What does it mean to be a resident of an adult home? It means a loss of identity. A loss of purpose, whatever that purpose might have been. On the first day of your admittance, you are told that there are certain things that will be done for you. You will have a housekeeper to clean your room, to provide you with clean linens, wash cloth and towels once a week. You will receive three meals a day and a snack in the evening. You will have laundry service. You will be provided with recreation and you will receive a personal needs allowance. And you may come and go as you please. There are some state regulations and house rules that you must obey.
It is not long before you feel that the things that are done for you are being done to you. You receive clean linen, wash cloth and towel when and if available. Your room is cleaned on a hit or miss basis. The three meals and snack you receive cost a dollar and eighty cents. You may think you can imagine what these meals are like, but you are wrong. They are much worse. I never knew there were so many beets, carrots, chick-peas, and broccoli stalks in the world. When you send your clothes to the laundry it’s like gambling. You never know what you will get back. Recreation is bingo, Trivial Pursuit and other interesting things. These things are so interesting that they would not hold the attention of a ten year old and are not well attended to say the least.
The personal needs allowance is the most important thing to you. You learn very soon that you must make yourself a budget and stick to it no matter what, because your personal needs allowance never covers your monthly needs. You must make a disposable razor last at least a week. You don’t get a haircut when you need one but when you can afford one by doing without other things that month.
Clothing must be replaced – for this you must save for months. If you need new shoes, it is better to get the old ones half-soled since it will cost about thirty-five dollars out of your monthly allowance. A winter coat or jacket is something else again. You had better have saved up for a new one when the old one falls apart, if you don’t want to come and go as you please in rags.
In the hot summer months you may think of having air conditioning in your room. But that would cost you and your roommate as much as $300.You and your roommate’s combined personal needs allowance is $284. Any mail that comes for the residents can not be important enough to see that the resident gets it the same day it arrives. If you get mail on Friday, and the administrator hasn’t had a chance to check it before he leaves, you will not get your mail until Monday or Tuesday.Medical care consists of residents being lined up to see the doctor, and then only for three to four minutes.
And it seems no one told the staff that they are there to serve the residents. They think they are there to keep the residents in line to make sure the rules are obeyed. They look on the residents with varying degrees of contempt. There is no thought taken of the residents as individuals. They are dealt with as a group. So the residents must respond as a group through the resident council. Resident councils try to work with the administration and staff to improve the conditions in the home when possible. Anyone who speaks up for themselves too often is threatened with a 30 day notice or forced re-hospitalization. This is done loudly and clearly so that the other residents will know better than to complain or argue about anything that goes on in the home. Given these circumstances residents have to turn to outside agencies such as the regulatory agencies, CIAD and MFY Legal Services. Sometimes they are all needed. In many homes the administration is only interested in the bottom line and passing the state inspection, not on meeting the individual needs of residents or improving the quality of their life. And we have all recently read about homes where conditions are deplorable and downright dangerous.
Residents have an important role to play in any revitalized inspection and enforcement system. They should be involved in training inspectors, and residents and resident councils should be able to meet with inspectors during exit interviews at the end of state inspections to find out the results of the inspection. Residents should have their own standing to move for receivership. And we must go much further. Mental health services must focus on rehabilitation and recovery, not maintenance and control. There should be the expectation that for those who can, people should transition to other more independent settings.