Volunteer Handbook by cUwNCpYT



    1600 Grand Avenue (Mail)
  36 Snelling Avenue S. (Office)
       St. Paul, MN 55105
         (651) 696-6882

Volunteers . . .
are the backbone of the
Seniors, a Living at
Home/Block Nurse

The Macalester-Groveland Seniors, a Living at Home/Block Nurse Program was founded in
1987 through a grassroots effort by area residents and community leaders to meet the changing
needs of seniors for those over age 65 in the community. The program brings neighborhood
professionals and volunteers together with their elderly neighbors. Elderly program participants
receive social, medical, health education, caregiver respite, companionship, or other support
services. These services enable elders to live in their own homes for as long as possible and to
delay or avoid placement into nursing homes.

Program Goal
We strive to support senior members of the Macalester-Groveland community who
choose to remain living in their homes by engaging community strengths and offering
accessible health, volunteer and caregiver support services.

Each year, nearly 100 volunteers share their time and talents and are matched directly with
clients in a variety of ways. The positions are important and meaningful for not only the senior,
but also the volunteer. Volunteers are extremely necessary in helping to fulfill our mission.

Volunteers come from area faith ministries, businesses, schools and individuals that live or work
in the Macalester-Groveland community. Their efforts help to fulfill the mission of helping
older adults make their lives more independent, healthful and meaningful.

We couldn’t do the exceptional work that we do, with out the dedicated volunteers associated
with our program. People, whatever their background and skills, have something in common ---
humanity, patience, compassion and the desire to help others.

Who Are The Volunteers
Macalester-Groveland Senior Program volunteers come from all walks of life. They are people
who provide weekly volunteer service or when they can. Many volunteers have been a part of
the senior program for several years, while others are just getting started with their volunteer
work. Our flexible volunteer scheduling and varied assignments offer something for those
working full-time or even for those available during the daytime hours. We do value and
appreciate any time you can invest in helping a senior in our community.

Qualities of a Volunteer
    A person in whom others can freely confide, knowing that confidentiality is a priority on
     their list of values.
    A person who willingly shares time, energy and talents with others.
    A person who can accept others as they are, rather than the way that person thinks others
     should be.
    A person who can allow others to express their own feelings without telling them how
     they should or shouldn't feel.
    A person who can sit quietly with others when they aren’t able to put their feelings into
    A person who cares about others, and reaches out to lend a helping hand and a listening
     ear.                                                                                3
Volunteers in Action: Companionship
It has been said that what a volunteer gains from helping others is equal to, or even more, than
what the volunteer gives. Below is a truly compelling story written by a volunteer recapping her
journey of friendship with an amazing woman.

A Tribute to Grace
I was asked to write about losing my friend Grace, who I was matched with in the Macalester-
Groveland Seniors program in January of 2006. She was a spry 97 at the time, living in a town
home not too far from where I live. Always the gracious hostess, the first time we met she
served tea and crisp little cookies her friend Marie makes, and made me feel instantly at home in
her little kitchen. We met most Wednesday afternoons, except when she had Guthrie tickets or
was entertaining family from out of town. Our time together included running errands, drinking
iced tea on her patio near the waterfall she had recently installed, visiting her old friends who no
longer drove, picking up supplies for her orchid growing hobby, and we even took a Tai Chi
class together once!

In addition to our Wednesday times, she had my partner and I over to her place for dinner a few
times, and we had her over to our home last Christmas Eve. We had a light supper, then spent
the evening sitting around our fireplace visiting. My elderly cat Guido (who died this August)
just loved Grace, and sat next to her on the couch with his tail wrapped around her arm- two very
old souls connecting might not seem unusual, but Guido tended to be very cranky and bit most
people who tried to touch him, including me on a number of occasions! But he welcomed
Grace's touch and snuggled next to her. Another holiday we spent together was Easter of this
year. She had a friend cook the meal, and invited us over to share it with them and a new friend
of hers from South America. Grace believed in making new friends wherever she went!

This summer, Grace and I talked more about death and dying as she was slowing down, and I
was dealing with Guido declining too. She told me she wasn't afraid to die, and felt blessed to
have lived such a good long life and known/loved so many good people. The last time I visited
her at home she was short of breath but in good spirits. That night she went to the emergency
room after a congestive heart failure attack. She spent some time in ICU, and I didn't see her
again until she was in a regular room. When I went to visit there, she was surrounded by her
"boys" Bill and Richard, one daughter in law, and several grandkids, all of who so clearly loved
her like nobody's business! From there she went to the Highland Chateau, as she was weak and
still very short of breath. When I saw here there she told me she wasn't in any pain, but didn't
want to live like an invalid. She had to eat pureed food and was hooked up to oxygen 24 hours a
day by then.

On the Monday of Labor Day this year she turned 99. Her boys had a birthday party for her
attended by lots of neighbors and friends. Her relations in Eau Claire sent a cake, and the boys
decorated with crepe paper streamers. Although she had been having trouble swallowing for
weeks, her birthday cake and ice cream seemed to go down just fine. That Wed her care team at
the Chateau told her she would never be well enough to return home, and that night she died in
her sleep.

I was, and have been, very sad since Grace died. The sadness is softened by the knowledge that
she died peacefully, and didn't have to suffer any more end of life discomfort than she did. My
time with Grace was intended as a good deed to help an elderly person stay living independently,
but to tell the truth, I definitely felt great joy during my time with her. Knowing Grace was a
delight I will cherish always. We were well matched and shared many good conversations and a
lot of laughter. Her energy and enthusiasm for life were quite impressive, and her warmth and
goodness are still with me even though she is in Heaven now with her Henry and all her other
loved ones. Written by a community Volunteer

Code of Ethics for Volunteers
As a volunteer, believing that the organization has a real need of my services, I realize that I am
subject to a code of ethics similar to that which binds the professionals in the field in which I
work. To accomplish this service I will:

    Be sure…look into your heart and know that you really want to help other people.
    Be convinced…don’t offer your services unless you believe in the value of what you
     are doing.
    Be a participant…be interested in others…Be cheerful…make them feel important.
     Never lose an opportunity to say a kind word…respect feelings…Be careful of personal
     prejudices…keep an open mind.
    Understand your program and your involvement…Speak up…ask about the things you
     don’t understand…be willing to learn…keep on learning…know all you can about the
     Macalester-Groveland Seniors Program.
    Be reliable…make promises sparingly, respect confidential information…be on time for
     your volunteer assignment.
    Welcome supervision as guidance…question if you don’t agree, but be a part of the
     working program…enjoy what you’re doing because, in the end, we are all trying to help
     each other.

Friendly Visitor Commitments and Expectations
    Try to visit with your senior for a minimum of one-two hours per week in person.
    Call the senior if you cannot visit or will be late.
    Have a positive attitude, relax and enjoy yourself! Both you and your senior will benefit
     from your new friendship.
    Keep track of the time you spend with your senior, even if out and about in the
     community. Record your volunteer hours in a timely manner via the volunteer log.
    Take advantage of on-going support and educational opportunities as you are able.
    Tell others about the wonderful service in our community and encourage others to get
     involved and volunteer!

