By Thao Phan
I began my journey in working with older adults and their health care at Asian Counseling and Referral Services in Seattle. In the Aging and Adult Services department, I saw many Vietnamese elders in the community who needed in-home care services and case management because their families were too busy and/or did not speak English to advocate for them through the complex systems of hospitals, nursing homes, Medicare, and Medicaid. This showed me that there was a great need for social workers to work with elders, especially those who did not speak English.
It also made me aware that for my professional development, I needed to learn about different settings and environments, such as nursing homes, assisted living facilities, and hospitals serving elders with complex health care needs. This would allow me to see the full picture of what elders may experience and the kinds of advocacy needed when navigating through health care systems. I next sought out the opportunity to acquire the experience in working with a new population in the Department of Veterans Affairs (VA).
My advanced practicum placement is currently at the VA Puget Sound Health Care Geriatric Research Education and Clinical Center (GRECC). The GRECC seeks to integrate psychiatry, primary care, and research to provide comprehensive care for older veterans. I work with patients who are using primary care and/or psychiatry. The veterans benefit from doctors and psychiatrists who are knowledgeable in geriatrics and who work together for the patient’s care.
At the VA, I have learned about not only the inner workings of a hospital and the latest research on diseases and other issues related to aging, but also the connection between policy and patient services and care. For example, because of ongoing budgetary issues, the primary care clinic is being phased out, which will negatively affect both veterans and their caregivers. I believe that policy makers in the future will likely recognize the importance of having this primary care clinic and may want to re-open it. I have also benefited at the VA from the different ways of communicating and connecting with patients who are not similar to me.
One of the things that I often notice is how caregivers of veterans do not identify themselves as caregivers. They focus so much on the veterans that they put themselves second. For example, when I call caregivers to ask how they are doing, the conversation shifts back to the care and well-being of the veterans. I believe this is an unbalanced partnership.
Social workers, care providers, and caregivers need to recognize that caregivers themselves need care. Without caregivers, many care plans for elders would easily unravel. I hope that in the future, I will have a chance to be involved in a program that recognizes the importance not only of elders, but also of their informal caregivers - family, friends, neighbors—who are central to their care and that will conduct comprehensive assessments of the family unit instead of only the individual.
Thao Phan is a current MSW Advance Standing student at the University of Washington School of Social Work. She is in the direct practice concentration specializing in gerontology. She is completing her practicum placement at the VA Puget Sound Health Care in Seattle, WA.