Practicum Notes - Summer 2006'


On Monday, May 22nd I started my practicum at People Inc. Monday and Tuesday were orientation days that went from 8:00-4:30. On these days we covered what exactly the company does, company policy, sexual harassment/abuse, basic first aid, and OSHA regulations that we might need while working for People. These days were long and covered some pretty basic material, but were essential for starting at any company.
Wednesday, May 23rd was my first day in the office. I am following service coordinator named Tanya Wesolowski. I was there from 9-1:30 this day. Tanya warned me that she was just going to throw me into things as that is the best way to learn this job. So, as soon as I walked in the door I was shown my desk and on it was a huge file and I was told to read it and get to know this little girl. This little girl is severally mentally retarded, has trouble walking unassisted (she just began walking on her own last summer), and cannot talk. She is 15 years old and lives in a group home with 3 other children around her age. She needs constant supervision and help in every area of caring for herself. She does attend school and her parents pick her up on weekends so she can spend time at home with them. Her parents are divorced and her dad is only recently involved in her care. Two months ago was the first time he came to take her home for the weekend, but has been visiting her once a week as well as taking her home with him every other weekend since then. 
I had until 11:00 to read her file and then we had to go to her group home to do an ISP. At the ISP meeting was the two head caretakers of the house, the house administrator, her mother, Tanya and myself. We discussed the goals that were set for this girl six months ago, what was accomplished and what wasn’t, as well as coming up with more goals for her to try to work on for the next six months. We also discussed how she enjoys loud, crowded places and came up with a few ideas as to places that all of the kids could go from the house as well as places where her parents would be able to take her on the weekends so that she can be more involved in the community.
Thursday was a calmer day all around. I was in the office from 8:30-4:00. I quickly became friends with the copier, fax machine and mail room. Tanya had me filling out some forms for a few of her cases and I wrote the invitations for the ISPs that have to be done next month. DSDs also had to be done for a few kids, so that was my next project. Everything had to be copied and sent to all parties involved. The last two projects that I worked on were a little more difficult, but interesting as well. I had to make calls and write letters and complete applications for two sisters who are looking to move into a different home. They are both mentally retarded and one needs 24 hour supervision, so it was harder to locate the places that we could send their applications to. After doing that I had to familiarize myself with the file of a little boy who is blind. He goes to school during the day and a program after that. However, his mother needs help taking care of him now that he is getting older. I had to make a few calls and arrange for his mother to meet with an organization that helps blind people learn to pick out their own clothes and walk with a seeing eye dog and be able to function on their own in society. It was a lot of paperwork in the office this day, but it was still interesting to learn and is a big part of this job.

Monday, 6-5-06 (8:00-12:00)
This was the last day of orientation. We learned proper lifting and transferring techniques as well as corporate policies, HIPPA rules and regulations, and electronic security. This was interesting for the most part, but HIPPA was repetitive for me since I already took a class on this for my current job at a drug store.

Thursday, 6-8-06 (8:30-4:00)
First thing I had to do this day was to call a couple parents and ask them questions for a survey that the company was trying to do. Normally this would have been extremely boring and repetitive after awhile, but it was actually interesting. For many of the parents this was my first time talking to them, so I got a feel for their personalities. I was also able to hear about the services that their children are receiving and what they feel that they need more of or more help with.
We then had an ISP meeting. This girl is trying to get a better job than the one she has which is repetitive work and bores her easily. She is also working with the people at her day program studying to take her road test. One of the things that we are trying to work on is to convince her to move into an apartment. She would not need constant supervision and is very independent. This would just make her parents life easier and is what they want, but they want it to be her decision and for her to want to move. We also feel that it would be less hectic for her since her three brothers and sisters would not be around and there would not be as much chaos in her life. This might make it easier for her to perform daily tasks that she not has trouble with.
Once we were back in the office I was handed a file and told that the girl was looking for after school respite care and I had to make up packets for it. I had to copy her file and prepare it to send out to five different programs and then prepare a cover letter explaining her situation and what she was looking for.

Monday, 6-12-06
This should have been a day for me to be at the office, but the person that I am following took a personal day, so I ended up having the day off.

Thursday, 6-15-06 (8:30-4:00)
Today started with a staff meeting. This was a smaller meeting than the last one as we just met with the immediate supervisor of the group. This was fun for me because I learned about the policies that are causing problems for everyone, so I no longer felt like I was the only one who knew nothing about what the paperwork was about. It was also good because I got to meet more people in the office and everyone was relaxed and made me feel welcome.
I then spent time preparing invitations and writing letters for ISPs for to different clients and mailed everything out. This was the first time I was able to write a letter by myself and no one even proofed it. They told me they trusted that I remembered what to do. This made me feel better about my work and even more comfortable there.
I also prepared paperwork for a client to move and filled out their county services. 
This was the best day so far in the office and made me feel the most comfortable in this work environment. After a day like today I know that this is something that I can do for the rest of my life! 

