3. Engagement #1
• Definition: “Engagement is concerned with the
process of establishing the client-worker relationship
upon which subsequent steps depend”
• The empowerment process begins in this stage, along
with identifying client needs
(Kirst-Ashman & Hull, 2012)
4. Research
“Effective Communication with
People Who Have Dementia”
• Communication barriers can
hinder identifying resident
needs and lead to deprived
human contact
• Use person-centered care and
focus on communication
abilities vs. deficits
• Tips: face the resident, use
simple sentences, allow time,
avoid contradicting or
correcting, and use touch
(Jootun & McGhee, 2011)
“Dementia Care: Using
Empathic Curiosity”
• Empathic curiosity = using
empathic listening to
understand perceptual
experiences
• Ask short, open ended
questions
• Pick up on emotional cues
• Give time to think
(Mcevoy & Plant, 2014)
5. Skills
Methods Used Skills Used
• Name badge
• Read life history
• Read progress notes daily
• Knock on their door
• Adjusted my voice to
resident’s hearing level
• Empathy (ex. Complaints
of pain)
• Meet the resident where
they are-physically &
cognitively
• Smile, acknowledge, and
introduce self
6. Reflection On Use of Self
• Personality
• Woo: Meeting new people, learning their names, and
finding common interests to start conversations
• Humor
• Self Disclosure
• Anxiety
• The presence of family members during admissions
(Dewane, 2005)
7. Outcome
• Successful
• Most residents enjoy and appreciate when you engage
with them
• Self-disclosure of where I was from proved to be
successful for making connections
• Improvements
• Become more comfortable around family members
8. Assessment #2
• Definition: “Assessment considers the process of
gathering and organizing data and information in
order to arrive at an accurate picture of the person-
in-environment situation”
• Involves defining the problem and contributing factors,
and recognizing what can be done to reduce or
eliminate the problem
(Kirst-Ashman & Hull, 2012)
9. Research
“Differentiating Levels of Cognitive Functioning”
• Rosewood is mandated to use the Brief Interview for Mental
Status (BIMS) assessment tool
• Compared Brief Interview for Mental Status (BIMS) and the Brief
Cognitive Assessment Tool (BCAT)
• BIMS strengths: quick, strong reliability, suitable for non-licensed
professionals to use, predicts cognitive diagnosis in general
• BIMS weaknesses: cannot differentiate the stages of dementia,
cannot differentiate between mild cognitive impairment and
dementia, and has a lower sensitivity
(Mansbach, Mace, & Clark, 2014)
10. Skills
Methods Used
• Sit face-to-face, annunciate
words, and maintain
comfortable eye contact
• Empathy (ex. If the resident
says they are forgetful)
• Patience
Skills Used
• Check upcoming
assessments and due date
• Printed off BIMS
assessment
• Locate the resident at the
right time in a quiet place
• Introduce myself and the
purpose
11. Reflection On Use of Self
• Relational Dynamics
• Used empathy during BIMS assessment
• Created supportive worker-client relationship by
highlighting the client’s strengths, not weaknesses
• Reaction Patterns
• Reacting to incorrect answers was difficult
(Dewane, 2005)
12. Outcome
• Successful
• I became proficient in administering the BIMS
assessment
• I was able to highlight client strengths
• Concerns
• The resident’s level of energy or state of health could
affect the scores and cause inconsistent fluctuations
compared to previous scores
13. Planning #3
• Definition: “Planning involves establishing goals,
specifying how goals will be achieved, and selecting
the most appropriate courses of action”
• Planning guides how you help the client from
assessment of problems, needs, and strengths
(Kirst-Ashman & Hull, 2012)
14. Skills
Methods Used
• Contact family members, if
possible, to set up time for
initial Care Conference
• Inform others of Care
Conference date and time
• Review the client’s records
(ex. Reason for admission,
progress notes)
• Bring notepad and pen to
write down client needs
Skills Used
• Multi-disciplinary
communication
• Empowerment- asking the
client what he or she needs
• Social justice advocacy-
tailoring to the client’s
wants
• Documentation
15. Reflection On Use of Self
• Belief System
• Family members should be involved in the resident’s
care and make efforts to attend Care Conference
meetings
• Families should allow clients the time to voice their
needs
• Professional Values
• Empowerment: residents should be asked directly
what their goals are instead of case managers inferring
(Dewane, 2005)
16. Outcome
• Improvements to be made
• Initial Care Plan: Ask the resident “What would you like
your daily Care Plan to be?”