   DO NOT accept money or large gifts from the senior. If someone insists, decline politely
    and explain that this is our policy. If appropriate, suggest they make a donation to the
    Macalester-Groveland Seniors Program. (donation envelopes are available in our office)
   DO NOT dispense medications or provide any kind of personal help or health care.

Setting Expectation and Limits
Setting limits is important and brings about a sense of security in the relationship. Please
consider the following guidelines:
     Let your senior know how long your visit will be. They may be lonely and expect you to
        stay longer then you can.
     When you have to leave, let your senior know how much you’ve enjoyed your time.
        Assure him/her that you look forward to next week’s visit.
     Encourage a variety of activities. If you always do the same thing (i.e. grocery shopping,
        board games), the senior may develop certain expectations.
    Limit your role to that of a Friendly Visitor. Never attempt to give professional advice of
     a medical, legal, financial or psychiatric nature.
    Even though you may be providing some transportation or shopping/errands, your
     primary role is friendship to that person. Be clear with the senior to prevent unreal
     expectations and resentment which can inhibit the development of a good friendship.

Setting Boundaries
Boundaries are the healthy limits in adult relationships that allow you to expend energy in our
interactions with others while maintaining the energy you need to care for yourself. They allow
you to say no when the expectations of others go beyond the scope of what you can give.

Saying no comes from a sense of balance between yourself and the needs of others. Appropriate
boundaries can empower families. They model a healthy relationship. They provide a model for
the caregiver to care for him/herself.

They allow you to communicate caring that is within the bounds of your abilities to meet needs.
For each person, it is different. However, you need to know that it is okay to say no when you
feel you have given all you choose to give. “No, I’m sorry, I just can’t do that for you.”

Your first response is to want to be helpful and accommodate the person and/or family's well
being. Sometimes you may feel uneasy or resentful about some requests. Those feelings are
often warning signals that you may have been asked to do something that is inappropriate such as
a request for money or material goods, asking for transportation other than when you are
scheduled to provide this service, phone calls to your home if you have not discussed this and
okayed it, and persons wanting to maintain contact even after your volunteer help is no longer
needed. (This may be appropriate, depending upon the situation.)

Setting boundaries can be difficult! If you need assistance in setting boundaries with the
person for whom you are volunteering or their family, the Volunteer Coordinator will help you
set up some guidelines.

Volunteers In Action: Giving and Receiving
As volunteers share their gifts and talents in working with an older person, the older person
sometimes wants to give in return by offering a gift such as chocolates, a book, or flowers from
the garden. Sometimes volunteers are not sure how to respond in these situations, fearing that
the older person will be offended if the volunteer does not accept the gift.
Generally speaking, these gestures are just a part of the “give and take” of neighborly
relationships. Unless the gift is of high value, it may best serve the intentions of the older person
to graciously accept the gift, being sure to thank them.

In the case of a large monetary gift, it would be appropriate to suggest that the gift might be
donated to the Macalester-Groveland Seniors Program. If you are uncertain about the most
appropriate response related to gifts, discuss any questions or concerns with the Volunteer
Coordinator or Executive Director.

Equal Opportunity and Ethical Conduct
Macalester-Groveland Seniors corresponds with the commitment to pledge and ensure fair and
equal treatment for all persons, regardless of race, color, religion, sex, national origin, disability
or veteran status. Personnel choice is based solely on a individual’s qualification for the position
that is available. The only exceptions are when, with reasonable accommodation, age or
disability substantially limits ability to meet or perform legitimate service standards or because
of safety hazards.

Volunteer Rights
Volunteering is a form of philanthropy. You are giving of your time and talents. The assets you
bring to the program are considerable. The following "Bill of Rights" will serve you in your
volunteer work. It is your right and obligation to ensure that these rights are respected and
brought to the attention of someone in an authority position should they be violated.

As a Macalester-Groveland Seniors Volunteer, you have THE RIGHT to:
 Be treated as a co-worker -- not just free help.
 A suitable assignment -- with consideration for personal preference, temperament, life
   experience, education and employment background.
 Know as much about the organization as possible -- its policies, people, programs, and
   future directions.
 Training for the job and continuing education on the job -- including training for greater
 A job description.
 A place to work--a designated place that is conducive to work and worthy of the job to
   be done.
 Be heard--to feel free to make suggestions, to have a part in planning.
 Recognition--in the form of promotion and awards through day-by-day expressions of
   appreciation and by being treated as a co-worker.

Volunteer Responsibilities
Volunteering is a rewarding experience. All of those involved in the relationship must have
respect for one another and a desire to cooperate in meeting designated needs. In addition to the
rights that you have as a volunteer, there are accompanying responsibilities. By recognizing
these responsibilities and fulfilling them, your experience with the Macalester-Groveland Seniors
Program will be enhanced. As a Macalester-Groveland Seniors Program Volunteer, you have

   Become thoroughly familiar with the mission of the organization and the goals of the
    program in which you are involved.
   Respect the confidentiality of clients’ names, histories and records, and the privacy of all
    those you work for as well as other volunteers. If you have criticism about another person,
    convey it to the volunteer coordinator or executive director.
   Be prompt and reliable in reporting for scheduled responsibilities, and notify your supervisor
    as early as possible if you are unable to work as scheduled.
   Attend orientation and training sessions as scheduled.
   Be considerate, respect the ability of the staff and work as a member of the team.

    Carry out assignments with a positive attitude, seeking the assistance of your supervisor in
     any situation requiring special guidance. Maintain an open mind about other people’s
     standards and values.
    Accept the right of the program to dismiss any volunteer for poor performance, including
     poor attendance.
    Decline work that is not acceptable to you. Communicate your personal limitations, e.g.,
     unacceptable out-of-pocket costs, transportation needs, time constraints, and other
    Keep an accurate record of your hours worked.

Rewards of Volunteering*
Although research evidence is inconclusive, some studies suggest that volunteering has
beneficial effects on physical and emotional health. If volunteers perceive a change in their
physical health or mental outlook, perhaps these perceptions are important in themselves.

The following statements are based on several research studies:
 Volunteers are better off physically than non-volunteers.
 Volunteers either maintained or improved physical functioning during their time as
 One study found lower mortality for volunteers.
 Volunteers have higher life satisfaction.
 Volunteers have higher self-esteem.
 Volunteers are less lonely, and they increase friendship through volunteering.
 Volunteers anticipate meeting new friends through the volunteer experience.
 Volunteers gain more social skills, new roles, and better social resources.

Taking Care of Yourself
In order to maintain a positive attitude in caring for others, it is important that volunteers and
caregivers take care of themselves. Some suggestions for taking care of yourself include:

1.      Take time for you. Do something for yourself at least once a day. Some examples
        include: engage in a hobby or recreational activity, read a novel, listen to music, etc.
        Seek a balance between time for you, time for your spouse and time for your children.

2.      Exercise regularly. Eat nutritious food. Get plenty of sleep.

3.      Take time to consciously relax several times during the day. Meditate. Slip into a
        soft, comfortable chair. Visualize the most peaceful scene you can think of. Empty your
        mind of tension. Take a warm bath. Massage your tensions away.