Monday, 6-19-06 (8:30-4:00)
Today started and ended with home visits. The first visit was a visit to a school to observe a little boy in the school setting to see how he is doing with his classes. He was not feeling well today and responded only when he had to. Normally he is a very talkative little boy who is mentally retarded, but is learning how to function on his own and take care of himself. Right now he is able to perform basic hygiene needs for himself, but only with prompting to do so. He cannot remember from day to day that he needs to brush his teeth or take a bath.
After this visit we did some paperwork and prepared packets for people who need some in home and after school respite. I also learned how to do ISPs in the computer after the home visit and what sections different people fill out.
We then had a visit to a workshop. The consumer at was having problems at the workshop and this was an emergency visit that his supervisor called. When we got there we were informed that he refused to listen to his direct supervisor, was continuously rude to the staff, and was now starting to cause problems with other workers. We talked to him and calmed him down as he was upset that this meeting was caused. We got him to agree to work on listening better and to realize that not everyone is going to want to be his friend just like he doesn’t want to be everyone else’s friend. His mother convinced him to keep everything to himself for the time being and when he goes home at night he can call her and she will pick him up and they will go for coffee and he can vent all of his anger, frustrations, and feelings to her and she will help him find a more productive way of dealing with the situation.
Our last visit was to two elderly sisters. They are currently looking for a new apartment together, but one needs a lot more care than the other, so it is very difficult to find a place for them. Currently they are on several waiting lists. Nothing was new with these ladies since the last time I spoke to them. They are continuing to go to their workshops and are pretty independent. The older of the two likes to cook and clean, so their apartment is spotless and they are eating well. Everything seems to be going well with them for the time being, so this was a short visit.

Thursday 6-22-06 (9:00-4:00)
Today started with a staff meeting where we learned about a couple new procedures that are being implemented into the company and the new paperwork that is going to need to be done for every client.
A few ISPs were typed and filed and sent out to the people that needs copies for their files. There are about ten people for every client who need copies, so sending them out can actually take awhile. 
The day ended with a visit to a little boy who is severely mentally retarded. He is having surgery next week to have a rod put in his back to straighten it out since now it is so crooked that his organs are being compromised and his stomach is actually in his lungs right now. The doctors cleared him verifying that once he is under anaesthesia they will be able to wake him up again. He just went on waiting lists for residential placement since he is now getting too big for his mother to lift. Currently when he needs to be moved him mother and sister have to move him together. The family is also waiting because their house is not handicapped friendly, so Habitat for Humanity is building them a new house that will help them and make their lives a lot easier. They should be moving this summer.

Monday, 6-26-06 
Today should have been one of my days to be at People, but the person that I am following had to take a personal day to take her daughter to the doctors.

Thursday, 6-29-06 (8:30-4)
Today was a basic office day. I started by doing a lot of filing of reports from the past week or so, which included the monthly reports.
After filing was done I had to add to an InHome Reshab packet that I had sent out the week before. One of the places responded that they are interested and they think that they can provide the services that this little boy needs, but they needed some additional information from us before they could begin the intake process. This was a test for me as far as Tanya was concerned. She handed me his file and the letter from the lady and told me to go to town calling who I thought I needed to call and pulling the information that we had on file that these people wanted. I did have to get all numbers from her before calling people, so she knew that I was calling the right people for the right reasons. I think I was more impressed with myself than she was that I actually knew where everything was in his file and who I had to call to get the rest of the information that was needed...
After I was done gathering information (I could not send it out because we had to wait for his mom to get back to us since I had to leave her a message and a form that the doctor had to fax over to us), I worked on the notes from the month of June. Tanya takes very brief notes whenever she talks to consumers or other people about the consumers and she said that I should have been around her long enough to be able to decipher what the conversation was and be able to word it in a way that her supervisor would understand. This task was given to me as being optional, as Tanya herself admitted that this is something that she hated, but I actually wanted to do it and enjoyed it because I felt like I got to know the consumers on her caseload better and while Tanya had faith in me, it was a chance for me to see just how much I had learned. This was also good for me because it made me realize just how important it is to document EVERY conversation and interaction with these consumers. It’s always good to take little notes for yourself to help yourself remember what is going on with these people who are coming to you for help, but it is also a reminder that everything that goes on in this company is being watched and looked over to make sure that these people are getting the best care and services that they possible can.

Monday, 7-3-06 (8:30-1:30)
Today began with a home visit to one of our clients who is only mildly mentally retarded, but who still needs a lot of help with things like balancing a checkbook and shopping and day to day tasks. She has just moved into her own apartment out in the community, so she is very excited. However, we had to explain to her repeatedly the need to lock and check that doors are locked and that she isn’t carrying money on her that she won’t need. She doesn’t seem to understand that just because the door is closed doesn’t mean that other people won’t try to get into her house to take what she has. When we left we made sure that everything was locked again to be safe, but we were both worried that when no one is there to watch her she will just leave the door unlocked when she goes places. Outside of locking doors, she is very independent. She walks to most of the places that she has to go to and has a bike to get to the ones that are farther away. For the places that are really far or when she has to go to the store she has a staff member who continues to help her and drive her to the places that she needs to go to. She was just so excited about the little things that being around her made me think about how I was when I first moved out. I just wanted my apartment set up so I could live in it and hated everything about making it home. I was so rushed through the whole process I didn’t get to enjoy anything, and think that’s how most people are. But this girl had the right idea. She had a list of everything that she needed and is slowly getting it. She was SO excited about her curtains and rugs in her bathroom that she couldn’t stop laughing and grinning! She was also very innocent about everything. She was very happy that her bird made the move ok. She was telling me how scared she was that the bird would die or fly away on her that she almost didn’t move at all. However, the bird moved just fine (she held his cage on her lap in the car to ensure his safety) and is doing well and that seemed to be all she really cared about. Everything else made her happy, but she truly cared about the well being of this companion of hers. So many of us just know that the animals will survive that we don’t hold them and see them through and we forget that the small things like that are the important things in life.
After this visit we had to go and visit one of our clients who we had seen the week before. This is the one who was having surgery for his back. His surgery was a success, but the next morning he developed pneumonia and was doing really poorly when we went up to visit him in the hospital. I was amazed at how glad his mother was, not only that Tanya went up to see him, but that I came too. She came right up and gave me a big hug and thanked me for caring. This is a family that doesn’t have much, and she really can’t afford to take time off of work to sit with him all day but it doing it anyway (at least until she knows that he is well again), but all the moral support they can get makes a HUGE difference to these people. For me, the hardest part of this was when he finally did open his eyes and he looked at the machines that he is hooked up to and I could tell that he wanted to cry. He was trying so hard to cry and tell his mom something and all he could express to us were the tears that were coming out of his eyes because he has a tube in his throat that is helping him to breathe. When we were leaving the hospital, Tanya told me that he has had pneumonia before and has made full recoveries from it, so we are both hoping that everything works out for the best this time as well.
After the hospital we headed back to the office where I finished Tanya’s case notes for the month of June and then it was time to go. We ended early because of the holiday and Tanya had to pick up her daughter because her sitter had plans to celebrate the fourth. 

