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MSW, Hospice, Gerontology, Chinese

December 21, 2013

My father died of colon cancer in a hospice.  I didn’t quite know what to expect in such an environment and was surprised to see patients, suffering from terminal illness, who were peaceful, cheerful and even joyful. I witnessed heroic levels of care provided and I also became aware of the important role of social workers in providing practical and emotional support to patients and their families. Later, I returned to the hospice as a volunteer for a short time out of gratitude for the care given to my father and to our family and learned a little more about the vital role of social workers in that environment.  Since that time, my thoughts have frequently turned to those experiences and, over the years since, I have been drawn more and more to the idea of becoming a social worker myself and working specifically with the elderly and possibly in a hospice environment.

 My mother was a dedicated nurse and, as I wanted to join a caring profession, I looked no further than nursing as a future career. Although I enjoyed the nursing program I joined and though I excelled within it, fate intervened. I suffered a fairly serious injury in the final semester and was unable to complete the program on schedule. This gave me some time to think about my future and decided that I did not have a vocation for nursing and that my future lay in some other unidentified field.  Because of an interest in language and literature, I took a BA in English Literature and subsequently an MBA in with concentrations in Marketing and Healthcare Management. Having gained this qualification and having worked in medical administration, I decided that the world has plenty of excellent administrators but perhaps not enough people who want to provide care to others and the memory of those social workers in the hospice returned to me once again.

 When I began to consider a career in social work, I wanted to be absolutely certain that the appeal was prompted by more than sentimentality. I very carefully considered what characteristics and skills are required to be an excellent social worker, especially in working with the elderly and I have genuinely concluded that I possess them or can acquire them.  I have also considered the core values of social work and entirely support them and would seek to uphold them at all times in my studies and future career.

 In my own culture affection and respect, even reverence, is generally accorded to the elderly and I share this attitude to them. When I was nursing, I always particularly enjoyed working with elderly patients, hearing their life stories and receiving the benefit of their wisdom and experiences. In this time when the population is aging, many people will be required to provide care in various forms specifically to this age group. My cultural background, family, volunteer and professional experiences and my personal regard for the elderly have convinced me that I should be part of those providing assistance to the rapidly growing part of the community.

 During my days as a student nurse, I was involved in the care of an old man who suffered from testicular cancer. He was awkward and permitted only a few nursing visits and none from social workers. I took his vital signs and gave him his medication each day. He was silent, even surly, and received no visitors. I would talk, he would remain silent and this one-way communication continued over several weeks. I knew that behind the façade there was a sad and lonely man who had unspoken needs. Finally he asked me to read the newspaper to him when I went to see him. This human contact developed into discussions about the plot of his favorite TV show and shared jokes. Finally he confided that he was estranged from his former wife and family but wanted to re-establish contact, he was afraid of rejection but was also afraid that he might die alone. The care team was informed and contact was eventually re-established. I witnessed the quiet but vital role of social workers in the resolution of this situation and was greatly impressed. My own role in seeing bitterness and fear replaced by a measure of optimism and family reconciliation was one of the most satisfying of my life.  I also learned a very important lesson which was that difficult people are unhappy people and that at some stage, they will always respond to a determinedly friendly and genuinely caring attitude. It also taught me the value of non-verbal communication. I could sense by an occasional look, that there was emotional pain behind the awkward shell of my patient. I hope to develop the skill of reading non-verbal signals in future. This experience also prompted me to undertake an informal study of the psychology of the very ill and specifically to an understanding of the five stages of grief (the Kubler-Ross model).

 I am aware that the caring professions sometimes attract the sentimental and unrealistic. I know that achievable outcomes are not always perfect and that a realistic but determined attitude is necessary to a successful social worker. I know that I possess the necessary attributes to identify and pursue achievable resolutions to problems. Cultural sensitivity is extremely important in the provision of healthcare. I have experience of two distinct cultures and have happily studied, worked and socialized with people of many different social and cultural backgrounds. I look forward to extending my knowledge of other cultures during my studies and sharing knowledge of my own. I have been learning Spanish and have achieved the ability to communicate on a basic level. It is my intention to advance this knowledge in future.