4.      Start the day with a positive focus: Try to maintain it throughout the day. Ask yourself,
        "What's right with my life?" Can you go one entire day without complaining?

5.      Name three positive things about yourself; name three negative things about
        yourself. If you can name the negative ones faster, perhaps it might be time for an
        "attitude tune-up."

 Fischer, Lucy Rose and Schaffer, Kay Bannister. Older Volunteers: A Guide to Research and Practice. Sage
Publications, Newbury Park, 1993.

6.     Just for a day, change your routine.

7.     Give support and encouragement to others, and accept it graciously. Compliment
       others. Do something for someone else every day.

8.     Avoid dumping your stress on others. Use stress management techniques to alleviate

9.     Don’t feel like you are “losing it” when you have a bad day. Everyone has an
       occasional "bad day." Take breaks. Talk to a trusted friend. Write out your feelings on

10.    Enjoy a good laugh with others. Laughter is “inward jogging.” Smile often. To be
       positive, act positive.

                       "Each day is an opportunity to start over again --
                 to cleanse our minds and hearts anew and to clarify vision.
                And let us not clutter up today with the leavings of other days."

Orientation and Training
Prospective volunteers should participate in a general orientation session. Orientation and
interview may be held jointly, depending on the circumstances.

At a general orientation, you will sign up for an individual interview. Interviews will be
scheduled in the days following orientation. The interview will consist of processing all
paperwork and discussing placement possibilities and timeframes of availability. The Volunteer
Coordinator will help match your interests to volunteer opportunities available at the time of
orientation. Depending on circumstances, such as health issues, scheduling conflicts or for a
variety of reasons, NOT all potential volunteers will be accepted. If you do have any immediate
health conditions or conflicts in schedules, please discuss at the time of the interview. Feel free
to ask questions, throughout the course of your volunteer assignment and all aspects of your
volunteer experience with us.

Background Check
Consistent with Minnesota State law, Macalester-Groveland Seniors conducts background
checks on all volunteers, age 14 and over. All current and prospective volunteers who have or
will have direct contact with seniors in the community will have a background check done in
accordance with Minnesota State law.

The purpose of the background check is to verify that the volunteer has no record of criminal
convictions or applicable actions, which would disqualify him/her from acceptance as a
volunteer. You will be contacted by the Volunteer Coordinator if you are disqualified.

Proof of Insurance
For anyone driving seniors, you will be asked for a proof of a valid driver’s license and car

Once you have accepted your volunteer assignment, it is expected that you keep a regular
schedule. To make maximum use of your volunteer opportunity, we ask that you give at least a
six-month commitment. We can work with your schedule and are quite flexible.

Volunteers are expected to be reliable in the performance of their volunteer duties and
assignment. The seniors depend on you! Please notify the Volunteer Coordinator if you will be
on vacation for an extended period of time or if there is any other reason you will be unable to
keep your schedule with your senior. Please take your volunteer assignment seriously and let us
know if you are having any problem. If you need to change your volunteer assignment for any
reason, please notify us immediately.

If you are unable to continue volunteering, please inform the Volunteer Coordinator as soon as
possible. Two weeks notification to your senior would be most appreciated. Volunteers who do
not meet the requirements of a particular assignment may be reassigned.

Volunteers who do not adhere to the rules of the agency or who fail to satisfactorily perform
their volunteer assignment are subject to immediate dismissal. Any of the following violations
are just cause for dismissal.
     Not showing up or calling either the senior or the Volunteer Coordinator.
     Negligence in any careless action, which endangers the life or safety of another person.
     Breach of confidentiality.
     Immoral conduct or indecency.
     Dishonesty, willful falsification or misrepresentation on your volunteer application or any
        other volunteer records completed by you at the time of placement. Or, alteration of
        agency records or documents.
     Engaging in criminal conduct or acts of violence, or if the criminal background check
        comes back with information which is in violation of our mission.
     Intoxication or under the influence of controlled substance drugs.
     Unauthorized possession of illegal firearms or weapons.

Volunteer Hours
For several reasons it is important to keep track of volunteer hours. More and more
organizations are accepting volunteer work as qualifying experience for employment. If you
need a reference or letter of recommendation, it is imperative to always calculate and submit
your hours to the Volunteer Coordinator.

Keeping track of volunteer time is also critical for funding purposes, corporate supporters,
annual reports and other statistical reporting for the volunteer program. We ask that you keep
track of your own hours and submit them to us at the end of each quarter. The timeframe is:
January-March, April-June, July-September and October-December. As a friendly reminder,
you will receive an e-mail with a volunteer log-in at the end of each quarter. Please plan to
complete and return the log-in in a timely fashion.

Dress Code/Appearance
In order to reflect a clean and professional image, please maintain the following guidelines:
     Volunteers are expected to practice good personal hygiene and wear clean clothing.
     Volunteers are expected to dress in clothing and footwear that is appropriate for the
       working environment in which he/she is volunteering.
     Be mindful of perfume and after-shave, as seniors may have allergies to strong scents.

In-Appropriate Clothing:
    No bare feet.
    No mini-skirts, short shorts, bare midriffs, jeans or t-shirts with inappropriate
      verses or suggestive artwork.
    No dirty, torn or painted jeans or shirts (unless you are painting or doing outside

Student Volunteers
Youth and family are encouraged to volunteer at Macalester-Groveland Seniors. Youth under
the age of 18 would need to be accompanied by an adult. Depending on the volunteer
assignment and the age of the individual some volunteer positions may be done individually.

Macalester-Groveland Seniors supports college students who must meet school requirements for
class credit or service learning and does allow for some flexibility in schedules. Through the
school partnership, we connect the resources of the college with the community needs and
strengths in order to support the capacity of the Macalester-Groveland community.

Students get first-hand experience with people whose “life experiences” differ dramatically from
their own. Additionally, students learn about some of the problems facing the larger community
and take action to transform it.

Letters of Confirmation
If you need to show proof of hours or length of service time (for school or employment), a letter
of confirmation or recommendation can be requested from the Volunteer Coordinator. Please
request this notification well in advance of the timeframe you need it.

Retired Senior Volunteer Program
Macalester-Groveland volunteers who meet certain eligibility requirements may become active
members of an organization called R.S.V.P. (Retired Senior Volunteer Program). This is a
FREE program and helps individuals age 55 and older put their skills and life experiences to
work for their communities.

As a R.S.V.P. volunteer, you would be eligible to receive:
    Transportation reimbursement – reimbursement for out-of-pocket expenses incurred
       while volunteering at Macalester-Groveland Seniors, such as a bus or automobile mileage
    Supplemental insurance – R.S.V.P. offers free supplemental insurances on the day you
       are volunteering. To meet your needs, they provide excess to auto liability, personal
       accident and personal liability insurance.
    Quarterly R.S.V.P. newsletter, filled with important and useful information.
    Volunteer recognition events and picnics throughout the year.

To become an R.S.V.P. free member, please contact the Volunteer Coordinator for more
information or details. Remember, there are NO FEES involved. This is a FREE program
sponsored by R.S.V.P.