Thursday, 7-6-06 (12:00-4:00)
As of today I will begin coming in on Mondays and Thursdays at 12:00 because I have started my summer classes and they are in the morning before this. 
Today when I got in Tanya went over the home visit that she had just arrived from (she actually pulled in the parking lot right after I did). 
After getting caught up and my list of things to do, I headed off to work and Tanya sat down to type her ISPs from last month. This is when it was discovered that someone took three of her ISPs off of her desk. We looked in all of her files and in her bag that she carries her monthly notes in and even in her purged box (where all of the old files containing information go awaiting shredding or filing) and they were no where to be found. Now in a state of panic, Tanya sent an e-mail out to everyone in the building asking if anyone has seen them and for them to let her know if they knew anything. After sending her e-mail one of the other supervisors in the building came over and informed her that two other people had important papers taken off of their desks. One case worker had all of her monthly notes taken and the other one had a ResHab packet that needed a parents signature before it was sent taken. No one knows quite what is going on in the office or why someone would take these things since the consumers that they took information from are all minors and really have nothing to steal, but it is strange and hopefully the supervisors will figure out whoever this person is before any more personal information is taken.
So, once the supervisors came over and told us that there was nothing we could do after searching and not finding the ISPs and that Tanya would just have to redo them, it was back to work. I took Tanya’s binder for her monthly notes and went into the computer and typed out all that I could for each of her consumers and got the notes ready for July. Once they were ready and printed I have to alphabetize them by group home. This took me about an hour and a half and then it was time for a home visit before our day was over.
This home visit was ironic in a way. This little girl was one of the ones whose ISP was missing. So, not only was this one of the usual monthly visits, but we also had to have the ISP meeting all over again. Tanya had filled in everything that she remembered from the original meeting, so it didn’t take quite as long. This little girl is in a wheelchair and suffered from muscular dystrophy. Normally I would write more about her, but she was at therapy and did not actually join in the meeting until the last five minutes. When she did join she had a lot to offer and is obviously a bright child. She was telling us about school and how she is glad to be on summer vacation and all she plans on doing is sitting home in front of the television relaxing. So many people look at these kids in their wheelchairs and think of how different they are from the rest of us, but this conversation with this particular little girl reminded me just how similar they are to the rest of us.

Monday 7-10-06 (12:00-3:30)
Today began with filing and getting paperwork ready for the home visit that we had this afternoon. The home visit was the only thing that went on today. This was just a routine monthly visit, but there is so much going on in this person’s life right now and so many new things that he is trying to start and get in place for himself that the visit took almost two hours. We began by discussing the usual...how is health is, upcoming doctor’s appointments, recent outings, etc. His father was excited to report everything that they had done together the week before when he was on vacation. He started by telling us that they went to the store down the street and he dropped his son off with a few dollars and told him to buy something and to then walk home. For the first time in his life his son got out of the car without hesitation with the idea that his dad was leaving him and he was able to walk home on his own as well. Next week his dad is planning on taking him to the store around the corner from their house to see if he can find his way home. (He does give him a cell phone to call him if he gets lost or scared.) He continued to tell us that they went to the beach to watch the ladies and then to the bar the next night to have a few beers and to check out the ladies(this consumer is 22...), and the next day they went to an art festival to see what types of ladies were hanging out there. To most people it may seem a little perverted that this is what this man is taking his retarded son out to do and that the ladies are all that he talks about around his son, but this is exactly what this young man wants...which lead right into our next topic for the day. This consumer is only mildly retarded and since he is 22, he wants to live his life like a “normal 22 year old.” Earlier that day when I was preparing paperwork for him to sign, one of the things that I filled out was for InHome Reshab for a program where someone would come into the home and help this young man out with his social skills and then take him out to bars and downtown so that he can meet some girls and hopefully find a girlfriend. Right now finding a girlfriend is on the top of the priority list for this particular consumer. By this point in the visit this young man was very hopeful and excited because we were starting to do something that he thought would help his world immensely. 