 It may also be relevant to my application to point out that I have been employed in the communications industry as Marketing Manager for an Asian magazine published in English. I have written published articles and consider this to confirm my ability to communicate at an excellent level in the language. My last measured TOEFL score was 567 but this score was recorded in 2008 and prior to my move to the US to study for my MBA degree during which I attained a GPA of 3.71. In view of this, I request a waiver of the minimum TOEFL score to join the program. I hope that this statement will also confirm my facility for communication in English.

 The aging of the world’ population is a relatively new phenomenon that presents many challenges to society in general including specific impacts on social work. The authors of the 2008 report of the Institute of Medicine confirm that there exists an increasing need for gerontological social work and the need to enhance specialized social work education, training and research. This is the area that interests me very much and is the area in which I hope to make a contribution as a social worker.

 Obviously, aging involves detrimental changes in health and physical ability together sometimes with loss of memory and mental acuity. It can also involve loss of income and consequent difficulties in accessing the personal and health related care that become increasingly necessary over an elderly person’s lifetime. Clearly social workers will be faced with problems that, while not new, will take up an increasing amount of their time and expertise and will require much innovative and original research. I hope to assist in providing such research.

 The first challenge is to provide preventative information and services on a universal basis. It is well established that mental acuity and physical ability can be extended significantly by regular and appropriate mental and physical exercise and other activities. To enable the elderly to lead a fulfilling life for as many years as possible should be the first priority. Measures to encourage the retired to regard their freedom as a wonderful opportunity to do new things should be extended to all affected. The opportunity to learn, to contribute as volunteers, to use their skills in hobbies, pastimes or even part-time work and to undertake regular exercise to a challenging degree should be made as widely available as possible and, the very beneficial effects of such activity, widely publicized.   

 I understand that the very elderly sometimes have had little say in the US about their lives but placing them in the unfamiliar environment of a nursing or care home is often a cause of great distress to them and is not the usual way of dealing with the problem in other parts of the world. Ways must be sought to enable the elderly to make their own decisions about where they are to reside and to enable them to live at home with appropriate support, if that is their wish, for as long as is possible. They should also be involved in the design of care delivery whether at home or in a community or nursed environment. The most successful retirement communities might be identified and their methods replicated. Families who accept responsibility for the care of their elders should be encouraged and supported as far as possible. The family’s role in encouraging beneficial activities by the elderly should also be made widely known.

 The vulnerability of the elderly is also a cause for concern and it is important that ways to strengthen and extend the protection of the aged against mistreatment of any kind should be strengthened and rigorously applied. Measuring physical and mental ability is relatively easy but accurately measuring personal contentment and well-being is a more difficult exercise. It may be that new measures will need to be researched, identified and applied so that the effectiveness of remedial actions can be established and adjusted as necessary. Educating people to value and respect age may be a difficult and long term exercise but I believe that determined attempts should be made.

 The need to deal with the challenges presented by this situation is not limited to the US. Most nations will be affected and will all have social workers concerned in this area of concern. It may be that research into the methods being considered or adopted in other countries may yield useful insights that can be usefully applied in the US. Certainly international collaboration could be very profitable. I realize that this whole matter is extremely complex but offer these ideas as a basic analysis and as some possible ways forward.

 I realize that this is a very prestigious program and will attract many well qualified applicants. However I do consider myself to be an exceptional candidate. I have a great interest in, and affection for, the elderly and am very keen to work directly with them to provide real and highly effective assistance. I am academically able. I have worked in the provision of care and the experiences gained will be of direct application to my work the program, it will also enable me to ‘add value’ to my class.  I undertake to apply all my natural diligence and intelligence to the program and to excelling within it. 

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