I was working in a group home with a bunch of developmentally disabled and mentally ill adults. These folks were some of the last to leave the big state hospital. This state hospital was operated in order to contain the members of the community who had developmental disabilities and mental illnesses. It was located in Salem Oregon. These clients were not only mentally retarded and mentally ill, but they also had a reputation of being potentially very violent.
We as staff were skills trainers and community support specialists. Basically we were on the front line of the de-institutionalization of this portion of the population that had spent over 30 years in a government run hospital.
We trained these people how to cook and clean, to do laundry and to shop for their own clothes and groceries. We taught them how to function in social settings and at dinner parties; we took them to movies and dances.
There was one special lady who lived in the four-plex group home that I worked at. Debbie was 35 years old and had been put into the state hospital by her parents as a young child. This was during a time when society believed that the state could care for this population better than their parents and the community.
Debbie was clever, but not very smart. She could be charming and sweet and in a flash could become extremely violent and dangerous, tearing out your hair and coming at you with teeth and claws, like an animal. She was thick in stature and tough and could easily tackle a 250 lbs man. I know this because I was a 250 lbs man and if I was caught off guard, she could easily knock me off my feet.
Debbie had been out of the institution for a little over three years and I had been working with her for about two years when this story starts. She had come a long way in the couple years that I had been working with her. When I first started at the home, we, the staff, would have days when we (usually 2 to 4 staff members at a time) would have to physically restrain her every twenty minutes. It could be grueling: unprovoked violent outbursts, restraint, talking Debbie down, release from the restraint and then a few moments of calm and then it would start all over again. Every 20 minutes for every waking hour.
Eventually we taught Debbie to verbalize her needs and wants and we also taught her how to go about meeting her own needs. If she wanted new clothes, she learned to work, earn money (or .token credits. toward her state pension), plan shopping outings, go shopping, try on clothes, purchase clothes within her budget and tend and maintain those clothes.
In time, Debbie.s outburst dwindled down to one every one or two days and often did not require physical restraint. When Debbie would .go off. we would just talk and encourage her to express her needs and make a plan how to meet those needs. It came to a point that Debbie was learning quickly how to express and figure out ways to identify and meet her own needs with very little staff intervention. This created a great sense of satisfaction among staff and within Debbie.
She tended to her own personal hygiene, laundry and housekeeping. She got a job in a sheltered workshop at Goodwill industries where she quickly moved up into a position of peer supervisor. She earned a paycheck and with minimal assistance, budgeted her money, started a savings account and regularly went shopping, to dinner or to movies.
She was a rising star. When she first got transitioned from living at the state facility, she was a mess. She had suffered much trauma from daily violence and the frequent rape by her fellow state hospital inmates. She was suffering from PTSD (Post Traumatic Stress Disorder) symptoms. After a couple years with instruction, encouragement and counseling, she had turned her behavior patterns around and was excited about her further integration into the community. Debbie.s behavior was becoming very predictable and pleasant. Hardly ever did she have an outburst and it was becoming a rare event that she would act out in a violent fashion.
Staff at the group home felt quite confident in taking Debbie into the community. She did not like church, but she loved outings, including going out for dinner at friends and staff.s homes, ice cream socials, and dances.
It was apparent that the more socialization Debbie got the more social she became. She was quickly turning into the little social butterfly. She would invite friends from other homes over for dinner, or popcorn and movies. She even started expressing an interest in men and dating.
Debbie had learned quickly from watching the soap operas that staff taped for her while she was at work, how to .come on. to someone and what was considered .sexy. behavior. Her first attempts at romance involved Debbie trying to seduce staff. We had to graciously decline her advances, explaining that we would lose our jobs or even go to jail if we were to acquiesce to her advances. Thank goodness for laws that protect staff as well as clients.
After these failed attempts, which she assured us later were just .practice., she started making moves towards the men in her neighboring group homes. A few of the men in these homes knew her from the hospital and were still horrified by the sight of her, and the rest were just too low functioning to know how to respond to her not so subtle advances.
There was one fellow though that just melted every time Debbie would walk by. This fellow.s name was Bob. Bob had been quite the handful when he was downsized out of the hospital and into the community, yet like Debbie, he was making a fairly smooth transition into the community . all things considered.
Staff and management had put a plan together to help facilitate this romantic encounter. We did some creative questioning about what the two thought of each other. We made queries into finding out what each of them knew about romance, courting, foreplay and sex. The state even sent in an expert from the hospital to fill us in about the sexual contact and habits and behavior patterns of the former inmates of the state hospital. What we learned from the state hospital expert was that the majority of sex being had at the institutions; besides the random acts of sex between staff, was rape. Knowing this we decided that we would have quite the task on our hands.
We coached both Debbie and Bob. We did role play exercises so that they could practice their rapport. We even organized a little in house dinner date with battery operated candlelight and soft music.
At first we discouraged the two of them being alone together. We did this because the one time they did sneak off together during a crisis we were having with another client, they emerged wearing each other.s underwear and they both had each other.s names written all over their bodies, even their faces, in permanent ink.
It was not the direction that we wanted to go with this and over the following weeks we tired of giving explanations to the state inspectors, case workers, job sight employees, community members and parents, why they two were covered with ink.
Many rendezvous between Debbie and Bob progressed from innocent chatter to kissing and heavy petting. It became apparent that it was time that we had to facilitate the furthering of their relationship.
We, the staff team, management, case workers and guardians decided that we would have to breach the subject of safe sex. Years prior, the doctors at the state hospitals had had the foresight to place all of the female inmates or residents on contraceptive pills. So pregnancy was not something we worried about too much. Nobody wanted to tend to the illegitimate child conceived from the rape of a developmentally disabled adult by another developmentally disabled adult.