At this visit we also talked about getting him into a DayHab Art Program that is offered by Starlight Studios. He is very artistic and is interested in receiving lessons. When we were filling out the paper work for this is was clear that this was not going to be a hard program to get this consumer into. The hard part here was going to be transportation. He lives with his family in Derby and there are not many options for transportation from there. They are already having problems with receiving enough transportation for him to go to work. We continued to reassure him that after the paperwork for the program is complete that we will do everything that we can to get some form of transportation. The consumer ended this conversation stating that he is willing to give up his current program and work and continue to live with his parents if he can get into this art program. He was very upset that there might be a transportation issue and stormed out of the meeting.
When he left, his father followed him to calm him down, but we had to move on with his mother. There was still one issue that needed to be addressed...residential placement. This consumer has been saying for a few months that he wants to tour apartments and move out on his own. However, this is the first time that any paperwork has been done because his mother and father have so many concerns about this. They are not concerned with him living on his own because they know that he can do that. He is fine on his own for a few hours at a time and there would be staff at any apartment, so that is definately not the concern. The concern here is first that moving was not his idea. One of the female staff members at his program brought it up and has been encouraging him to move out of his parents home. They are concerned that he is not saying that he wants to move becuase this person told him to and not because he actually wants to. They are also concerned because he is the type of person who would look at one apartment and say that he wants to live there without even looking anywhere else or comparing any places to weigh his options. They are just worried that he is going to move and then be unhappy. We did start paperwork today that will be sent out, but they are happier knowing that it usually takes awhile to find a placement and that will give them time to make sure it is really what he wants. His mom says that she will know it is what he wants when he can bring it up on his own on a day when he does not have program. That way she knows that no one at program put the idea in his head and he really wants to move. 
After this visit the day was over and Tanya told me to be prepared because all of the paperwork from this visit was going to be waiting on my desk so that I can finish it and send it out and see this through to see what the entire process is like with these types of applications and processes.

Thursday 7-13-06
Today should have been a day for me at the office, but I had to call in because I slipped a disk in my back Tuesday night and still could not walk. Tanya said that was ok. She is still going to leave all of the paperwork on my desk for the consumer we visited on Monday. She said that a couple days would not make a big enough difference to worry about and they are not in a hurry for any of the services.

Monday 7-17-06 (11:30-3:30)
Today when I got to the office it was just as Tanya had promised me. All of the paperwork from the week before was waiting for me on my desk. So, the first thing that I had to do was complete all of that and then send it out. After this I filed all of the monthly reports from June and started to transcribe the noted for July that had found their way onto my desk. Every conversation pertaining to a consumer has to be recorded in their monthly notes. So, like every other case manager in the office, Tanya has a notebook by her phone where she records all of her conversations and makes notes for herself. I have taken on the job of transcribing these notes into the monthly reports. She told me that I don’t have to because she knows how terrible that job is, but I actually like doing this because it gives me a chance to continue to follow the consumers and to have a better idea of what really goes on (what the common problems are in acquiring services and what different solutions there are to these problems and what different resources are out there). A lot of this is stuff that Tanya explains when I’m there, but it’s hard when I’m not there.

After filing we had a visit to a consumer that I had already met once, so I was excited to see her again and see how she was doing. This is the consumer whose ISP review was done on 6-8-06. This was a shorter visit since there was not too much new with her. Her mom was mentioning that she signed her up for swimming lessons again and yet again this girl is too afraid of the deep end to pass the course. When she said this the consumer looked at me and asked if I had ever taken lessons. I told her that I had and how when I was little I took lessons for a few years so that I could keep getting better. I told her that I was afraid of the deep end too, but my teacher gave me a foam board thing to help me float and that they don’t leave you alone until your comftorable. Then she made a comment that it was probably easier for me because I’m not retarded and I can dive well and understand everything that is told to me. I was surprised by this, but didn’t have to lie in my response. I simply told her that it took me a few years before I was allowed to swim alone because it’s not an easy thing to learn and you have to practice. That it’s like riding a bike. You start with training wheels and then when they come off someone has to hold you up for awhile and then eventually you feel comfortable and your body just kinda knows what to do. It really has very little to do with IQ and more with how much you practice. And as far as diving, I couldn’t do a dive ot save my life. The closest I come is a belly flop! When I finished telling her all of this I wasn’t sure if I helped or not, but she started laughing and said that I was brave for doing belly flops because they hurt, but she was willing to practice if I would come and watch her and maybe even swim with her. When she said this she looked right at Tanya, which made me feel better because I would have had to look to her for an answer anyway. But Tanya looked at her mom and said that next months meeting can be poolside if that’s ok with her and we can all go swimming together after the paperwork is done. When we told the consumer that this would be the last time that she would see me she just smiled and said that it would be like a going away party. It’s things like this conversation that make me realize that I could do this forever. These conversations make all the paperwork and little tasks worthwhile!

Wednesday 7-19-06 (8:30-4:00)
Today was a long day in the office. I spent the entire day finishing transcribing the notes for the July monthly reports so that they are now up to date. Some responses came back from the consumer who I had sent stuff out for the week before, so I had to get each individual place the additional information that they needed and get that all ready and sent back out. This is the consumer who wanted to get into the art program at Starlight Studios. We learned today that he will not be able to receive any type of transportation for this until January. This was a hard day for Tanya because when talking to the lady at ParaTransit she learned that the reason this consumer cannot get transportation is because another consumer on Tanya’s caseload is already using the services and they are in opposite directions. When she got off the phone she didn’t know how to tell this family that they would have to wait until January, but at the same time she didn’t know how to ask the other family if they could cut back on transportation so that he can go to art classes. So the art classes are now put off until January when there is more transportation available. Tanya said that this is one of the hardest parts of this job. You just want to do everything for your consumers, but when the services overlap and conflict, who gets the service. Like in this instance, is there a way to choose which family needs the transportation more or which program is more important. Both of her consumers need the programs and the transportation and there is no way to satisfy both.

