Deinstitutionalization (it's not as scary as it sounds, well it was for a little bit)

Adult foster care homes in Michigan did not exist as they are today until the early 1970s. Before that, those with mental illness and developmental disabilities were housed in large institutions also known as asylums. There were a number of state institutions or asylums in Michigan, some of which are detailed on the Historic Asylums of America website. These facilities had many names over the years that seemed to change with social attitudes. For example, before most of it was demolished in the 1990s, Oakdale Regional Center for Developmental Disabilities was originally named the Michigan Home for the Feebleminded and Epileptic when it opened in 1895.

Today, most of these institutions are no longer operating thanks to the efforts of deinstitutionalization during the 1970s and 80s. This movement sought to reincorporate those with developmental disabilities and mental illness into the community by providing residential settings in which to live. Establishing these care homes was often met with much resistance from their respective communities. The resistance came in the form of threats, rocks through windows, gunfire and even arson directed at the care homes causing those residing and working in them to fear for their safety.

Fortunately, the attitudes toward care homes have significantly improved over time as evidenced by the interactions I had with the neighbors of the home I managed. The neighborhood is friendly toward everyone who lives and works in the home, waving as we drive by and coming over just to say “hi” from time to time. It’s especially apparent at Halloween when we have just as many trick-or-treaters as the other homes on our street. The people in the home all love watching the kids in their costumes come to the door and the visitors always acknowledge the people and sometimes bring them some candy or other treats.

While the fear seems to have subsided, there are still some challenges from communities in regard to care homes. Education of both the community and staff is key to the success of keeping the developmentally disabled in their residential settings and keep the institutions a thing of the past.

A little more information

I am trying to get it cleared through our corporate compliance department to post a link to my company's website. In the meantime, here is the link to our responsible mental health agency for our Oakland County programs. It can provide some more background information on adult foster care homes, including pictures and videos. It also provides contact information if anyone would like to become involved with the organization.

Considerations

The promotion I spoke of in my previous post, “Moving on up” actually took me up two rungs on our corporate ladder. So now I am my boss’s boss. I not only have to navigate the transition to supervising my former peers, I have to do the same in regard to my former supervisor. I’ve made the transition from peer to manger before, but my current situation is something I have never experienced.

When I was promoted to manager many years ago, things went fairly smooth. None of the other staff in the home seemed upset, in fact they were genuinely happy I got the position. The same seems to hold true so far after this promotion, but I wonder what will happen when we hit our first bump in the road.

One bump that may arise is directing or disciplining my former boss who is now my subordinate. How do you deliver constructive criticism to your former supervisor? Not that I have any concerns right now, as my former supervisor and I have a good working relationship. However, I’d rather be prepared for what may come rather than attempt to figure it out in the moment. Trusty Google offered little help when I searched for any articles or blogs related to my situation. I did find one article of interest by Dennis Danilewicz from the American Payroll Association. It provides tips and techniques for managing former peers, but I think some of the points can carry over to supervising your former boss.

It seems to come down to defining your role within the company. Using the team approach with clearly defined leadership is one way to cement the roles of employees. The company I work for is a huge proponent of using the team approach and requires administration and management to participate in team building activities on a regular basis.

Aside from professional development, the old standards of open and effective communication, professionalism, and leading by example come to mind as the best ways to minimize the stress of this transition. Only time will tell as I make my way through this unfamiliar territory.

Moving on up

So I got a promotion at work. I’m crossing over to the administrative side of things as the new regional director for our services in Oakland County. No longer a group home manager, I will be responsible for fun things like budgets, policy development and enforcement, and being the boss. This is my second week on the job, and I already miss my old one.

The transition is going to be a tough one, because I have to adopt a new mindset. In my previous position, I was directly responsible for ensuring the care of the people who live in the home. Now, while I’m still responsible for the people and the services they receive, I have to deal with the overwhelming needs of the corporation as a whole. This balancing act created a long standing line dividing administration from those who work directly in the home.

The division is not something blatantly spelled out, it’s more of a “that’s just the way things are” kind of thing. I always referred to it as the home side and the administrative side. I was perfectly happy being on the home side, in the trenches with the staff, questioning administrative actions. It wasn’t so much an “us versus them attitude,” but at times it appeared that way. We all work together, but each job position came with its own primary concerns.

Now, I’ve crossed over to the other side and I’m quickly finding out that administration has its own trenches. I still get to question things, but now it’s on the level of governmental agencies that are directly involved with the services we provide. Unfortunately, I’m still only one voice and now I’m in a much larger sea of bureaucracy.

One thing is certain, I won’t forget where I came from which will hopefully help bridge the gap between home staff and administration in my corporation. It’s going to be quite the dance, though as I have be cautious so as to not put my job in jeopardy.

Family

We all have our definition of family. Some think of mother, father, sister, brother or any combination of those, but that’s not necessarily the case for many of the people who live in group homes. They don’t have regular or sometimes any contact with relatives, as parents have either passed away or gave up guardianship to county agencies. For them, family takes a different form; we, the caregivers, along with the other people who live in the care home become their family.

