetings that address issues, provide necessary training, and discuss methods of bettering current implementation procedures and protocol. At Jewish Family Services, I have the privilege of partnering with students in differing disciplines as we work with clients to establish a partnership and provide necessary care through submitting short field notes documenting observations, writing reflections, and attending small group discussions and seminars.

As a person gets older, they are faced with many problems, including their health, socialization, and increased need for assistance in various areas. Managing these different facets of their lives becomes gradually more challenging as their health worsens and their needs become greater. Providing support and care to better accommodate these issues is paramount toward maintaining and increasing their quality of life. Therefore, it is my role as a social worker to be cognizant of all these potential factors to deliver the most effective services.

Having worked with the elderly population for quite some time, my desire is to restore control and independence for the aging population through geriatric case management. Providing support not only to the elderly, but to their families, helping them navigate the complicated healthcare system and Medicare, assisting them with their healthcare needs, connecting them to proper resources, and bestowing emotional support for a rapidly growing population is my desired career trajectory. Emphasizing the importance of control, independence, purpose, and quality of life are the crux of addressing the social issues/problems this population faces.

The opportunities and experiences I have been afforded through working with two different agencies, and thus, two different sub-groups of older individuals has allowed me to develop my skillset as a social worker. Working with my caseload over the course of a year has bestowed the opportunity to draw on my practitioner skills more through problem identification, goal creation, care plans, and intervention strategies.

While one of my initial reasons to join the McGregor PACE and Jewish Family Services’ team for my practicum was to glean as much experience as possible in an interdisciplinary setting, the lessons and experiences I have learned have far surpassed my expectations. As previously mentioned, my caseload at McGregor PACE consists of more complicated individuals who face many challenges. One client in particular, has been a member of the program for over a decade, presenting many health and behavioral issues requiring a great deal of attention and support. Through my individualized and intimate work with her, I was able to establish a level of trust, which allowed me to uncover her devastating childhood. My client disclosed her recurrent experiences of abuse and neglect from her father. This breakthrough not only served as the impetus for a total shift in my fieldwork’s trajectory, but it facilitated a complete change in her care.

With the new knowledge of her history with trauma and abuse, her behaviors, unexplained medical issues and symptoms, both physically and psychologically, began to make sense. This discovery sparked my interest in acquiring as much information as I could on the subject of childhood trauma and abuse and its manifestation on older individuals. The more literature I read on the subject, the more I began to understand my client entirely. This revelation prompted my curiosity and concern regarding the systems that are in place at McGregor PACE, as I was befuddled as to why this was not detected years before by any healthcare professional. Had her history been known, she would have unquestionably received better care and support.

During this time, I had just begun my practicum at Jewish Family Services. The Aging in Place program was structured so that a group of differing healthcare students was randomly designated a particular client. My group was initially provided with some basic and necessary information regarding our client prior to our first session. Within that information, we were informed that our client suffered from chronic back pain, tremors, and depression – in addition to being a Holocaust survivor. This information about my client’s history of childhood trauma and abuse placed a spotlight on the recent connection I had made with my other client.

The prevalence and incidence of childhood trauma and abuse is vast. Extensive research has uncovered the connection between childhood trauma and abuse and its long-term impact and manifestation on a person’s physical and mental health. This empirically supported and well-established connection elucidates the need for universal screening in order to make the most effective interventions and care plans for aging adults.

I am extremely grateful to have been afforded the opportunity as student scholar of the 2018 Ohio Scholars in Aging Program. This program has expanded my understanding and familiarity of age-related policies at the state level. It was exciting to meet other students who are passionate about helping older adults in a multitude of capacities. Having the opportunity to learn about the depths of aging-related policy making, as well as governmental programs for older adults from dedicated professionals was an invaluable experience. The Ohio Scholars in Aging Program opened my eyes to many aging-related issues and has provoked a desire to advocate for older people on a state level. As I continue my graduate education through developing my knowledge and skills as a social worker, I am more equipped to practice informed-based care thanks to the Ohio Scholars in Aging Program.