A Resource Binder:
Community Project

Introduction
We quickly discovered during our internship at a local county behavioral health senior center that serves adults age 60 and older, that we needed access to resources that were not available to us when we started interning there. What we discovered was that the most frequent resource we were looking for was a place for our clients to live. The barrier we encountered was an easy to access and central place to find this information. This was when we decided that a resource binder was the solution. When we started, we wanted two binders, one for housing information only, and the second binder would contain all other services related to our older adult services.

The unique aspect of these binders was that they were targeted for everyone, including the mentally ill. There are many services available for older adults who do not have mental illness. Their ability to do their own research is much higher than that of the mentally ill older adult. Not only do the mentally ill have special needs, they also deal with the ‘normal’ aging process that all older adults go through. One of our goals at the senior center was to enable our client’s ability to be self-determined. The resource binders were filled with brochures and pamphlets to help guide and assist our clients in making the decisions as to where they want to live, or other needed services.

Statement of Need
Although the interviews and the literature reviews were informative, they had no actual impact on the community project. The problem we encountered was trying to locate services in a timely manner. Before we started compiling the brochures and pamphlets, all we had as a resource guide was the phone book. It contained many outdated services, as many programs no longer exist due to recent budget cuts. This prompted the idea of a resource binder where any person, be it the social worker, or the client or a lay person, would be able to go to one place and find all the local resources that are age specific to the older adult and their many needs.

We learned some astounding figures because of the literature review and interviews. One thing we discovered was that people age 75 and older is the fastest growing age group in the United States. This group is known as the ‘old-old’, and as they age, it cost more to care for them. According to Zastrow and Kirst-Ashman (2004), it costs $40,000 a year to house an older adult in a nursing home. What this means for us, is that it is more cost effective to keep clients as independent in their own homes as long as possible.

Description of Intervention
Our literature reviews focused on the effects the budget cuts had on the mental health care service delivery system. Mental illness touches almost every person at some point in his or her lives. Their behavior can make it difficult to place the older adult with mental illness. Most of our client’s are poor and Social Security is their sole source of income. With Social Security they are eligible for Medicare, a government funded health insurance program.

During the interviews, we found discrimination to be an obstacle for this population, because property owners are reluctant to rent to the mentally ill, no matter what their age. One of the direct service providers we interviewed said the biggest challenge she faces is finding placements for older adults who are homeless. She said board and care homes would not take clients with mental illness, regardless of age. Nursing homes are less than ideal, and are most often full to capacity. The local county psychiatric health facility personnel have to find a place for their older adult clients to live, because they cannot release them onto the streets, as they can with the younger adults. What this means for their older adult clients, is that they might end up staying for months at a time waiting for a placement.

The idea to compile brochures and pamphlets was to let the client read what the various facilities offer. We wanted to find places that our clients could afford. By having the housing resource binder with their brochures at hand, made finding this information easy to access. The brochures allowed the user to see what the different facilities have to offer.

Evaluation of Intervention
The project has actually come together rather well. This semester the agency we interned for recently hired a receptionist who has been instrumental in making phone calls for us. We simply did not have the time and were becoming concerned about how and when we would be able to gather the information we wanted for the resource binders. Fortunately, she was able to call the various board and care homes, assisted living homes, skilled nursing facilities, and senior citizen apartment complexes, for the housing binder. She contacted the list we gave her that include all other services for the second resource binder. We asked her to request brochures or any other information they could send to us, including extra copies to give to our clients.

Most of the feedback we received was positive. Everyone we interviewed agreed that a resource binder was desperately needed. One of the suggestions we received was from a supervisor who works at the same agency where we intern. She recommended having incoming interns go through the binders and keep them updated. This would serve two purposes: one, it would help new interns become familiar with the resources available to our clients; and two, it would keep the binder up to date.

Everyone we interviewed was interested in obtaining a copy of the resource binders. This was a problem, because we do not have the money or resources to copy these binders due to their nature, with brochures, pamphlets, and applications, they will not be easy to copy. What we told them was if the wanted copies, to come to our agency and we would copy whatever information they were seeking. We have dubbed the brochures in the binders “master copies”; this way we will not lose the information in the binders, and they get the information they need. In fact, both of us have already copied information for people and have used the binders several times. These resource binders have already proven to be useful.

Reflection of Project
The second binder was slow in the making, and almost did not happen. Fortunately, the second binder is also completed. The housing binder has everything from the least restrictive type of housing like apartment complexes for seniors, to the most restrictive, like skilled nursing facilities. The second binder includes information about advanced directives, Alzheimer’s, alcohol and drug information, home health care agencies, medical equipment information, and senior services from A to Z.

One aspect that we both like about the resource binders is that they will be easy to keep updated. We have asked the agencies we have contacted to send us updated material when they have changes, or go out of business to let us know. They are all very cooperative and more that willing to help with this project. Since they are in the format of a binder, pages can be easily removed. In addition, if the suggestion to have incoming interns go through the binders as part of their training, this will aid in the updating process. Our supervisor is excited about receiving this binder, as it is our contribution to the agency.

References
Zastrow, C. H. & Kirst-Ashman, K.K. (2004). Understanding human behavior and the social environment (6th ed.). Belmont, CA: Brooks/Cole Thomson Learning Inc

Interviews: To protect the confidentiality of the people we interviewed we will not use their names or the names of the agencies they work for.
County Department of Behavioral Health (October 2004). Personal interviews between two administrators and two direct service providers.
County Department of Behavioral Health Psychiatric Health Facility (October 2004). Personal interviews between two administrators, one direct service provider, and one consumer.
County Department of Behavioral Health Senior Center (October 2004). Personal interviews with one direct service provider and three consumers.