Thursday 7-24-06 (11:30-4:00)
Today started with finishing the notes from July. There were more than I expected because there was a problem with one of the consumers, so Tanya had to make several calls on the issue and they were all pretty in depth and all of them had to be recorded in the monthly notes.

After this we did have a home visit. This should have been a quicker visit, but there were a couple topics that this consumers mother went into detail with and had a lot of questions about. This girl is 19 and wants to become more involved in the community. The last time she met with Tanya at school, Tanya had given her the names of some places to call to see what they had going on that she could join in. She had told this girl that she would start the required paperwork, but that she should be allowed to go on the outings before paperwork was finished, that all these places want is a beginning of the process and to know the level of care that people need and that could be done over the phone so that she would be able to join events before the end of summer. However, at this meeting we were informed that her mother refused to call or let her call to see what was being offered until she heard for herself what these places were about and the types of events that they held. Tanya was frustrated to hear this because she could have called the places that her daughter was given the information for and they would have answered her questions, but also because Tanya had given this girl the information and her mother should have known that they were legitimate places if Tanya had given her the names...and if she questioned anything she could have called Tanya and she would have verified everything over the phone. Now because they waited this poor girl missed out on a camping trip and a pool party that she would have enjoyed going to. However upsetting the situation was, Tanya remained cool and answered all questions, but did stress the importance of calling some of these places right away before they miss any more events.
We also discussed living arrangements with this consumer. She was supposed to move the week before and the day she was supposed to move Tanya received a call that she had decided not to move at this time and she now wants to live with her mother until she is 30. When asked about the situation, her mother answered all of the questions with answers that really did not make much sense. She said that she did not want her daughter to live in a place where she would have to share an apartment, she should be able to wait until a single apartment opens up. The consumer then added the fact that she does not wish to move until she is 30. When asked about this and why all of a sudden 30 is the right age to move, she looked at Tanya and said that was good because then her mother would be in a nursing home and would not need her help anymore. This is a challenging case because this young girl does want to move out and be on her own as well as being able to get more involved in recreational activities and make more friends, but her mother always seems to find an excuse at the last possible moment as to why she should not do something. So, she is constantly getting her hopes up and excited about something and then never being allowed to do anything. Her mother is sheltering her way to much, but at the same time she is also using her daughter as a tool to be able to stay home longer. The mother is becoming sickly and her older children want to put her in a home where she can have constant care that she needs, but she refuses because her youngest daughter is still home to take care of her. It doesn’t seem to matter to her that her daughter has Down Syndrome or that she wants to move out and make new friends. It is sad to see how many parents use their kids as tools to get what they want out of life and they think that because their children are mentally retarded that they don’t understand that they are being taken advantage of. However, all of the kids that I have met so far that are in situations like this are all aware of exactly what is going on around them and what they are being used for...and none of them hold back from pointing it out.

Wednesday 7-26-06 (8:30-4:00)
Today I started by finishing the notes from July and prepared to hand them in. They were able to be handed in early since there were no other home visits this month. Any additional notes could now be filed with the August reports. When these were done I prepared the notes for the month of August. Tanya is pretty much caught up and really had nothing major for me to do today, so I took the case notes from the last two months for every consumer and the information that remains the same from month to month (doctor’s names, personal goals, etc.) I entered into the computer so that they will type out in the notes from now on and Tanya will not have to worry about filling it all in every month. All she will have to do now is go in and change the information that should ever change. However, most of it will not change for a long time if ever. This actually took me all day since there are 27 consumers on her case load and there were two new pages that I had to add in addition to all of the information that I was inputting.
Tanya also took me out and bought me lunch today as a way of saying thanks for everything that I have helped her with. A few people from the office came with us, including her supervisor. Her supervisor informed me that as long as Tanya has been with People she has never been ahead of schedule and no one has ever seen her desk since she usually has so much paperwork on it...however, since I came more and more has been done and I’m the first intern she has had to completely catch her up with everything! This made me feel appreciated, but at the same time made me realize that any days left in the office could be extremely long since there is not too much left to do...the work has to catch up with us now.

Monday 7-31-06
Today should have been a day for me to go in from 11:30-4, but Tanya called me this morning telling me that I should not come in since she is taking a sick day. Both her and her daughter are not feeling well...so I got the day off today!

Wednesday 8-2-06 (8:30-4)
Today began with Tanya handing me her notes from an ISP that she had done a few weeks earlier and she told me to do my best to type it up. This was her chance to see just how much I had learned. She was looking to see if I would be able to decipher her notes and reword them in a way that was understandable and appropriate and also if I would be able to look into the past ISP to find information that she had not written down that was needed. This took awhile since it was my first ISP and I was nervous looking up information and still had a hard time figuring out what was important enough to put into this document that is used for so many different things. As nervous as I was, Tanya had no complaints and handed it in to her supervisor exactly as I had typed it.
After the stress of trying to write an ISP, I was thankful for the opportunity to do some basic filing to calm my nerves. 
There is a consumer on Tanya’s caseload that needed some paperwork filled out for a couple different agencies for a couple different programs. Some of the programs were for respite, some were for recreational activities so that this consumer can become more active in the community on her own without having to rely on her parents to take her everywhere, and some were for residential placement. This consumer has decided to start to look into an apartment of her own, so now is the time to start the paperwork. Needless to say, there was a lot of copying that needed to be done and a lot of forms that needed to be filled out, so this task took the rest of the afternoon for me, but it was worth it simply because of how excited the consumer was at the prospect of attaining some of these services in the future. These are things that take a lot of time to get into play, but these consumers are so excited over the ideas that I am grateful for the chance to be here to help Tanya fill out paperwork and get things started just a little faster.

