Tuesday, July 15, 2014

July 15 Post Nine

Pam and Brian spend some more time with Michelle after her surgery to make sure she is well enough to live on her own. Because of her regressing skills, they have to work with her to make sure she can still complete basic tasks at home and perform her own personal hygiene. It takes a year before they are comfortable letting her go to live on her own.

Michelle begins living in an open community for adults with Down Syndrome. The community is monitored by several nurses and doctors, and volunteers that come once or twice a week but mainly the residents run the day to day jobs such as food operations, working the stores and libraries, and cleaning common areas such as the park. The community is a full square mile with apartment residences separate from the community buildings for working and social life. The community lets residents settle in for 3 months before they begin working. Michelle gets a job at the grocery store next to her apartment as a shelf stocker. Her job is to stock the shelves with food products and help customers find what they are looking for. She works 4 hours a day and receives a set pay every week for affording her own groceries and needs. The grocer job is similar to work in the soup kitchen for her so feels fairly familiar and helps monitor her deficiencies when she begins to forget.

Michelle makes  a few close friends that she enjoys spending time with in common areas like the park and game center. They love to get together and play board games together or dance around to music. It has become best for her to write down all of her daily activities in a calendar including time reserved for seeing her friends each day so that she has a regular schedule every day.  She is prompted by the nurses and aides who work there and that really helps her keep a schedule.

Pam and Brian come to visit her once a week to begin with on the weekends. Over time, their visits become less frequent and they visit once every two weeks, and then only once a month. When they visit, they bring her home with them for the weekend and spend time together. Pam and Brian have moved back in together but have decided not to get married again. They live together in their own small home with two dogs that they rescued. They sometimes discuss having another child together but Pam refuses to have any more children. Brian feels he was partially cheated out of raising a child so he wants a new chance.

After five years, Michelle decides to get a kitten. She sometimes gets lonely at night when all of her friends are home and she has not fallen asleep yet and it has started to make her feel depressed. She names him Tibby and puts his daily care into her schedule as well for feeding, watering, and changing the litter. Tibby brings Michelle’s mood back up and she does much better now hardly feels depressed at all.  

Michelle uses the exercise bikes and walks around the yard daily.  During the winter months the lack of exercise seems to affect her mood.  Occasionally Michelle will throw a tantrum, but that is usually due to issues with housemates.  One of the housemates recently got her favorite aide worker fired because of something she had whispered about other employees to the others she works with in that home.  This caused Michelle to become isolated and angry for weeks and no one knew what to do or whether they should just begin ignoring her.

Questions:

1. What are the benefits or consequences for adults with Down Syndrome when they adopt a pet?

2. What are the risks for middle aged women who decide to become pregnant? What are the chances of Pam having a second child with Down Syndrome?

3.  Do Down syndrome individuals get attached to those who care for them?  Would an environment where there are constantly new workers benefit or ultimately hurt those residents? If so, why is that?

4. Instead of ignoring Michelle, what should the staff start doing to make her not focus on the friend/worker she lost?

5. What are some programs for adults who are intellectually disabled?

Decision Point:


Do Pam and Brian keep Michelle in this community or do they look for a “community” that is more integrated into the community with a better more personal staff to resident ratio?



http://www.ndss.org/Resources/Transition-and-Beyond/Employment-Volunteer-Work/

2 comments:

  1. Questions:

    1. What are the benefits or consequences for adults with Down syndrome when they adopt a pet?

    Adopting a pet would be a positive aspect for someone with Down syndrome if first they enjoy being around animals and second have the capabilities to care for that pet. Some individuals may want a pet to keep them company but then don’t want to take care of it, or don’t know how to. This would be a negative aspect because then the pet’s health would start declining if the owner forgot to take them out and feed them.

    2. What are the risks for middle aged women who decide to become pregnant? What are the chances of Pam having a second child with Down syndrome?
    It is risky since Pam is older to have a second child at her advanced age because there are more complications that can occur. Having a child with Down syndrome is a risk especially when the mother is older. Pam and Brian may have an increased risk of having a second child with Down syndrome if they one of them is a balanced carrier of the translocation. The chance of passing the translocation depends on the sex of the parent who carries the rearranged chromosome 21. If the father is the carrier, the risk is about 3 percent, with the mother as the carrier; the risk is about 12 percent.

    3. Do Down syndrome individuals get attached to those who care for them? Would an environment where there are constantly new workers benefit or ultimately hurt those residents? If so, why is that?

    Research has shown that Children with Down syndrome have similar attachment styles compared to typical children. However, typical children can still really get attached to others passed an unhealthy limit. When there are constantly eh same people around, individuals start to develop relationships with them and the longer they know each other, the closer they get. This may be potentially harmful in this environment if the residents didn’t understand the difference between the workers and the residents. For example, they might always want the nurse to play cards with them, not understanding that the nurse has a primary job of handling the care of the patients, not being a friend who is always free to play cards. This would also be difficult if the staff transitioned often. Many residents get close to the staff in any sort of home, so if the staff switched a lot, this would be difficult for the residents, because they wouldn’t have that bond or consistency.

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  2. 4. Instead of ignoring Michelle, what should the staff start doing to make her not focus on the friend/worker she lost?
    They should introduce her to some new activities in the home. If there are children from schools that come to visit for a choir concert or to have art activities she should participate. They should put her in an environment that allows her to have different social interactions with different ages. They should also sit down with Michelle and explain that the worker is no longer there but introduce her to the new workers.

    5. What are some programs for adults who are intellectually disabled?
    programs for adults who have intellectual disabilities could be organizing card games, organizing a choir at the home where they can sing, having a bingo night, they could organize a sports team, have a group reading club, a knitting club, and so much more. Adults with disabilities have so much potential, it would just be crucial to find out what they enjoy doing.

    Decision Point:


    Do Pam and Brian keep Michelle in this community or do they look for a “community” that is more integrated into the community with a better more personal staff to resident ratio?

    This is something that should be discussed with Michelle. For now, she should stay in this community where she has already settled in and gotten comfortable. Being in a home with a more staff to resident ration would greatly increase the price which Pam ad Brian won’t be able to keep affording. And with the home the Michelle is currently at, she has gotten comfortable, has made friends, and has a job. She has routine and consistency in her life and changing everything around at this point could be harmful to her.


    http://americanpregnancy.org/birthdefects/downsyndrome.html
    http://www.down-syndrome.org/reviews/2073/

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