General Requirements, Information and Guidelines for volunteering with
seniors of the Macalester-Groveland Seniors Program.

Program Assistance for Friendly Visitors
Your commitment and volunteer efforts are very important to us! Here are some ways we can
lend our support.

        If you have a problem or concern, call us and we’ll help find an answer.
        If your match is not working out, let us know and we’ll try to find a new visitor for
         the senior, as well as a better match for you.
        If your senior wants you to do more than is expected of you as a visitor, we will call
         the senior and kindly reinforce the parameters of your volunteer commitment.
        If your senior has needs beyond the scope of Friendly Visitors (legal, medical,
         housing, personal care, transportation issues, etc.), let us know and we will enlist the
         help of our Case Manager.
        If you need to end your volunteer service for any reason, contact our office so that we
         can assign another visitor to take your place.

Establishing Trust, Honoring Confidentiality
Trust is important in any healthy relationship because it promotes openness, sharing and growth.
For a senior who may have already sustained many losses, trust is especially important. It takes
patience to develop trust --- Give it time!

        Be dependable. Call if you will be out of town, are ill, or cannot keep your visit time.
        Respect the privacy and individuality of the person. Keep the senior’s personal issues
         and information in confidence except in case of emergency or danger.
        If the senior shares family complaints/concerns, stay neutral and do not take sides.
         JUST LISTEN…
        If you suspect abuse or think that a follow-up on a problem is necessary, call the
         Volunteer Coordinator.

Reduce the Spread of Infectious Diseases
        If you develop a cold, flu, fever, etc., or become exposed to an infectious disease, DO
         NOT make a home visit. Call your senior to explain why you cannot come and make
         plans for your next visit. If you are feeling well enough to have a phone visit, that is
         always an option.
        Seniors will be asked to call you or our office to cancel a visit if they become sick
        Wash hands thoroughly upon entering and leaving a home, after using the toilet, and
         before meal preparation and/or eating.

Preventing Infection: Handwashing
The single most important method of preventing infection and controlling disease has been found
to be handwashing. The following procedure is recommended:

   1. Stand away from sink; using running water; adjust it to the desired temperature.
   2. Wet hands and wrists thoroughly, holding them downward over sink to allow the water to
      run toward the fingertips.
   3. Using a generous portion of soap, scrub each hand with the other, creating as much
      friction as possible by interlocking the fingers and moving the hands back and forth over
      the palms (for 30 seconds); back of hands, wrists, between the fingers, and around the
   4. Rinse the hands thoroughly by holding them under the running water, with elbows higher
      than the hands to allow the water to flow downward to the fingertips.
   5. Dry wrists and hands with clean towel or paper towels, wiping from the fingertips down
      to the wrist area.
   6. Since the faucet handle is considered contaminated, turn off the water by using a dry
      paper towel when available.
   7. If washing facilities are inadequate, waterless antiseptic soap may also be used.
   8. Apply hand lotion frequently to prevent chapping of the skin.

Protecting Confidentiality and Privacy
By volunteering with a senior friend, you may find the person grows to trust you and begins to
share with you personal and private information. The Macalester-Groveland Seniors Program is
a neighborhood program that thrives on the natural helping relationships and friendships among
neighbors. The close circles in which volunteers, seniors, and staff interact in the neighborhood
and at church, make it vitally important that volunteers learn to keep confidential information
that a senior friend may share.

There are important distinctions to be made among different kinds of information. Some
information is public knowledge, for example, that a woman's husband has died. Some
information is based not necessarily on facts, but on people's interpretations of what they
believe to be true. For example, people discuss that the widow must not be grieving, because
people have not seen her crying. As a Macalester-Groveland Seniors volunteer, you should
never engage in interpreting the situation of a senior friend (or others). This is gossip. Finally,
some information is private knowledge. This is the kind of information that may be made
available to you in your role as a Macalester-Groveland Seniors volunteer and which you are
required to keep confidential. For example, you know, because the widow is your senior friend
and has told you, that she feels numb and has been unable to cry over the death of her husband.

There may be a great temptation as a volunteer to discuss private knowledge with others to
correct their erroneous interpretations or gossip. As right as this may seem, it is NOT
appropriate to share private knowledge under any but the following circumstances:

   Information, even private knowledge, should be shared with the Macalester-Groveland
    Seniors staff if the staff needs to know such information in order to support the volunteer or
    provide further assistance to the senior. Volunteers should be honest with seniors about
    the possible need to share limited information with Macalester-Groveland Seniors staff.
   Knowledge about a person’s intention to harm him or herself or others or knowledge about
    the abuse or potential abuse of a vulnerable adult should be shared with appropriate
    authorities and Macalester-Groveland Seniors staff. Again, should such information be
    expressed by the senior friend, volunteers should be honest about the need to share such
    information, with whom it will be shared, and why, and invite the senior to participate
    in the communication

When you need to talk about your volunteer experience:
 Discuss your volunteer situation with Macalester-Groveland Seniors Program staff, focusing
  on your experience as a volunteer.
 Attend volunteer support meetings and in-services to discuss your experience with other
  volunteers, again, concentrating on your experience rather than the senior's.

Working with Older People
Older people have the same basic needs as everyone else. They need to have opportunities to
be creative, to form friendships, and to make important life choices. It can be easy to give more
help than is needed and more advice than is wanted. Older people need to maintain control
over their own lives.

Older people are often forced to adjust to many changes in their lives. They may have
suffered losses and personal ties. These losses may include the death of their spouse, other
family member, and/or friends; changes in physical functioning; loss of familiar neighborhood
stores. They may feel lonely and be grieving.

Like people of all ages, older people may be afraid of old age, of being alone, of suffering
pain, illness and loss, of not having enough money, or of being manipulated or ignored.

Loneliness and fear can cause depression. These feelings can lead to withdrawal or hostility.
Some people may become difficult to like because of their low self-esteem. Their anger may
even cause aggression and irritability. The frustration of being old in our society can result in
personality changes.

If you understand these factors and respond with sensitivity, you will be of greater help to
your client. It will also help you learn how to prepare yourself for aging and how to recognize
and eliminate stereotypes about older adults.

You may also visit a person who has adjusted well to growing old and does not present any
problems of this nature. Either way, you will benefit as much as your senior client.

No matter what your age, you can still have personality conflicts. If you feel you have a
problem with your senior client, talk with the Volunteer Coordinator as soon as possible.

Talking with Older People
Communication can be challenging even in the best of circumstances. As the people we care
about grow older, it can become even harder to talk about difficult issues. When you're worried
about the health and safety of an older relative or friend, it can be easy to forget that everyone--
no matter what age--needs to feel in control of his/her own life. Here are some suggestions that
may help you when you're talking with seniors. Listen to them at least as much as you talk. It
can be easy to fall into the trap of talking too much, especially if you're discussing a difficult
topic and feeling a little nervous yourself. Remember, conversation is a two-way street.