Monday, 8-7-06
Today should have been a day in the office for me, but Tanya took a long weekend so that she could go on vacation with her family. Because she will not be in the office I will have the day off today, but I will be in the office on Thursday to make up the hours.

Wednesday, 8-9-06 (8:30-4:00)
Today began with an monthly visit and a 30 day review all in one meeting. Because so many things were covered, it was a long meeting, but I was able to learn a lot here. There was a 30 review period for this consumer because the program that he is in is a waiver program and it is mandated that all waiver programs must have a 30 day review meeting with the service coordinator, the head of the program, and the staff who directly supervise the consumer when they are in program. Also in attendance of these meetings are the consumer and a family representative, in this case the consumer’s mother. We first met with the staff person who runs the recreational aspect of this program. He was telling us the different types of opportunities available in the program and how the consumer is coming along. This consumer is learning how to cook and he enjoys sculpting and the various art classes offered. He is also able to attend more outings with the group because he has become comfortable with the staff and is now listening to the directions given to him, whereas when he first started he would look at the staff and declare that he didn’t know them when they asked him to do something. So, it was looking good for this part of the program. Next we met the staff member who oversees this consumer in the workshop aspect of the program. He said that from the beginning this consumer has been a good worker and has had no problems. He takes direction well, however he will only do his work when he is left alone. They have found that whenever staff or coworkers are around this consumer will just stand there and stare at the wall. He realizes that this is the place where he needs to work, but is so uncomfortable working when other people are around that he just freezes. Staff quickly picked up on this and now they give him orders on what he is to do for the day and then they walk over to the other side of the room and continue on with their work and leave the consumer alone. If he has questions about what he is supposed to be doing the consumer is comfortable enough to walk over to staff or call them over and ask for clarification. So, for this consumer it was a good evaluation and the paperwork was completed to keep him in this program on a permanent basis.

When we got back to the office after the meeting the ISPs that Tanya and I had written the week before were now in Tanya’s mailbox with corrections and comments from her supervisor. She handed them to me and said to see if I could figure out what Diane wanted and she would double check them after I was done (and of course not to hesitate if I had questions). For the most part the major issue was spelling or wording of phrases, nothing major. I was glad to see that the ISP I had written the week before only had one comment on it...I thought it was going to have more problems than that. Once I was done with all of the corrections I had to fill out a cover letter for them and send them out to everyone that is involved in the care of the consumers and to the consumers themselves.
Once Tanya saw that I was comfortable with the ISPs, reading and writing them, she introduced me to the new system that the residents in the IRA’s are going into. This is a new system where the house can update their material and service coordinators can update their material and the software makes sure that everything matches and brings it all together into one ISP. Well, they have been using this system for almost a year now, but like all companies they have changed the software and now all of the ISPs from the last 5 months have to be redone. The service coordinators have less than a month to do them all or all of the information will be deleted. So, Tanya showed me what they needed changed and told me that I could start that while she wrote up the rest of her new ISPs that were due. Because these ISPs were already done it was mostly cutting and pasting, but there was some information that I needed to look up for every consumer that I was doing this for. Tanya showed me the social summary that People keeps for every consumer. In this are their strengths, needs, and interests which were some of the new areas in the ISP. She also showed me where I could find historical health information and historical job information in their files. I did two of these when Tanya asked me to stop and quickly send out some ISP invitations for the next month before I left. 
The task of send out invitations is an easy one since all I really had to do was go into the computer and change the dates and for the meetings and when the reports were due and then make copies of everything and send it out to the people who care for the consumers as these are the people who are expected to attend these meetings. There is also an invitation for the family member who is primarily responsible for the care of the consumers so that they may attend the meeting as well. These meetings are the best time for them to voice their concerns should they have any regarding their loved ones care.