• Keep resident involved in the outside community
17. Implementation #4
• Definition: “Implementation in generalist practice
deals with carrying out the intervention plan after
initial engagement, assessment, and planning. It is
the actual doing of social work”
• Intervention encompasses “treatment” and other
activities social workers use to solve or prevent
problems or achieve goals
(Kirst-Ashman & Hull, 2012)
18. Research
“Use of Doll Therapy for
People With Dementia”
• “Doll therapy is the careful
use of dolls to improve the
wellbeing of people with
dementia”
• Educate family before
implementing
• Not right for everyone
• Allow for natural
engagement
• Be aware of mislaid dolls
“Using Environmental Modification
and Doll Therapy in Dementia”
• Benefits include calming
effects, improved
communication, social
connectedness, and
reduced aggression and
distress
• Ethics: dignity, age
appropriateness, and
residents’ view of the doll
(Hahn, 2014)
19. Skills
Methods Used
• Recognize social cues
• Compliment the resident
• Coordination with staff
members and teamwork
(ex. Removing the doll)
Skills Used
• Speak with case manager
about residents and doll
therapy
• Observation
• Do not label the doll as a
“doll” or “baby”-let the
resident decide
20. Reflection On Use of Self
• Style of Communication During Conflict
• Negative comments about the dolls
• Belief System
• I favor natural interventions or treatments instead of
treatments that rely on medications and narcotics (ex.
Anxiety or depression)
(Dewane, 2005)
21. Outcome
• Successful
• Residents’ faces “lit up” when given a doll
• Provides comfort
• Improvements
• Educate staff to treat the doll like an actual baby, if that
is what the resident believes
• Educate staff on how to respond to residents who
belittle those who have a doll
22. Research
“Dementia and Reminiscence: Not Just a Focus on the Past”
• Purpose: psychosocial intervention that stimulates
memories and cognitive processes by using the five
senses
• Person-centered approach
• Improves loneliness, depression, recall, personal identity
and overall happiness
• Tips: use one theme, do not interrupt, and close by
reorienting to current time
(Swann, 2013)
23. Skills
Methods Used
• Compile short stories or
trivia questions to prompt
memories
• Consult with case manager
about residents who would
benefit from interaction
• Gather residents together if
possible or 1:1 interactions
Skills Used
• Genuineness
• Warmth
• Speaking loudly
• Active listening
• Age awareness
24. Reflection on Use of Self
• Personality
• Includer: I enjoy having everyone involved during
reminiscence groups so they can feel connected and
valued
• Personal Values
• Religious practices, family structure, sexuality, and
working hard to provide for personal and family needs
(Dewane, 2005)
25. Outcome
• Successful
• Easy and enjoyable activity for staff to implement
• Easy way to assess the cognitive level of residents
• Repeated stories were told in new ways every time
• Improvements
• Encourage staff to implement more reminiscence
groups to get more residents involved and help them
make connections with their peers
26. Evaluation #5
• Definition: “Evaluation is a process of determining
whether a given change effort was worthwhile”
• Measures achievement of intervention goals, program
purposes, and client satisfaction
(Kirst-Ashman & Hull, 2012)
27. Research
“Clinical Utility of Patient Health Questionnaire-9 (PHQ-9)”
• PHQ-9 measures depression severity and is used to
evaluate the resident’s adjustment to living situation,
medication changes, etc.
• Study results: proved acceptable to patients and
caregivers, quick and easy to use, valid measure of
depression severity, valid measurement of need for
antidepressant therapy, but cannot discriminate between
patients with and without dementia
(Hancock & Larner, 2008)
28. Skills
Methods Used
• Sit face-to-face and
maintain comfortable eye
contact
• Empathy (ex. If the resident
has complaints about
feeling down)
• Probing
• Clarifying
• Broker skills (ex. Thoughts
of dying)
Skills Used
• Check upcoming
evaluations and due date
• Printed off PHQ-9
evaluation
• Locate the resident at the
right time in a private place
• Introduce myself and the
purpose
29. Reflection On Use of Self
• Personality
• Touch: Used to support residents when they are
experiencing or expressing negative feelings or
emotions
• Belief System
• Consulting residents with religious advice regarding
thoughts of death
(Dewane, 2005)
30. Outcome
• Successful
• For those who had the ability to comprehend longer
sentences
• The use of touch was successful
• Improvements
• Some questions are not appropriate for the elderly or
those with terminal illnesses (ex. Thoughts of death)
31. Termination #6
• Definition: “Termination is the end of the professional
social worker-client relationship”
• Occurs when services are no longer needed or no longer
benefit the client’s interest
(Kirst-Ashman & Hull, 2012)
32. Skills
Methods Used
• Proactive planning
• Organization and
coordination
• Broker- connecting
individuals with resources
• Effective written
communication (ex.