Be as positive as possible. Try to make constructive suggestions instead of negative statements.
"Let’s try having a housekeeper do the heavier work so you can keep things the way you like
them," may work better than, "You know you can't keep this place clean anymore."

Try to set aside a quiet place to talk, ideally during the time of day when the older person is
feeling at his/her best. Allow the older person to lead the conversation as much as possible,
asking questions only as necessary.

Remember that older people still need to make decisions about their own lives. Maintaining
people’s sense of independence and dignity may be as important as getting their groceries

Be patient. Allow enough time for older people to complete their thoughts without interruption.
Some older people need extra time to express themselves. Remember that part of feeling secure
is feeling needed. Sometimes it can help to talk about your own feelings and let older people
offer you comfort.

Never argue--no matter how much you want to! Realize that each of you may have differences
in your approach to a problem or your feelings about it. Try to talk about those differences
without criticizing.

If you’re really having problems discussing something, slow down and let go of it. Leave it for
another day when you aren’t frustrated or upset. Try to think beyond the words and the
behavior to what the older person is really feeling.

“Tips” for Developing Relationships with Older People
   Be dependable. Plan a scheduled visit with the older person and call in advance if you are
    unable to keep an appointment.
   Be patient. Some older people require more time to do things than they used to. You are
    likely to hear stories repeated. Listen with interest and responsiveness.
   Take time to build a caring, trusting, honest relationship.
   Use your normal volume and tone of voice unless you are asked to do otherwise.
   Face older adults when speaking to them. Older people who have some loss of hearing often
    look for visual clues.

   Learn about the older person's interests and encourage them to talk. Be cheerful; your mood
    and attitude may have an impact on the senior.
   Don't discount what older people say, or assume they are forgetful. Most older people are
    not senile and often have infinite wisdom.
   Whenever possible, do with people rather than for them. Help them make their own
   Encourage them to develop new interests or to revive old hobbies.
   Respect senior confidences. Remind them that the information they share will not be shared
    with others.
   Do not take sides in arguments; be reassuring, and help them think through alternatives.
   Use dark ink or a felt-tip pen when writing information to older people. Informational
    handouts should be of lighter colors (avoid bold or fluorescent colors).
   Be prepared to answer questions. If unable to answer a question, explain that you will need
    to check other sources. Assure them that you will contact them with the information by a
    certain date.

Getting to Know the Older Person
Some of the following questions might be helpful in getting to know your older neighbor over
time. It may also give them pleasure in reminiscing with you. Listen carefully to the stories,
asking further questions only as necessary.

   Tell me about your parents. . . . About your grandparents.
       Do you know how they met?
       Do you have pictures of them?
       What are some of your favorite memories?
       What did they do?
       What were they like?
       What values did you get from them?

   When and where were you born?
      Did you hear stories about it?
      Were you named after anyone?

   What are some of your earliest memories?
      What were holidays like when you were growing up?
      Do you remember the house you lived in as a child?
      What were you like when you were a child?
      What did your family do for fun?
      What kind of chores did you do?
      What was your first job? Other jobs?
      How old were you when you got TV? Electric lights? A car? Rode in an airplane?
      Other firsts?

   Who were influential people in your life? Influential experiences?
      What things did you do that you are especially proud of?
      Were there any special turning points in your life?
      What were some of the rough times?
      What did/do you like doing for fun?

   What has stayed the same through life? What has changed?
      What would you do differently?

   What advice do you have for me? How can I prepare for growing older?
      *What's best about growing old? What's hardest?
      *What frightens you? Then? Now?
      *How do you feel about retirement?
      *Do you think about death? What do you think about?
      *Consider putting your conversations on audio or videotape.
      *Record the person's laughter, mannerisms.
      *Take pictures.
      *Include grandchildren in the sessions.

Suggestions for Visiting Activities
       Read aloud from favorite books or newspapers.
       Play games (i.e. checkers, Scrabble, chess, cards, cribbage, etc.)
       Do jigsaw puzzles, crossword or word games.
       Assist with writing cards or letters.
       Reminisce.
       Do a tape recording or video recording of memories.
       Share photo albums
       Suggest re-doing an address/phone book.
       Help them learn their computer better.
       Go for a walk outdoors if possible.
       Share a trip to a local store or park together.
       Do crafts or an art project.
       Look at books of photographs.
       Talk about your travels and where the senior has travelled to.
       Discuss current events (perhaps bring an interesting article or paper with)
       Start a windowsill garden project.
       Bake cookies together.
       Listen to music. Have a sing-a-long. Watch a movie together.
       If you play an instrument, bring it along to play for them.
       Go out for a cup of coffee or to lunch.
       Show the senior something new in the community that they may have not seen yet.
       Go to a movie.
       Just take a drive.
       Make a scrapbook for them to give to someone.
       Attend an event or take them to a senior center for an activity.
       Sit outside at the park or near a lake and enjoy the nice weather.
       Discover what the senior likes and try to participate in that activity.

Good Nutrition & Seniors
Many seniors are on special diets (i.e. salt-free, diabetic). This may mean giving up many of their
favorite foods. If you plan to escort someone out for a social occasion that may involve a meal,
make sure that the menu is compatible with his/her dietary needs.

     Try to find out if the senior is on a special diet.
     Remember, that as people get older, appetites and caloric requirements decrease. Many
      seniors eat several small meals a day. There is also a decrease in taste and smell.
    With some diets and medications, fluids are especially important. Suggest fluids at some
     point during your visit.
    If you are helping a senior with shopping, read labels carefully to determine if foods
     contain excess sugar or salt. You can make suggestions, but remember that people
     develop eating habits over years and may not change. They have the final word on what
     they eat!
    When appropriate, you may want to even suggest they try Meals on Wheels. Check with
     the Volunteer Coordinator for more information.

Volunteers in Action: Friendship
Friendships are developed as volunteers interact with Macalester-Groveland Seniors Program
seniors. For the past three years Betty has enjoyed the companionship of some special
volunteers. Betty seldom leaves her home as she is dependent on the use of oxygen. Her
volunteers brighten her life by providing friendly visiting.

It is fun to hear the stories told about the different projects and enjoyable times shared with
Betty. Making homemade noodles, canning pickles and tomatoes, or baking 100 cookies at a
time are only some of the adventures the volunteers have shared at Betty’s house.

Even though she lives just a short distance from the shopping mall, Betty had never had the
opportunity to go there. What would be a simple trip for most people becomes more
complicated for Betty with her oxygen. One day the volunteers surprised her with a trip to the
mall and lunch at a nearby restaurant. This event was a heart-warming occasion for everyone

“This was one of the best days ever, because I had all my ‘girls’ with me!” says Betty. The
volunteers ended “Betty’s Big Adventure” with a ride on the Merry-Go-Round! If anyone asks
about kind, caring volunteers, just ask Betty!

Emergencies -- “What if. . . ?"

WHAT IF. . .

There is an emergency?
Dial 911. Stay calm. Use common sense and refer to emergency procedures on the next page.

You are helping someone walk and they begin to fall?
If you cannot steady the person falling, don't try to catch them, but do protect their head
especially and gradually let them fall, avoiding sharp edges and hard items if possible.