It may seem a lot to ask of a person, to be hired as a caregiver and expected to develop a familial relationship with those for whom you provide care, but it’s not an expectation, it’s a natural progression. After working at the home for a time, the people grow to trust and depend on you for things beyond the essentials of care giving. They want you to help alleviate their fears, share in their hopes, and support them in significant life events. In turn, if you’re having a bad day, they will do their best to cheer you up and make you smile.

This interdependence I experience is by far the best part of my job. It’s more than simply ensuring the health and safety of the people; it’s about birthdays and holidays and learning things together. I enjoy going Christmas shopping for them and watching them open their gifts or getting in the kitchen with them to cook the big holiday meal. It’s rewarding to watch as they learn to accomplish a new skill and to see the excitement on their faces. Sometimes I get to sit back and watch as Donna initiates positive interactions with Walter, and she smiles over her shoulder for my approval. These are the best days. It’s the promise of these moments that keeps me coming back.

Staffing Issues

I’ve definitely worked with a lot of interesting people during my time at the home. Many staff have come and gone, but left a lasting impression on us who still work there. Sister Annie was one of the more memorable individuals who came through our door. Annie was not a nun, but she was very active in her church and wanted us to address her as sister because we were “all brothers and sisters in the Lord.” She was a middle aged woman with a kind face and gentle demeanor who always wore a fuzzy leopard print hat and carried a clear purse. It was my first year as manager and I was glad to have her on board because she seemed like she would treat the people well.

I obliged her request regarding her name until she began signing the legal documentation for the home as “Sister Annie Collins.” Then came the concerns from the other staff regarding her attempts to make the people in the home watch televised church services on Sunday mornings and the “sermons” she delivered herself to the people and staff. Religious practices take place in many group homes but the people must have a religion declared in their plan of service and their guardians have to give approval for them to participate in religious functions. This was not the case at the home I managed.

I sat down with Sister Annie to discuss and clarify these issues with her and the conversation went something like this:
“By law, there cannot be any talk of religion in this home because the people choose not to participate in religious practices,” I explained.
“But everybody needs God, honey. What harm can come from a little of God’s word?” replied Sister Annie.
“I can only respond to that by saying we can’t impose our religious beliefs upon the people who live and work here. So no watching religious based programming or reading aloud of religious materials.”
“Everybody here could benefit from having God in their lives. Like poor little Mary, she really could use help from the Lord.”
“That may or may not be, but it’s not for us to decide.”
“Well somebody needs to decide. The poor girl is in a bad way; she needs an exorcism!”
At that moment, I wished someone else was the manager. It was all I could do to keep my face from showing my shock. Was this conversation really happening?
“Well, we can’t perform exorcisms on any of the people,” was the best I could come up with for a response.
“I can, I know how to do it! I know if we just got that demon out of her, she would be as normal as you and I,” replied Sister Anne.

The conversation continued for another half hour which included her questioning my religious beliefs and accusing me of being an agent of the devil. Sister Annie didn’t stay with us very much longer after that; she wasn’t fired, she quit for her own reasons. I would have to pull her file, but I believe she wrote down as her reason for leaving that we were all going to hell and she didn’t want to go with us.

Spaghetti dinners

During my first few weeks of employment at the home, I learned that dinnertime was the main event of the evening. Not just because the people all loved food, but because it often resulted in them going rounds with each other. Even though they all had the same food on their plates, someone else’s food always looked better. It was our job as staff to ensure that meal time was family style and we were to role model for those who lived in the home.

Spaghetti night would prove to be the most challenging for all of us. It seemed like it should go well because it was everybody’s favorite food, but that turned out to be the biggest issue. They would get excited when they saw the pasta and sauce and it would escalate from there. Once we all sat down at the table, a slight calm came over everyone as they focused on the plate of food in front of them. That was always short lived though.

There’s one spaghetti dinner that always stands out from the rest though. It started like any other—everyone was in a good mood and smiling as they took their first bites. Mary looked up from her plate and apparently decided Walter’s food looked better than hers and dove across the table to get a handful. As we were trying to direct Mary back to her seat, Brian dug his fingers into Karen’s arm so she flipped the table sending spaghetti and green gelatin flying everywhere. Walter put his fist through the wall and Carl was trying to hit him. Dinner was over.

Once we helped everyone calm down, it was time for cleanup. As I was wiping off the walls, the floor, and the ceiling, I cursed the dietician for coming up with this dinner menu. Spaghetti and gelatin? Really? Do they not realize how difficult it is to clean up that combination? When I Moved on to the windows, that’s when round two began; Walter shoved Mary across the living room just as she walked by. She flew face first into the closet door.
As I helped her off the floor, blood was streaming from her nose and mouth, covering the lower half of her face. She smiled and started laughing (pain usually caused this reaction) which directed my attention to her missing tooth.

“Is she ok?” my manager asked.
“Does she look ok?” I responded. “She lost a tooth!”
“Oh my god! We need to find it!”
“Screw the tooth, she needs to go to the hospital.

I applied first aid and took her to the van. My manager was still running around looking for the tooth and saying something about milk, while I grabbed the keys and Mary’s insurance information. As I put the van in reverse, my manager knocked on the window.
“I found her tooth,” she said. “It was still stuck in the closet door.” She handed me a sandwich bag half filled with milk. Rolling my eyes, I threw the bag on the seat next to me and backed out of the garage.