Posted by Robin McManus
As a fairly recent and idealistic graduate of a masters program in social work, I was attracted to the part of the job description for guardian case manager at JF&CS that advertised, “we make a real difference in people’s lives.” When I met my new client, Ann*, however, I began to wonder, was the difference referred to positive or negative?
Ann is a very vivacious and dignified 92-year-old widow who never had children. She had been living independently her whole life and was currently residing at the Jewish Community Housing for the Elderly (JCHE) Coleman House in Newton. As a longstanding member of the sisterhood at a local synagogue she was well respected by the Jewish community in Boston and beloved by many friends.
In recent months Ann’s rapidly advancing dementia had caused her to severely neglect her health, nutrition, finances, and personal hygiene. Depression had also isolated her from the very community that was once such an integral part of her personal happiness. One of the cruelest parts of dementia is that Ann was not able to recognize any signs of this self-neglect and truly believed that she was well able to manage on her own; she had become very resistant to any assistance offered to her and often became belligerent with health care workers who tried to intervene on her behalf. The community at JCHE was becoming increasingly concerned and, simultaneously, Ann was becoming increasingly resistant to this concern. It had become crystal clear that Ann was no longer able to safely manage living independently.
*Name changed to protect privacy.