You break a dish or something in the house by accident:
Tell the owner, apologize and offer to replace if possible.

The care receiver is confused and orders you to get out?
Don’t leave the care receiver alone. Try a calm, firm approach, assuring the person its okay.

After a couple of visits, you find a client too difficult to manage?
Talk with the volunteer coordinator immediately.

Emergency Procedures
1.     Stay Calm
Reassure and calm the victim.

2.      Do Not Move or Pick Up Anyone
Wait for help to arrive, unless a hazard is immediate or the victim needs CPR (cardiopulmonary

3.     Call 911 For Help
Major life threatening conditions usually involve problems with breathing, the heart, heavy
bleeding or serious falls.

911 is the emergency number to call for ambulance, fire department and police assistance.

Stay calm. Know the address or location of the emergency and be prepared to describe what the
problem is.

4.     Until Help Arrives
Follow Basic First Aid Procedures


1. Call 911.
2. Call emergency contact person, if that information is known to you.
3. Call Macalester-Groveland Seniors staff at (651) 696-6882...


1. Call Macalester-Groveland Seniors staff at (651) 696-6882.
2. Go to the senior's house and follow the steps outlined below.


1. Knock loudly and call out the person's name. Check the back door as well as the front.
2. Look for signs indicating whether the person may be out (e.g., the person drives and the car
   is missing).
3. Look in the windows, if possible (Do you see a purse or boots or something else indicating
   that the person has likely not gone out?)
4. Check with neighbors to see if they have any information.
5. Call Macalester-Groveland Seniors staff at (651) 696-6882...
6. Call 911 indicating the details of the situation and the possibility of a medical emergency.
   Make sure you have the person's address to give the 911 dispatcher.

Common Chronic Conditions
There are several common conditions of elderly people causing them to need the support and
assistance of a caregiver.

Definitions of Common Chronic Conditions:

 Alzheimer's Disease
A progressive, degenerative, neurological disorder which causes brain cell destruction. It
interferes with the ability to remember, to learn new information, to use good judgment, and to
do simple tasks in caring for one's self.

 Other Dementias
Dementia is a general term referring to an impaired intellectual or cognitive capacity severe
enough to interfere with a person's daily functioning. The symptoms can be caused by many
diseases, some treatable others not.

 Stroke
A blood clot or hemorrhage from a blood vessel in the brain. Some types of neurological
symptoms often result, depending upon where the injury to the brain occurs.

 Cardiovascular Disease (Other than stroke)
Coronary artery disease results when the blood supply flowing through the arteries is reduced or
blocked. The oxygen supply to the heart muscle becomes reduced. When this occurs, a warning
is triggered called "angina pectoris". The warning may be experienced as squeezing pain in the
center of the chest and pain radiating to the left arm. Heart attack is the lay term for coronary
vascular occlusion or myocardial infarction. The blood supply has not been able to get to all
areas of the heart muscle due to damage to artery walls that eventually lead to vessel obstruction.

 Arthritis
Arthritis refers to joint inflammation. This disease involves the degeneration of the connecting
cartilage of the joints, replacing it with new bone formation. The result is pain, stiffness upon
rising, and creaking joints. Because of the discomfort, people try not to use the affected joints
which results in further restriction of joint motion.

 Diabetes
This condition is the result of an abnormal increase in blood sugar level caused by a reduction in
insulin produced. Signs may include increased thirst, excessive urination, increased appetite
with loss of weight, tiring easily, slow healing of sores and cuts and reduced vision. The
complications from diabetes may result in blindness, loss of limbs, kidney failure and heart
failure, and/or diabetic coma.

 Depression
Usually as a response to severe stress or loss (a loved one), symptoms of depression may appear.
There is an overall mood of sadness about the past, an inability to live with the present, and a
fear of the future. These signs are emotional, psychological and physical changes and might

include: a change in appetite, sleep patterns, social activities, emotional responses, grooming and
hygiene. When depression results in a person being repeatedly negative about life, withdrawn,
won't talk, or talk about suicide, professional help is needed. Depression is often disguised in
physical symptoms that have no obvious cause. Symptoms of depression can last for a few
months or for years.

 Lung Disorders
Emphysema is a common lung disorder often associated with smoking. The air sacs in the lungs
become distended and lose their elasticity thus decreasing lung capacity and oxygen supply to
the body. The lack of oxygen getting to the heart and brain because of emphysema has a major
impact on energy level and mental functioning. Lack of oxygen can cause a person to
experience memory loss, disorientation, insomnia and irritability.

 Parkinson's Disease
A progressive neurological disorder characterized by tremors, muscle rigidity, a stiff gait, slow
speech, and a mask-like expressionless face.

Listening: A Clue to Better Understanding
How long has it been since you have really listened to someone? If you are like most of us,
chances are you are so busy with work, family, friends and entertainment that you seldom take
time out to find out what the people around you are really feeling and thinking.

There is a pressing need in our society for people to listen to one another. “Oh, if someone
would only listen to me" is a frequent lament of modern-day America.

What is listening? Can it be learned or is it such a subtle art that some are simply born good
listeners? In truth, listening consists of relatively simple skills which can easily be taught
and practiced.

Listening to another person consists of three key aspects. The first of these is eye contact.
An important beginning to communication in Anglo-Saxon American culture is through the eyes.
It can be helpful to reach many people by looking at them. Be sensitive, however, about eye
contact with people of other cultures such as Latin, Asian, American Indian and Southern
African American communities, who may consider it to be rude and disrespectful, especially
when talking with older people.

Second, relax physically. If you are "up tight" and tense, it becomes virtually impossible to
listen to another person. Take a deep breath, feel the floor under your feet or your back against
the chair, drop your shoulders deliberately if they are arched. Use any of a variety of relaxation
techniques to make yourself more comfortable and less tense. People who are physically tense
are often more interested in themselves than others. In addition, if your own level of tension is
high, you will tend to make those around you uncomfortable.

Finally, focus completely on the other person. Forget yourself; you are responsible only for
listening. Follow the comments of the person with whom you are talking closely. Try to
understand this point of view (you can bring in your views later in the conversation if you wish,
but that is not listening).

Ask questions related to comments the person makes. If you find yourself at a loss as to what
to say, think back and ask a question about something of interest to you mentioned earlier in the
conversation. Don’t change the subject and introduce new topics or opinions of your own.

If you will listen attentively to others, you will be surprised at how interesting people are
and how much they have been telling you about themselves. In turn, you will find yourself
rewarded by deepened relationships with others.

In summary, your goal is to listen attentively and to communicate this attentiveness through a
relaxed posture, appropriate use of eye contact, and verbal responses which indicate to the other
person that you understand what he is communicating. Specific behaviors which you may want
to utilize are:
1. Relax physically; feel the presence of the chair as you are sitting in it.
2. Let your posture be comfortable and your movements natural. For example, if you usually
    move and gesture a good deal, feel free to do so at this time also.
3. Use eye contact by looking at the person with whom you are talking. Vary your gaze rather
    than staring fixedly. (Be aware that direct eye contact with persons of some cultures may be
    considered rude and disrespectful.)
4. “Follow what other people are saying" by taking your cues from them. Stay with the topic
    that is introduced rather than jumping from subject to subject.
5. Let your responses indicate to others that you are "with them" as they talk.

