Natalie Wang | CIIP 2023 Blog Portfolio
Posted: July 5, 2023
During orientation, I was reflecting on the ways that conversations and trainings on diversity and equity are conducted at an institution like Hopkins. As a rising senior, I have been in a variety of these settings in different contexts over the course of the past few years here at Hopkins. One thing that was consistently in mind was what Keiona Gorham, of MOMCares, mentioned in the introduction of her session–that she was not interested in accommodating or assuaging the discomfort of white people in the room. This resonated deeply with me. But this led me to spend time with the question: how can this goal or desire be fully realized equitably in settings where more introductory content is being presented, and where everyone involved is coming in with varying degrees of prior knowledge?
In reflection with other CIIPers, some humanities majors mentioned not having encountered some of the concepts our speakers brought to the conversation on race, racism, and systematic oppression. Conversely, some STEM majors were very well-read in these topics and had been a part of these discussions in their classes and extracurriculars. This reflects the diverse nature of experiences that the Hopkins student body, not to mention that we all have different experiences of privilege and oppression at different intersections. Ultimately, everyone comes at these topics from such a different standpoint, which can make for very rich discussions. I wished that we could have more time to dive into the nuances of the speakers’ topics. While I understand the importance of getting everyone on the same page, I find myself looking forward to continuing these conversations over the course of the summer. In particular, I found myself wanting to be able to be a part of a longer conversation on allyship and the associated nitty-gritty complexities. But thanks to the orientation programming, I will be even more attuned to these topics during my CIIP experience this summer.
Keswick is a nonprofit that works not only as a skilled nursing and rehab facility, but also to facilitate healthy aging in older adults in Baltimore across the city, not just the residents who are currently here. In this first week, I have begun the process of being onboarded onto the various community health initiatives and projects that Keswick is a part of. For example, one need for older adults living in the community is transportation–not just to the grocery store and the doctorâ€™s office, but also to attend social events like church and bingo. This is essential to making sure that older adults do not become isolated, allowing them to live not just live more social lives, but also helps maintain cognitive resilience and memory health. One of the programs that Keswick works on is Community for Life, which I have been primarily working within. This government-subsidized program helps transport older adults anywhere in Baltimore, as well as provide handyman and other services to promote aging in place. This prevents older adults from having to move from their homes, and gives them more agency and autonomy in determining how they live as they age.
The social issues at play are many-fold. First, the support given to older adults is continuously a challenge. A social safety net for older adults is not politically glamorous, but is a significant need as our population continues to age. Furthermore, folks who are homeowners may be forced to lose their homes as they move into skilled nursing or assisted living facilities, which means that they may be losing generational assets and wealth. The ability and means to accumulate intergenerational wealth is a luxury that is often not extended to Black and brown homeowners in Baltimore; in this way, this program can serve as a way to support and maintain marginalized communities.
With it being a shorter week due to the holiday on Monday, I was looking forward to work on Tuesday and excited to see what the week had in store. I had two events on my agenda that day: Garden Club and Brain Blast. At Garden Club that morning, I spent time weeding with the staff, residents, and Wise and Well members. In the garden at the center of the campus, there are planter boxes neatly arranged with a variety of different flora: roses, gardenias, carrots, lettuce, and herbs like basil, sage, and mint. It was the perfect start to the week, chatting away and spending time literally touching grass. It was easier to get to know everyone when we had a task. I was reminded of my childhood, when we had the space to set up a planter in the backyard, and grew strawberries and Chinese chives in the summers. These uniting themes of nature and cultivation and beauty made for easy conversation even among strangers. We harvested some lettuce and herbs, and everyone got to take home.
Later that afternoon, I attended a Brain Blast class that was open to Wise and Well members. We worked through different brain challenges that were meant to exercise working and long-term memory and executive function. For example, we were to fill in a sheet with different occupations that started with each of the letters with the time crunch of 2 minutes. It was fascinating to observe the generational differences in what people would come up with; there were some professions that had simply become irrelevant as time went on. For example, I learned that there used to be people who delivered ice door-to-door so that people could fill their iceboxes with fresh ice. It has been refreshing to start to become more integrated into the Keswick community and get to know the staff, residents, and members.
A typical day at Keswick Multi-Care Center starts in the Wise and Well Center, where I check into the volunteer and intern space and start on my first mug of coffee of the day. I check my Keswick email to see if any Community for Life members have gotten in touch the previous night. I then cross the campus to deliver the daily newsletter to the residents on the second floor. Some of them might be asleep, but I briefly chat with those who are up. Many residents watch TV as they eat breakfast. I then go back to the intern space to make calls to Community for Life members, utilizing a giant spreadsheet of all the Maryland Department of Aging-referred members who make up my caseload. Since the CFL program offers so many different services (lawn cutting, transport, falls risk assessments, handyman services, and decluttering, to name just a few) I work most directly with Jeanee, the service navigator, to confirm communications with different vendors.
