Field Placement Case Study

I. Identify Field placement
My field placement is Social Adult Day center, which is under the network of Hamilton Madison House—a settlement house located in Lower Manhattan. This organization was designed to assist seniors who have physical movement problems or cognitive impairment in learning positive ways to manage their emotional and physical challenges. Specifically, services provided include nutritious meals, cognitive and recreational activities that promote intellectual stimulation and strengthen verbal skills, educational classes such as paper folding and computer. What’s more, bi-lingual as well as bi-cultural social workers dedicatedly work in the organization to offer case management for seniors, building up rapport and trustful relationships, helping them solve issues related to benefits and entitlement and so forth.
II. Identify the client
The client is a

member of my field placement. Currently, she is 67 years old. Twenty-six years ago, she immigrated to United States from Mainland China via Family-based immigration based on her husband application. Thus, as soon as she came to U.S., she became documented American citizen who has right to receive benefits and entitlement. After the immigration, she always lived in Lower East Side NY, a community next to Chinatown, with her husband and mother-in-law; her children live in places far away from New York City, and call or come to visit her twice or once per month. My client only speaks Mandarin and has limited English-listening capability. Additionally, four years ago, she encountered a serious car accident, the results of which include decreased vision, worse memories, rheumatic diseases and trauma towards cars.
III. Assess the community-level of macro practice
Based on the client’s narrative, core communities directly relevant to her daily life are the geographic community where she lives—Two Bridge, and cultural community matching to her Chinese background—Chinatown.
The client stated that Two Bridge is quiet safe and there are two parks within 10-minute walking distance. Every morning after getting up, she prefers to take a walk in the park. However, the barrier the client encounters is that she belongs to a minority population in this community resulting from language and cultural background—Chinese American who speaks Mandarin. To begin with, majority of residents are African American, White, and Latino. Even though there are a few Chinese, almost all of them speak Cantonese, due to the fact that most Chinese immigrants living in Lower Manhattan came to U.S. several decades ago when Mandarin had not been persuasively used. Thus, the client never communicated with her neighborhoods. What’s more, the client also never attended community activities or workshops since these events are operated in English or Cantonese. In other words, besides walking in the parks, she does not have any other interaction with anything or anyone in this community, which is a kind of isolation.
On the other hand, the existence of another community—Chinatown, serves as the strength for the client. Chinatown is located next to Two Bridge. Despite the fact that majority of people in Chinatown speak Cantonese, the environment and atmosphere of this community still give client a strong sense of belonging since it has similar cultural features as the community she lived for around 40 years in China. In addition, the client received qualified education when she was in China, so she knew Chinese characters and could do basic non-verbal communications with people in Chinatown. Therefore, she is able to buy things from Chinese brands that she gets accustomed to eat and use. Actually, everyday afternoon, the home aid accompanies the client on a walk to Chinatown to buy food and living necessities.
IV. Assess the organization-level of macro practice
In terms of organizations with which the client have close connections, my field placement—Social Adult Day Center (SADC), and the clinic the client go to see doctor should be included.
As for SADC, there are two strengths for the client. The first one is that R, the current director of SADC, knew the client very well. In fact, R referred the client to this organization from City Hall Senior Center, another senior center under Hamilton Madison House, because R was the client’s case manager in CHSC and she knew that the client faced loss of memory, vision and other mental issues resulting from the car accident. Therefore, R constantly observes and interacts with the client on a week basis to ensure her physical and mental conditions. Another strength is that services offered by SADC, especially breakfast and lunch serving and a safe environment, really help the client overcome difficulties she confronts when the home aid does not come. To be specific, the home aid comes to the client’s home five days per week to help cook meals and do household chores. Thus, in the rest two days, going to SADC and having meals in the organization avoids potential dangers the client might face when she stays at home alone, guarantee her nutrition and health, and ensure her interaction with others.
Although strengths are explicit, language barrier still exists for the client in SADC. SADC is an organization for seniors located in Lower Manhattan; thus, Cantonese is the dominant language used by seniors as well as staffs, no matter in communication or in carrying out various activities. Therefore, the degree of the client’s involvement is much lower than other seniors. Based on my observation, for most of time, she prefers to sit in the corner and stays silent.
As for the clinic, it has both strengths and barriers. The most obvious strength is that the clinic the client is referred is located in Chinatown and has doctors who speak Mandarin, which significantly increase the convenience and effectiveness of diagnosis and treatment. However, at the same time, the barrier also comes from language issue. Since the client can only see doctors who speak Mandarin, it means that she has limit access clinics or hospitals that do not use Mandarin as main languages even if they have better quality of services and interventions to improve the client’s healthy conditions.
V. Assess the system-level of macro practice
Admittedly, it is difficult to assess system-level for the client because she does not clearly know what kinds of benefits and entitlements she has.

Nonetheless, from personal perspective, the key strength the client has at this level is her U.S. citizenship. Owing to the citizenship she achieved as soon as she arrived at the U.S., the client is able to legally obtain all benefits that she is eligible for, among which Medicare and Medicaid are of most importance. Medicare removes huge financial burden from the client’s shoulder. For instance, Medicare took major responsibility of treatment fees resulting from the car accident. In addition, most of issues the client has when she goes to see the doctor are related to eyes and memory that might cost a huge amount of money, which definitely beyond her affordability if she does not have the health insurance. In terms of Medicaid, it is also critical since it serves as the precondition of Long Term Care Services and Personal Care programs that the client currently relies on-- a home aid who speaks Mandarin and takes care for the client five days per

week.
With regards to the barrier, due to the client’s language issue and physical problems such as poor memory and decreased vision, she only can negatively receive benefits she has, yet has very limited ability to actively apply for or continuous other benefits without assistance. To be specific, she might have no idea about what benefits she could apply, and she might forget what kinds of benefits she has and when and how to ask for renewal. Even though SADC provides case management for the client, social workers offer this service merely based on client’s willingness and requirement. As a result, the client might lose the benefits owing to miss the deadline of renewal or miss the benefits she is eligible for, which eventually might negatively affect the client’s living condition and quality of life.
VI. Assess the client’s exclusion/marginalization
The client’s exclusion is quite obvious and exists at each level, which results from the language she speaks. Mandarin is a minority language compared to Cantonese, let alone English. Therefore, the specific needs of those who speak Mandarin often be overlooked. With regards to the client, her exclusion from three levels could be concluded on the basis of the content above. First, at the community level, the client is, to some degree, separated from the geographic community since she never communicates with neighborhoods and never participates in community activities. Next, at the organization level, she has lower extent of involvement in the SADC even if she sits in the organization because she could not understand what others talks about, and has much less access to hospitals with better facilities and personnel since doctors speak English. Then, at the system-level, she has limited access to benefits information via websites and phone calls.
Furthermore, also because of language, the client has limited range of activities. Based on her narrative, in the past nearly 10 years, she never went to other places besides Two Bridge and Chinatown on her own. She wants to go but is afraid of getting lost since no Chinese-version signs or specific services offered for Chinese population in other places in NYC.