Listening Skills
Show we are ready to listen:
     Proximity: Face the person, be close enough to hear. Be sensitive to a person’s
      comfortable personal space. Always ask before touching.
     Eye contact: Look at the person when he/she talks. (Remember cultural variables.)
     Posture: Maintain an open relaxed posture, lean slightly forward.
     Gestures: Use natural gestures to indicate interest. Nod occasionally.
     Verbal encouragement: Use minimal verbal statements that relate to the person's
     Focus: As much as possible, focus your attention on the person speaking, try to block out
      all physical, intellectual and emotional distractions.

Observe the speaker's verbal and non-verbal cues:
     Voice: Observe tone, volume, emphasis, choice of words, repeated themes.
     Eye contact: What does the person's eye contact tell you?
     Facial expressions: Are the facial expressions consistent with what is being said?
     Posture: How is the person holding or not holding themselves?
     Body Movements: Is the person relaxed? Fidgeting? Comfortable? Uncomfortable?
     Consistency: Do the verbal and non-verbal messages match?

Listen for Content and Feeling:
       Central theme: Listen for the central, core feelings and/or content the person has
        explicitly stated
       Feeling: Determine what feeling you think the person is expressing

Focusing on the speaker:
     Paraphrasing: Restate to the person in your own words the central, core feelings and/or
      content the person has stated.
             Paraphrasing lets the speaker know the person is listening.
             Allows the speaker to correct misunderstanding.
             Helps clarify for both the speaker and listener how the speaker is feeling.
             Helps the speaker to better understand the issue when listener provides summary
             of content.
      Examples: Let me see if I have this straight . . .
             It sounds like you are feeling ______ because __________.
             I heard you say______.
             So you are feeling ________ because _____________________ is happening (in

               your life) which is making you feel _____.

Listening and Responding Appropriately
Sometimes it is appropriate to listen with empathy, being sensitive to and reflecting on
feelings that are communicated:

1. To begin a relationship of trust and caring.
2. To help other persons understand themselves better and to get in closer touch with their
   feelings and attitudes.
3. To understand what another person is saying when you don't know what they mean by what
   they say.
4. To learn more about a person, especially feelings or ideas.
5. To fully understand other people's views when their ideas and your ideas are different.
6. To fill time when you are not sure what other kind of communication style to use.

Other times it is necessary to respond more directly:
1. When the other person is seeking information only, or needs immediate action.
2. When the other person is acting inappropriately (abusive, seductive, aggressive).
3. When the other person talks all the time to avoid talking about something important that
   should be discussed.
4. When the other person is not in touch with reality, is suicidal or intoxicated. Concerns
   related to these situations should be discussed immediately with the Volunteer Coordinator.

Self-Assessment for Communicators*
Rate yourself on your responses to the statements below. Use a scale of one to five to rate how
strongly you agree with the statements, one being low agreement and five being high.

_____1.                I speak slowly, audibly, and distinctly.

_____2.                I use simple words and avoid jargon or slang.

_____3.                I listen as much as I speak: I do not interrupt.

_____4.                I allow extra time to communicate with someone whose first language is not

_____5.                I respect silence and do not fill every gap in communication.

_____6.                I consider the effect of cultural differences on messages being transmitted, and I
                       check my assumptions.

_____7.                When experiencing frustration or sensing conflict in a cross-cultural situation, I
                       ask myself, “What's really going on here?”

_____8.                I adapt my style to the demands of a situation.

_____9.                I appreciate different ways of communicating.

____10.                I do not judge people on their accents or language fluency.

____11.                I use the telephone appropriately.

____12.                I try to be open and direct in giving feedback.

____13.                I make an effort to talk about differences. I try to include people in discussions
                       that affect them.
____14.                I never make ethnic jokes, and I object when others do.

    C 1989 Copeland Griggs Productions, 302 23rd Ave., S.F., CA 94121

Respecting Cultural Diversity*
Ethnic groups have a strong sense of pride in being American, but are equally proud of their
cultural roots and back ground. It is important to learn to be sensitive to these cultural
differences. The following tips may help in gaining a better understanding and respect of
cultural differences:

   Begin cross-cultural education by reading about and talking with people of other cultural and
    ethnic groups. When in doubt, ask. Never operate on assumptions. Become aware of the
    cultural backgrounds, customs and values of the minority persons with whom you will be
   Become aware of cultural orientations of common words, trends and policies.
   Be aware that the cultural significance of time is different for different groups. Be aware of,
    but not dictated by, that difference.
   Sometimes an overly familiar approach may be seen as disrespectful. A warm, but formal
    approach is appropriate until a relationship is established. Initially, use the titles of Mr., Mrs.
    or Ms. rather than a first name.
   If a person tries to avoid direct eye contact, follow that lead. In Asian, Native American, and
    some Hispanic and African American cultures, direct eye contact may be interpreted as
    confrontational, disrespectful or rude.
   Some people are natural touchers. Rather than automatically touching others, develop a
    relationship and evaluate when or if physical closeness is accepted.
   Learn to listen with your eyes and ears. Remember, communication is both verbal and
   Be flexible, patient and tolerant. Anticipate positive intercultural relationships, but be aware
    of the possibility of rejection or indifference.
    There may be a period of testing. Don’t give up too easily; try to build the relationship.

Diversity: Building Bridges*
The best approach when working with any older person, regardless of their ethnic or cultural
background, is to:

   Treat that person as a unique individual
   Ask questions for clarification
   Listen and take cues from the way an individual communicates verbally (choice of words,
    tone and volume of voice, pace of speech)
   Observe and take cues from the way an individual communicates nonverbally (degree of
    physical closeness, eye contact, facial expression, body movement)

Life Changes and Loss*
Some of the life changes and losses experienced by older people can include:
 Retirement from work
 Widow(er)
 Death of loved ones: spouse, relatives, friends, and acquaintances
 Death of a pet, sometimes the only companion

 Adapted from Appreciating Diversity: a Tool for Building Bridges. AARP, Washington, DC, 1996.
 A Manual forTraining the Program Assistant in Adult Day Care. National Council on the Aging, Washington,
DC. 1993.
     Reduction of income
     Reduction of physical strength and endurance
     Change in living environment
     Role changes in the family
     Reduction of physical contact and intimacy
     Changes in mental functioning

For many older people, some or all of these losses are coupled with sensory changes, illness,
disability, or decreased functional capacity. It is essential to understand the losses and offer help
in adjustment and compensation. Above all, it is important to concentrate on the older persons
personal resources that have remained intact.

Most often, lifetime experience and well-honed survival skills will help participants make the
best of their life situations. In extreme situations the psychological changes that occur as a result
of various losses may, however, lead to an emotional disorder. The losses (physical, social,
mental or economic) may mean loss of resources and represent decreased mastery over one’s
world. The older person may experience “an emotional reaction of fear or anger, and either a
search for assistance from others or a retreat from others.” These reactions can be expressed in
such ways as manipulativeness, hypochondria, or depression.**

The decision to use services of the Living at Home/Block Nurse Program is often difficult for the
older person, who may feel a loss of control of his/her life in accepting help. Loss of control can
be a serious threat and needs to be handled sensitively.