Depending on when activities might be scheduled, I may leave my computer to attend Wise and Well classes or other events. One of my favorite activities is Garden Club at 10 am on Tuesdays. Members of the Wise and Well staff and I weed, plant, and water all the different plants that are in the garden with residents and members. Last week, we harvested sage, lettuce, and mint. It’s the most relaxing way that I can think of to start the morning!
Other days, we have regular art classes in the art room with the artist in residence. With our list of residents who have decided to participate, we go up to the floors to transport them from their rooms to the art room. Prior to the Juneteenth weekend, we colored in Juneteenth-themed posters while listening to classics from the 70s and 80s.
Prior to the CIIP internship starting, I had no idea what to expect. I didn’t know what my day-to-day was going to be like, let alone what my overarching goals would be in this particular setting. I think that being able to go in open-minded in and of itself was a major goal of mine, especially as someone who likes to know what exactly will be happening at least 3-5 business days in advance. Now that we’re halfway through the internship period, and a routine has been established, I feel that I can advance my goals further than just being open to the possibilities and helpful to the organization in which I’m placed. I can also continue to seek to build relationships in the workplace. Some of the people that I’ve met include the other interns and volunteers who work with me. While I’m the only intern working on Community for Life, others have assignments with social work or other related departments. We have high schoolers all the way through senior volunteers. There’s one lady who always brings a dog that residents can pet and play with.
I also hope to continue developing an understanding and empathy for this line of work around case management or some level of social work. Oftentimes, my direct supervisor and I can feel exasperated because our clients aren’t helping us help them for one reason or another. But I can understand both sides of the situation. Ultimately, the biggest problem is that for our government scholarship recipients in the program, the things that we can offer are too limited for their needs. This pitches the work in a different light. Continuing to develop the emotional resilience for this kind of draining work will be key moving forward.
Bingo is a mainstay of the Keswick resident community. It’s always a busy day for transport–we have to make sure that everyone who wants to go to bingo can attend. From the residents’ rooms in the Coggins or Baker buildings, there is a relatively long trek to the auditorium. We wheel each individual to their favorite spot in the auditorium. Oftentimes, some will request to sit closer to the front to accommodate hearing loss. On these days, I definitely get my steps in. I then will stay and help folks play, to make sure that they’re following along with the caller, being prepared to verify a bingo if it gets called, and getting the prizes to each winner. To be completely honest, I wasn’t entirely sure how bingo worked before this internship but now I have an in-depth knowledge, even of the different variations of bingo (blackout, four corners, etc). While bingo in and of itself may not be relevant to my future profession or life goals, the lessons that I learn in transporting and supporting older adults is certainly a part of whatever I choose to pursue in the future.
For one, through bingo and other social activities like art therapy, snowball days, and Garden Club, I get to interface with the day-to-day lives of older adults. Particularly in healthcare settings, it is easy to use the snapshot of what we see with an older, sometimes deteriorating older adult in a hospital bed to inform everything from clinical decision-making to how we treat the patient. However, getting a chance to live their daily lives with them in partnership gives me critical context as a reminder of the resident as a whole person, with their own personalities, histories, and passions. This will inform my career as a future clinician and also as a member of a community with aging adults.
One way in which my placement intersects with the city is that all the clients on my caseload are referred to Keswick Community for Life through the Maryland Department of Aging. These older adults fall under a certain income threshold and live in Baltimore City, which places them also in the demographic of potential recipients of services from other placement areas.
Speaking to clients on the phone, many of them have young grandchildren who need to be cared for. Depending on the ability of the older adult themself to carry out activities of daily living like eating, bathing, and mobility, they may be partly responsible for childcare–particularly in the summer months when parents are working and kids are out of school. However, particularly given physical limitations, these older adults may not always be able to fully care for these kids, which puts both the kids and older adults at risk. Other placement areas running summer camps like MissionFit, for example, could be sources of support. In addition, some of these risks are exacerbated by the fact that the homes of aging adults can easily fall into disrepair as light handyman jobs become more difficult to do themselves. Leaks, mold, and dysfunctional heating/AC can be incredibly detrimental and dangerous for families. To support aging in place, the Community for Life program aims to support adults to maintain the safety of their homes for both themselves and their families. This is an area in which there could be real policymaking changes that could be made to improve the quality of life of aging adults, which can be moved forward by placements like the Baltimore City Council’s office. Being the ones in direct contact with aging adults, the Community for Life program at Keswick is more familiar with the needs of aging adults and could inform policy changes.