Thursday, 8-10-06 (11:30-4:00)
Today began with updating one more ISP in the new system, and then there was a meeting concerning one of out consumers and her YALT program.
YALT is still one of the programs that I have so many questions about, but after this particular meeting I have to say that I have more questions than ever. This particular consumer was attending the Canisius YALT when her doctor wrote a prescription for her to be given a medication should she have a seizure that lasts more that 5 minutes. Now, protocol for the YALT is that any seizure lasting more that 3 minutes 911 is called, but because there was a prescription Canisius called and said that this consumer could no longer attend because they are not a med certified site. So, Tanya called the consumers mother and asked her to call the doctor which she did and the doctor voided that prescription and said that if she has a seizure YALT following their protocol would be good enough. However, because this was all started the people at Canisius had started talking to the consumer about switching to Daemen because they were med certified. She knows a few people at Daemen and after a tour there decided that she would like to go there instead of Canisius. So, Daemen called her mother and asked for a script from the doctor saying what kind of supervision level this consumer fell under. Her doctor said that she needed constant supervision because she has a seizure disorder. YALT called Tanya and said that this was unacceptable because the consumers have to have at least 15 minutes of independence on the campus since there are times when they are able to be away from the staff. So, once again the consumer’s mother called her doctor and he wrote a script saying that she could be alone for 15 minutes and should she have a seizure it was adequate that one of her peers could report the seizure to someone. Now YALT had a problem with this because this script mentioned a peer being around and they cannot guarantee that someone will always be around. So, the nurse from the YALT called the doctor this time and faxed him a list of the different choices that he could choose from as to the level of supervision that she needed. This meeting came after he once again chose 24 hour supervision. However, when asked to see the list Tanya and I read over the options that the nurse gave the doctor and they went from bad to worse, unacceptable to more unacceptable. I whispered to Tanya asking her what the right answer would have been that the doctor should have chosen and she didn’t even know. When she asked the nurse what the right one was since none of them seemed good and she told the doctor to pick one, the nurse said it wasn’t important. All she saw of importance was what he picked. At this point the lady from the Canisius YALT said that the script stating she could be alone for 15 minutes was the best one and would have been good enough if the doctor didn’t mention that a “peer” could report a seizure. To this Tanya said that she took that to mean that anyone who noticed the consumer having a seizure could call 911 or report it and that would be good enough. But this time it was the Daemen YALT lady who answered that it was not good enough. Now that we had asked the same question ten different ways and kept receiving the simple answer that it’s not good enough but no answer as to what was good enough I had to say something. I knew I would be out of place, but I could see that the consumer was just as confused as Tanya and I were and I was guessing that since she is my age she was probably thinking the same thing that I was. So, I raised my hand and tried to be as polite as I could, which was hard because at my end of the table everyone was frustrated and confused and I was no exception. I told them that maybe I just didn’t understand their program well enough since I am just an intern but I didn’t understand. Their logic to the peer thing was that there are times when the consumer would be alone on the campus. And I looked at the consumer and simply asked her where she ever went without a friend. And I pointed out that being her age I don’t go anywhere without someone...not even the restroom. And when I do want to be alone on campus it’s impossible. I just on campus the week before and there were people everywhere, so that’s why I didn’t understand what the problem was with that script. When I looked over and saw that the consumer was about to cry she was so frustrated I just looked at her and told her that if she knows a place to go on the Canisius campus where you can actually be alone she had to tell me, because after failing a test or fighting with a friend I could really use that place. It was the first time in the meeting she smiled and spoke. She said that she had no idea where that would be but she could use that place too. At this point her dad who had attended the meeting and appeared calm the entire time just suddenly started screaming that these people were being extreme. His daughter was being punished for something that wasn’t her fault and she had no control over and now all she can do is sit home in front of the tv all day because she can’t take part in any programs if she’s not in YALT. He looked at the nurse and told her that she quite frankly the most arrogant person he had ever met and her list to the doctor was bogus. She went down the options she gave to the doctor one by one and said why none of them were acceptable. So, he told her to write down word for word what the script needed to say and that he was going to the doctors directly after the meeting to have him write a script in the nurses words so that there would not be any problems and his daughter could be back in her programs on Monday. And before he left he told the nurse that she had better be in her office when he faxed over the script and have everything set up by Monday or he would be having a word with her boss or whoever he had to above her to figure out why she was holding his daughter back. That was the abrupt end to that meeting, and I for one could not wait to get out of that room. The lady from the Canisius YALT asked to talk to Tanya once everyone was gone and I had a feeling that Tanya was going to yell at me or ask me not to come back or something so I just went back to my desk and finished the ISP invitations for the ISP that Tanya had scheduled that morning for the following month. When she came back to her desk the lady from Canisius was still with her and she looked at me and said that she didn’t even know a place on campus where you could be alone, but she had to keep answering that way because that’s the answer her boss gave her to answer and he was sitting right there. After she left, much to my surprise, Tanya thanked me for speaking up. She said that she was trying to ask the same questions, which I could tell she did, but she said it was more effective that I could point out to them that I was the consumers age and knew the campus. Plus, she was surprised that I said what it took to get the consumer to talk. Tanya knew that once the consumer opened up that she wasn’t happy or said anything that gave away the fact that she was holding back tears because she wasn’t allowed into program that her dad would explode and set everyone strait. She said that this is the hardest part of the job because you get to frustrated and you can keep asking the same questions, but you can’t point out that these people are purposely holding back the consumers and you have to say something to provoke the family members because only the family members can yell and scream and call these people names and call them what they are. She was extremely upset that the nurse had sent the doctor that list and made him pick something off of it when none of them were right. She said the lady from Canisius told her that is the list of unacceptable answers. For some reason Daemen was sabotaging it so that this consumer could not start at their program. For now the lady from Canisius if filing a report against the nurse for that and doing everything that she can so that the consumer can start at one of the programs Monday regardless of what script they have. So, it was a long, hard, confusing meeting, but some truths were brought to the table and hopefully there will be a good outcome for the consumer. The people from Daemen kept suggesting that this consumer just go to work and forget YALT, but thankfully the people from Canisius as well as Tanya (and I have to agree as well) believe that this consumer should not be forced into work at the age of 20. She should be able to go through all of the programs and even take a few college courses if she wants like any other 20 year old in that system! 