Forwarding information on)
Skills Used
• Assess resident’s length of
stay
• Communicate with resident
and family regarding
community services and
schedule follow-up
appointments
• Contact Hospice or palliative
care
33. Reflection On Use of
Self
• Coping Skills
• Termination due to death
• Professional Values
• Residents choosing the services they desire cannot
always happen due to financial purposes
• Personality
• Positivity: Helping the client recognize positive aspects
of termination
(Dewane, 2005)
34. Outcome
• Successful
• Staff make their best efforts to provide appropriate
after- care services
• All residents leave with a plan
• Steps are taken to honor, support, and provide dignity
to residents who pass away
• Improvements
• Macro improvements need to be made within financial
assistance programs so residents can afford the care
they need
35. Follow-Up #7
• Definition: “Follow-up is the act of acquiring
information about a client following termination”
• Focuses on how the client is functioning in the areas
that brought them in for initial services
(Kirst-Ashman & Hull, 2012)
36. Skills
Methods Used
• Professional voice and
introduction
• Warmth and genuineness
• Probing and clarifying
• Relaying communication
onto staff members
Skills Used
• Send greeting card
• Obtain satisfaction surveys
and contact information
from coordinator
37. Reflection On Use of Self
• Belief System
• The importance of people’s opinions
• Humor
• Responding to family member’s jokes
(Dewane, 2005)
38. Outcome
• Successful
• Family members and residents that were contacted via
phone surveys were very willing to provide input
• Improvements
• Not all case managers call residents or their families
after discharging
39. Cultural Biases
• My BiasesMy Values
• Residents receiving disability benefits
• Residents who worked at home
Make all possible
efforts to work
• Religious blindness
• Residents who express thoughts of death
Christianity
• Some elderly residents do not have
positive views of diversity
Acceptance and
respect for all races
• Favoritism
Verbal
Communication
40. Personal Values Related to
Professional Values
Honesty
Teamwork
Individualism-fairness
in everything is not
good
Helping Others
Close and open relationships
Everyone's life is valuable
Core SW Values:
Service
Social Justice
Dignity & Worth of the
Person
Importance of Human
Relationships
Integrity
Competence
(NASW, 2016)
41. Ethical Decision Making
1.10 Physical Contact
“Social workers should not engage in physical contact with clients
when there is a possibility of psychological harm to the client as a
result of the contact (such as cradling or caressing clients).”
Ethical decision of using touch in use of self
1.01 Commitment to Clients
“Social workers’ primary responsibility is to promote the well-being of
clients.”
Ethical concerns regarding Doll Therapy
1.16 Termination of Services
(e) “Social workers who anticipate the termination of services to
clients should notify clients promptly and seek the transfer, referral, or
continuation of services in relation to the clients’ needs and
preferences.
Ethical concern of discharging residents who are not ready
(NASW, 2016)
43. Professional Roles
• Facilitator- activity groups such as balloon toss
• Educator- during admission process and tours
• Researcher- evaluating evidence-based practice
• Enabler- recognizing strengths and feelings of
residents who have situational stress
• Broker- connecting residents with religious
resources
44. Resources (APA)
Dewane, C. J. (2005). Use of self: A primer revisited. Clinical Social Work Journal, 34(4), 543-558.
Hahn, S. (2014). Using environment modification and doll therapy in dementia. British Journal of Neuroscience Nursing, 11(1), 16-19.
Hancock, P., & Larner, A. J. (2008). Clinical utility of patient health questionnaire-9 (PHQ-9) in memory clinics. International Journal of
Psychiatry in Clinical Practice, 13(3), 188-191.
Jootun, D., & McGhee, G. (2011). Effective communication with people who have dementia. Nursing Standard, 25(25), 40-47.
Kirst-Ashman, K. K., & Hull, G. H. (2012) Understanding generalist practice. Belmont, CA: Brooks/Cole
Mansbach, W. E., Mace, R. A., & Clark, K. M. (2014). Differentiating levels of cognitive functioning: A comparison of the brief interview for
mental status (BIMS) and the brief cognitive assessment tool (BCAT) in a nursing home sample. Aging and Mental Health,
18(7), 921-928.
Mcevoy, P., & Plant, R. (2014) Dementia care: Using empathic curiosity to establish the common ground that is necessary for meaningful
communication. Journal of Psychiatric and Mental Health Nursing, 21(6), 477-482.
Mitchell, G. (2014). Use of doll therapy for people with dementia: An overview. Nursing Older People, 26(4), 24-26.
National Association of Social Workers (NASW) (2016). Code of ethics. NASW. Retrieved from https://www.socialworkers.org/pubs/code/
code.asp
Swann, J. I. (2013) Dementia and reminiscence: Not just a focus on the past. Nursing and Residential Care, 15(12), 790-795.