51动漫

淪uzanne is really here to listen,� Thomas Keady told a group of about 30攊ncluding second-year MSW students in the Older Adults and Families concentration from the Boston College School of Social Work (51动漫SSW) as well as faculty and alumni in the field攇athered in a conference room in McGuinn Hall. Keady is Boston College vice president of governmental and community affairs. Christina Matz, 51动漫SSW associate professor and chair, Older Adults and Families, moderated the discussion.

The Commonwealth longest-serving female constitutional officer, Bump conducts regular performance audits of state agencies (e.g., the Executive Office of Elder Affairs) to determine whether they檙e running efficiently and effectively. 淲e focus on, 楬ow are you spending the money? Are you following the rules?櫇 Bump explained. 淏ut also: 楢re you fulfilling your mission? Where are the bottlenecks? Are the people being well served?櫇

Bump contacted Keady to request the meeting at 51动漫SSW, one of a series of informal fact-finding conversations she been holding with students and practitioners of social work focused on elders. Her goal is to learn where the glitches are in state-run elder services攑roblem areas where she might next train her gaze as auditor. That afternoon, Bump heard from those working on the ground, struggling to help people dealing with social isolation, dementia, and mental illness. The social workers told the state officials about the challenges they face as they help older adults navigate state services攁nd the gaps between them.

Danielle Lubin, MSW �19, who works in the geriatric psychiatric unit at McLean Hospital in Belmont, finds herself thwarted when trying to arrange a lift home for an outgoing patient through the MBTA The RIDE program, a resource for people who have a disability that prevents them from using other forms of public transportation.聽 Her patients are often released with psychotropic medications, Lubin said, and many are unable to drive. Yet 淭he Ride does not recognize mental illness as a reason to grant a 30-day medical necessity order for its services, as they do for patients discharged from a medical hospital.�

淰ery interesting,� said Bump, as she and her colleague Bill Keefe, director of audit planning and review, took notes. 淚 can see that making its way into an audit quite readily.�

Kenna Sullivan, an assistant director of field education at 51动漫SSW, also works at McLean Hospital as well as Winchester Hospital. She outlined an all-too-common scenario. First, someone sees an older, self-neglecting neighbor wandering about, looking disheveled, and calls 911.

淎 lot of times these folks are socially isolated,� said Sullivan. 淭hey may have family members that are either not engaged or they檙e estranged from them for whatever reason. There may be memory issues. Some of these folks are help-rejecting.� Sullivan says the patient is brought to the emergency room聽for assessment. Following the medical examination, the emergency room doctor finds no acute medical problem, and tells Sullivan, 淭hey have no medical issues.聽They do not require a medical admission and therefore they are your problem� as the emergency room social worker.

聽淪o then, we檙e kind of stuck,� related Sullivan. 淭he dollars-and-cents people in the hospital are saying, 榯here no medical justification to admit them and therefore there will be no reimbursement� however, I don檛 feel safe sending them home given their mental status and their inability to care for themselves.澛� 聽聽

Kelsey Anderson, MSW �19, finds instances of self-neglect in her work on a local Alzheimer Association help line. In one case, she said, a man with a dementia diagnosis called and revealed to Anderson that he hadn檛 been eating. 淗e didn檛 have food in the home,� she said.

When Anderson asked a superior what to do, she was told, 湗Well, you could report it to [Adult Protective Services], but they檙e going to say, 業f you haven檛 had eyes on him, you don檛 know that he not eating, so we檙e probably not going to substantiate this.櫇

Connecting socially isolated and mentally ill individuals to the services they need is a constant challenge made harder by systemic flaws of that sort, Anderson continued. 淏asically, we have to wait until he gets worse and he can檛 live alone, or something happens that so severe that he ends up hospitalized. It a major gap and it creates silos that get in the way of being able to help these adults to live successfully in the community.�

After listening to these and other tales of bureaucratic snags and snarls, Bump said that not only might the issues raised that afternoon become areas of inquiry for future audits, but also that her office serves as a resource for the state legislature, potentially putting data on such failings in elder services directly into lawmakers� hands.

淭hank you for the service you檙e providing to all of your clients, and to our society,� Bump added.

Before concluding the meeting, Matz noted gains on issues facing older adults in recent years, including Massachusetts Governor Charlie Baker first-ever mention of aging in a State of the Commonwealth address in 2017. 淭here a lot that really great that going on in Massachusetts right now around aging,� said Matz. 淎nd then there a lot that we could do better.