My Agency

          My agency is a geriatric center.  Both conceptually and practically, a geriatric center is not to be confused with a nursing home.  Conceptually, the vastly different title serves to avoid the stigma associated with nursing homes.  Practiacally, the geriatric center that I work for is much greater than any mere nursing home because it also includes assisted living as well as private apartments.  My agency has the ability to provide housing and care for over 700 residents.  Furthermore, there are specialized units, capable of providing care for residents with intense needs such as ventricular respiration and dementia. 
          The unit that I work in is the Alzheimer's/Dementia unit.  One of the floors that I work on is entirely popultaed by residents who are incapable of ambulating.  The other floor that I work on is entirely populated by residents who can ambulate, albeit some do so rather poorly.  Each floor has a supervisor who manages all of the staff and residents on the floor.  The floor supervisor's title is the 'neighborhood coordinator'.  The neighbor hood coordinator also serves as an advocate for their 'neighborhood' (aka floor), who can appeal to the higher ups in the bearacratic administration when necessary.  There is also a head nurse on each floor, who supervises and coordinates the nursing care being administered on that floor.
          My agency promotes interdisciplinary participation in the implementation of resident care.  The nursing staff, social worker, dietician and neighborhood coordinator work together in order to devise, adjust and rewrite the care plans of every resident in their charge, every three months.  Furthermore, all of the aforementioned employees also work with the medical doctor in charge of that resident, as well as the recreational therapist, physical therapist, speech and hearing therapists, in coordinating the care being provided for each resident.
          The best aspect of my agency is the result of a policy which requires employees to maintain a positive friendly demeanor.  Everyone says hello to one another in the hallways.  Athough the friendliness may be mandated and in some cases superficial, it does seem to facilitate respect between employees.  This respect, while it may merely be superficial, does make the work enviornment more comfortable and effective.  Having such a comfortable enviorment both allows employees to do their best work and provide the best possible care for the residents.
          I have the ability to choose from any resident on either of my floors and meet specifically with them for any reason. Furthermore, I have a multitude of residents who exhibit bad behaviors and the behaviors are extremely well documented.  As a result, it would be really easy to choose from any resident, meet with them every week and moniter their behaviour.  However, I am not sure if it is possible, meaningful or effective for me to try and change the behavior of an individual who suffers from dementia.
          Every time a bad behavior is exhibited and nopticed by the staff, it is documented.  At the quarterly review, each bad behavior is addressed and discussed.  After looking at the behavior from the perspective of each discipline, a plan is decided on and implemented in response to the incicdent.  It is often the case that a resident will change or the behavior will subside for a period of time, sometimes longer than others.  However, it has never once been clear to me that the change in behavior was a result of the plan that was implemented in response to the behavior and not just random coincidence.  In fact, it is often the case that the bad behavior appears to be a random occurence more than a response to the context in which it occured, or specific enviormental stimuli.