completed

My female owner completed her first externship today. When she first started her placement at the end of March, she felt that she would never be able to see this day, although logically, she knows that this day would arrive. With a sign of relief, she walked out of the facility for the last time today, as a trainee psychologist.

She spent a total of 15 weeks, working two days a week, at the aged care facility. Clocked 100 hours of direct clinic contact hours. This included running a 9-session CBT group (it was meant to be 10 sessions but my female owner was too lazy to run the last one. Also, she was pissed at having to do a memory training as well), a 2-session memory workshop and 89 hours of individual sessions. She also had the privilege of attending two training sessions, one on experiential learning of what it is like to have dementia (participants were kept in a small room, wearing a mask on their faces and had cotton bud in one ear, mini grains in their shoes. They had to accomplish certain tasks according to a prescribed method or sequence.) and the other was on person-centred therapy for people with dementia.

In her work, she encountered residents with varying state of cognitive and/or physical impairment. Most obviously, individuals with different kinds of dementia: Alzheimer’s, vascular and even alcohol-induced . Mobility covered the whole spectrum, from those who were bed-ridden or had a leg/s amputated or used wheelers/ walking sticks to those who were perfectly mobile. Medical conditions included cancers, osteoarthritis, lymphodema, renal and urinary problems, heart problems etc. Psychological problems ranged from grief and loss over death of loved ones, independence, control and physical functioning, depression, anxiety, behavioural issues, non-adherence to medication treatments.

From the various diversional therapists, she learnt more about Australia: how to bake pumpkin scones, the existence of cane toads, how to eat vegemite with crackers and cheese (yum! She says), gardening, cooking, Brisbane music festival etc etc.

Through observing them at work, my female owner picked up valuable techniques in relating to older adults. Besides speaking louder and slower, she learnt to acknowledge them by their preferred name, to make small talk with them, to speak to them at their eye-level and before doing anything, tell them exactly what she would be doing. She began to see the residents as individuals, with years of experiences shaping them into the persons they were. My female owner learnt the importance of remembering their likes and dislikes, e.g. their preferences while drinking coffee or tea, the kind of activities they enjoyed and even, where they preferred to sit in communal activities.

As a psychologist, my female owner struggled to make herself relevant to the residents. They often saw her as an available person to listen to their life stories and were not prepared to do any active therapy (and she totally understands their point of view). Hence, my female owner did heaps of reminiscence therapy with the residents. She learnt very quickly that residents were not ready for the traditional CBT. Hence, she intervened using subtle CBT messages e.g. she drew out the positive things residents were doing for themselves, kept reinforcing them and worked with them to look for more ways to enhance their psychological well-being.

In her opinion, my female owner did not receive adequate clinical supervision. Her clinical supervisor was as naïve as her with regards to the inner workings of an aged care facility and would propose ideas that showed a lack of understanding of the practical constraints that externs faced in their placement. Often, my female owner felt like a guinea pig as her supervisor would ask her if XXX should be done for the next batch of externs who would be doing similar placements. Many times, my female owner felt like telling her to quit thinking about future batches and concentrate on supervising her current externs first.

Such a long post. Maybe one day, I will write more about my female owner’s experiences. For now, suffice to say that she is ready to move on to other things (which unfortunately includes tonnes of paperwork and writing up a folio for this placement).