We were concerned mostly with the spread of sexually transmitted diseases. The obvious conclusion was to teach Debbie about the proper use of condoms. Since I was one of Debbie.s regular staff I was on the team that was to teach her the skills required to properly use a condom.
There was another group of staff that was to teach Bob the skill to properly apply and use a condom. Our main concern was that Debbie knew these techniques. We figured that if Debbie decided that Bob was not her man or if eventually moved beyond Bob, we could not be sure that her next lover knew the skills or the importance of proper condom use. A discussion ensued concerning who would be given the responsibility of teaching Debbie condom skills.
Nobody on our team of skills trainers was thrilled about the idea of teaching these skills, yet we knew that they had to be taught. We sat in a group; case managers, skills trainers and program managers and discussed the pros and cons of certain people teaching these condom use skills.
The case workers were first to explain that they could not do this job because it was not appropriate for them as bureaucrats to be so involved in such an intimate aspect of their client.s life. The program managers decided that for them to be involved with this skills training episode would undermine their authority as managers; therefore they were out of the running. This left a small pool of skills trainers to choose from. The females of this group spoke up immediately pointing out that because of Debbie.s antagonism and jealousy toward the female staff members, it would not be a good idea to ask the gals to teach Debbie these skills. This left only the fellows. There were three of us, one of whom would be chosen to teach Debbie how to use a condom.
The first fellow refused, claiming that he was Catholic and did not believe in condom use. This was the first time that any of us heard of his religious convictions. It was wheedled down to me and Old Man Frank. I volunteered because Frank was looking a bit green from just talking about the subject. So I was given a box of condoms and was left alone to do the skills training all by myself. I tried to be as sterile and clinical as possible, but it was clear that Debbie was convinced that I was going to dawn the condom myself and demonstrate in person. It was clear when she left the room half way through the conversation and reemerged about five minutes later wearing her sexy lingerie. I started back paddling, trying to explain to a very disappointed Debbie, that I was just going to explain condom use and was not going to have sex with her.
Debbie.s staff regrouped and we decided that we would let Old Man Frank have a go at this task. Frank was in his mid sixties and had been married five times and had half a dozen children. From the stories that he told, he had a keen understanding of human sexuality, sexual concepts and situations, and was certainly not easily embarrassed. To top it off we all knew that Debbie was not at all attracted to Frank.
He was a chubby, slightly short man with a large nose and grey hair and beard. Frank had a gentle demeanor, he was thoughtful, intelligent and soft spoken, and the more we thought about it the more it seemed like he was the man for the job. I relinquished the box of condoms and the responsibility to Old Man Frank. Frank sat down with Debbie and talked to her like a kind and patient grandfather. Gently and slowly, making simple and clear his explanations, giving detailed descriptions and with a sly use of poignant questioning, Frank ascertained a clear understanding of what Debbie understood and didn.t understand before he continued.
After several discussions over several days, having spent several hours, Frank emerged convinced that Debbie had learned the proper application, handling and use of condoms. We were all very curious how Frank managed to explain to Debbie about the mechanics of condom application. We all assumed at first that he had used his fingers to roll the latex down in demonstration. He shared with us that he first made sure that Debbie understood the body parts of man and woman and that a man.s private part became erect when sexually aroused. She understood this. He then made certain that Debbie understood how the different male and female private parts were fitted together. She understood this also. Then Frank went into the kitchen and brought out the household broom and explained to Debbie that a man.s erect private parts were similar to the handle end of a broom. He then demonstrated how to open the condom package and roll the condom onto the handle. It was as simple as that.
Almost immediately we saw a change in Debbie.s attitude and an end to the sense of urgency that Debbie had when it came to dating. She was much less frantic about the guys and had an air of calm dignified confidence.
We were amazed! Frank had become everyone.s hero gaining the praise and admiration of not only his peers but accommodations from management and the state workers and case workers.
Debbie was doing great! Her violent behavior all but disappeared. Her verbal outbursts disappeared. Her performance at work and her interactions with her peers were framed by grace and self control.
As the weeks went by, she chose on her own to start doing all her own laundry and household cleaning and cooking without any prompting, supervision or direction from staff. She was becoming increasingly independent. Everything was just so perfect that it was a little eerie. None of the staff complained. Nobody said anything, most likely out of fear that mentioning it would jinx the good fortune we all felt we were having.
Debbie was doing such a good job at taking care of herself; all the staff had to do was to assist a bit with shopping, budgeting and transportation. Staff would inspect the cleaning and see that the house was immaculate and just sit and fill out their paper work. It was not until one day several months from the time that Frank had worked his miracle, that we realized something was amiss.
It was spring and we had all the staff on site on a Saturday doing a spring cleaning of the four-plex. We were cleaning behind refrigerators and stoves and scrubbing walls and shampooing carpets and washing windows. All of a sudden Debbie was getting very, very upset. We tried including her in the spring cleaning, and explaining to her that just because we were helping with the spring cleaning that it did not mean that she was not doing a superb job all by herself. Nothing seemed to work to calm her down. As we got to her home she became completely unglued. She continued swearing that her house was already clean, and it was.
Staff checked behind the refrigerator and stoves; clean. We checked for dust; none. The windows were perfectly clean, nothing really to be done except to assist in turning the mattress in the house.
We turned her roommate.s mattress, re-made the bed and then entered Debbie.s room and went to turn her mattress. We lifted up her mattress and instantly knew the reason for Debbie.s excellent state of mind, and her most recent agitation and we also instantly discovered the flaw in Old Man Franks instructions. For under the mattress, between the mattress and the box spring was the household broom with a condom on the handle. I guess Debbie was smarter than we thought.
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