Grief and Loss
Older people may have suffered many losses, including death of their spouse, family member
and/or friends; changes in physical functioning and changes in geographic location. They may
feel lonely and be grieving. Following are some general suggestions to help people adjust to the
losses and grief that they face at various times throughout life:

1. Acknowledge the loss. Express frustration, dismay, and sorrow. Remember, grief is a
   process which takes time to work through.
2. Acceptance and understanding. Learn to understand what is happening and be patient and
   gentle with themselves.
3. Reassurance. Accept the support and friendship of others. Although people need time for
   themselves, there are also times when it is helpful and healthy to be with others who give
   them energy and the desire to go on.
4. Patience. Too often people expect themselves and others to "get over this" rapidly when, in
   fact, they may have many "ups and downs" for weeks and months following the event.
5. Seek help. To facilitate feelings that are unexpressed, people need to be open to receiving
   professional help if they feel unable to move on.
6. Care for themselves physically. People grieve with their bodies as well as their hearts and
   spirits. They need to keep their bodies "tuned-up."
7. Avoid getting depressed about being depressed. Know when to roll with it, rather than
   fighting it and letting themselves get down from it.

     Casciani, Joseph M., Ph.D., and Stanley M. Rest, Ph.D. Aging and Mental Health: A Guide for
     Nursing Home Staff Development. Sacramento, CA State of California Department of Aging.

                                       Give sorrow words~~
                                    The grief that does not speak
                                   Whispers the o’er fraught heart
                                         And bids it break.
                                      Shakespeare ~ Macbeth

Behavior Changes: Call the Nurse
Intervention by the Block Nurse may be advised if you observe any of these changes in the
behavior of your Macalester-Groveland Seniors Program client.

Normal Behavior
Very social, talkative, friendly

Wears clean clothes, neat in appearance, hair combed, clean-shaven

Able to maintain home, make meals, balance checkbook
Is oriented to date, time, place, familiar with people’s names and relationship

Ambulates independently or comfortable with assistive device, can climb stairs if needed.

Self-administers medications responsibly, use of drugs or alcohol is not excessive
Obtains groceries or accesses meal programs to assure good nutrition; eats healthily

Behavior Changes

      Withdrawn, mood swings, inappropriate conversation
      Dirty clothes, unkempt appearance, has bad odor
      House cluttered and smelly, seems confused about cooking and daily chores
      Doesn’t remember family names, phone numbers, name of doctor, clinic
      Poor sense of balance while walking, shaky, susceptible to falling
      Reports discontinuing medications, increased intake of other drugs/alcohol
      Appetite decreases, no food in house, no interest in cooking or eating

Action: If you observe extreme changes in the behavior and well-being of a client, contact the
Macalester-Groveland Seniors for further instructions and resources.
Minnesota Statues on the Vulnerable Adult
Minnesota has a law that requires all people in licensed occupations, and others, to report the
abuse or neglect of a group of citizens known as vulnerable adults. These people include the
mentally or physically disabled, the elderly, or other adults who cannot protect themselves if
abused or neglected by those who are supposed to care for them. They are the vulnerable adults
who could be abused by those with whom they come into contact anywhere, at any time. All
Minnesota citizens can report such abuse. A license is not required to do that.

Minnesota statues provide that professionals and their delegates are required to report to
appropriate authorities if they believe a vulnerable adult has been abused or neglected
(Minnesota statutes, Section 626.556 and .557).

Staff and volunteers who are engaged in the healing arts, social services, hospital administration,
psychological or psychiatric treatment, education or law enforcement and clergy, are required to
report abuse or neglect of any vulnerable adults.

If a reporting is required, and made in good faith, the law provides immunity to the person
making the report from lawsuits for damages by the person charged with the abuse or neglect. If
you suspect that a client is being abused or neglected, contact the Volunteer Coordinator
within 24 hours. She will assist you in both the reporting and the processing of the proper

Persons age 18 or older...

            who live in licensed facilities such as nursing homes, hospitals, treatment centers
             for chemical dependency, mental retardation, mental illness or physical
             disabilities, OR
            who receive services from licensed facilities such as developmental achievement
             centers or home health agencies, OR
            who are in family settings and would not by themselves report abuse or neglect to
             them because of impaired physical or mental function, or because of emotional


Physical abuse
Conduct that produces pain or injury and is not accidental

Verbal abuse
Repeated conduct that produces mental or emotional stress

Sexual abuse
Violation of criminal, sexual conduct or prostitution statutes

Illegal use of the person or property through undue influence, duress, deception or fraud

Care provider neglect
Failure of caretaker to provide necessary food, clothing, shelter, health care, or supervision

Absence of necessary food, clothing, shelter, health care, or supervision

Exploitation through neglect
Absence of necessary financial management that might lead to exploitation

Record the following details:

       What happened?
       To whom did it happen?
       When did it happen?
       Where did it happen?
       Who did the abuse?
       Who was responsible for the neglect?

Providing Physical Assistance
1. CLUE THE CARE RECEIVER IN - Be sure care receiver knows what you’re going to do
    - and how you are going to do it - and how s/he can help.
2. GET HELP - If load (equipment or care receiver) to be lifted is more than you can handle -
    regardless of the wait.
3. CHECK YOUR FOOTING - Your feet should be apart to give you a broad base of support
    for better balance and stability.
4. MOVE CLOSE - Instead of reaching from a distance, move in and hold object close to your
    center of gravity (concentrated mass in pelvis).
5. SQUAT - Don’t use "mobility" (back) muscles. Bend hips and knees and keep back straight.
6. LIFT - Use "work" (thigh) muscles by straightening your legs.
7. BE SMOOTH & SYNCHRONIZED - Avoid strain produced by jerky movement. GET
    TOGETHER (It's a good idea to count 1,2,3) with the person helping you.
8. TURN - DON'T TWIST - Shift position of your feet to turn - don't twist your body.
9. DON'T LIFT when you can pull or push an object. It's safer and easier that way.
10. TEACH AND PREACH - "Good Word" to others - so all of us will lift well and safely.


                  Aging with Wisdom:

                      How to Stay Young

          Youth is not a time of life; it is a state of mind.

            People grow old by deserting their ideals.

Years wrinkle the skin, but to give up enthusiasm wrinkles the soul.

          Worry, doubt, self distrust, fear and despair --

           These are long, long years that bow the head

             And turn the growing spirit back to dust.

               Whether you are seventy or sixteen,

            There is in the heart of every human being

      The love of wonder -- the sweet amazement at the stars

              arid the starlight things and thoughts.

                The undaunted challenge of events,

     The unfailing childlike appetite for what is coming next,

                 And the joy and the game of life.

    You are as young as your faith and as old as your doubts,

     As young as your self confidence and as old as your fear,

        as young as your hope and as old as your despair.

                                               ~author unknown


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