Monday, 8-14-06 (11:30-4)
As soon as I got to the office today we had to go to the DDSO office in Cheektowaga for a monthly face-to-face meeting. I’m calling this monthly meeting a face-to-face because the actual reason that we were meeting here was to register this consumer for services from the DDSO for in-home respite. With this respite, he would like to have a male staff member help him learn how to act around people his own age more appropriately and take him out to bars and nightclubs so that he can meet girls. He has had several girls who are friends, but what he really wants in his life is a girlfriend. So, while we were here supplying information and supporting the consumer in the registration process, Tanya was able to ask a few questions and in less than five minutes gain enough information and have her paperwork signed so that this could count for her monthly meeting. The main reason that service coordinators have to meet face to face with each one of their consumers is to actually visibly see that the consumer is alive and well and to make sure that if they are sick they are receiving treatment or to see bruises that could potentially result from staff/family that the consumer might be too scared to report abuse over the phone. If there is visible evidence of abuse of any kind consumers are usually more likely to report the incident and tell what has happened to them rather than to hide the fact because they are afraid that they will not be believed.
From here we headed back to the office where I was able to do some filing and keep up on that before there is a pile of papers and it takes all day to file away, and I also filled out an addendum for one of our consumers. This is a consumer who has been employed at Southeast works and after his 30 day review he was asked to stay, however, without this addendum he would not be allowed to stay. So, I filed out the addendum and sent out a copy to him mom for her to sign and to the consumer for him to sign. 
Last for the day was a home visit to a consumer who I had met last month. This consumer is super sweet and can be so much more independent than her parents will allow her to be. She has been asking Tanya to help her to become more involved in the community and to help her to start looking for residential placement. At this meeting she was excited because she had been contacted by Heritage Centers and they asked her if she would like to join their gang for a bowling party that they were having. Her mom let her go and there she received a calendar of events for the next two months and they told her that she was more than welcome to join them whenever she wants. There are so many times with this job that it seems that Tanya is just handing me forms and telling me to fill them out and send them to this person and that company and always remember to keep a copy, but after seeing the look on this consumers face I realize that it is all worth while. There were three forms for Heritage Centers for this girl and five documents that had to be copied and sent out, and at the time it seemed like a big hassle, but the end result when everything comes together is worthwhile.

Wednesday, 8-16-06 (8:30-12)
Today was different because Tanya was not in the office until around 10:30. She had a home visit at 8am out where she lived, so she told me that she would be late and I could come in whenever I wanted and continue on with updating the ISPs in the new system. I actually arrived closer to 8:00am this morning with my coffee and set out to work. I was able to complete all of the seven ISPs that were left on Tanya’s list. For each one I had to look through old ISPs and files to find the history information that was needed, but it was interesting. When Tanya came into the office she pretty much let me continue on with my work and left me alone and simply grabbed a file and went to work on her ISP that she had started a few days before on another computer. At 12:00 she came over and said that she was leaving and I could stay or leave whenever I wanted...depending on how many hours I needed and how many ISPs were left. So, since I had all of the ISPs updated, printed, sent out and saved in the computer, today was an early day for me.

Monday, 8-21-06 (9:00-4)
Today began as a busy day in the morning and ended with a home visit. First, I copied all of the notes from the month of August from Tanya’s notebook into the Monthly Consumer Reports, and then I updated and printed out all of the Monthly Consumer Reports for September. When I was finished with this Tanya had me copy and send out a few different things that were requested by Heritage Centers for a couple different people. Even Tanya noticed that it was ironic that today she came into the office and in her mailbox were several letters from different people over at Heritage all wanting more information on her consumers who had applied over the past couple months for different services. 
After the morning in the office we went to visit a consumer that we had seen every month since I started here. This consumer lives just past the fairgrounds in Hamburg and as such has attended the fair more than a couple times. She was telling us all about her experiences and we compared notes. In the end it was determined that she had a better time than Tanya and I did put together. She was more than a little excited about meeting the munchkin from the Wizard of Oz - she even got his autograph. Her mom explained that the Wizard of Oz was her favorite movie growing up. She used to watch it everyday and then go around the house pretending to be one of the munchkins in the movie. This consumer is one that I would consider to have come a long way in the few months that I have known her. She informed us that she is starting a new job at Kinko’s and is more involved in the community than ever. Everything seems to be coming into place for this young lady at the moment.

Wednesday, 8-23-06 (8:30-4)
Today is my last day in the office and it is bittersweet. I really have enjoyed my experience here and don’t want to leave, but leaving means that classes are beginning and diving into the semester brings me that much closer to graduation and then I can hopefully get a job doing this and helping these people on a permanent basis. 
Tanya let me have a pretty laid back easy last day. I started by finishing her notes for her Monthly Consumer Reports for August and then I prepared her ISPs for September so that all of her paperwork is in order for her. I finished an ISP and got it prepared for review by Tanya’s supervisor. There were some problems with the new computers that were put into the office on Monday. When I was in the office I would work on the computer in the cubicle across the aisle from Tanya. This was actually Kellie’s computer, so when she came in and found out that I had fixed her computer she was ecstatic. She said that she had been having problems the day before but didn’t know how to fix them. After the computers were fixed and everything was set for Tanya for September it was time to say goodbye. This has truly been an experience that I will never forget. I have met some amazing people that I will never forget and hope to keep in touch with...on both sides. In the office I have met people who help people with special needs and fight so that these people can live happy, healthy, productive lives everyday and I wonder if they realize just how big of an impact they make. And I have met people with “special needs” who are simply amazing. They are all truly innocent beings who appreciate the smallest things and who everyday are able to do things that “ordinary” people would never think that they could accomplish. I have learned the most from these people and wish them only the best in life!



PracticumExperiences