Why reject the community pathways model of care?

In theory, a licensed group home should provide a safe, caring environment for a person with a developmental disability. For an individual whose parents are no longer living or whose parents have their own health issues and are unable to provide care, it is the most prevalent alternative. Some people thrive in this environment, so why take on the day to day responsibilities of caring for a disabled adult?
Read this story : http://www.law.com/jsp/nlj/legaltimes/PubArticleLT.jsp?id=1179824708875&slreturn=1&hbxlogin=1 that describes the problems in the D.C. group home system.
Read this article: http://findarticles.com/p/articles/mi_qn4191/is_20070217/ai_n18637111 about 3 Colorado group homes that had to be closed.
Read this article about a group home in San Jose : http://www.metroactive.com/papers/metro/01.12.05/disabled-0502.html

Can things go wrong when a disabled adult lives at home with family and caregivers are paid to come into the home? Yes, they can go wrong. However, with the oversight of family members who care enough to be closely involved, problems can be observed and corrected quickly. It is unrealistic to expect perfection in any model. What can a family do to ensure that the care is the best possible in their own home?

First, look for support staff who have experience in area of the clients greatest need. For V, behaviorial issues have been her biggest obstacle to progress. I always look for someone who has experience with clients who have exhibited similar behaviors and who have a calm disposition, who do not become easily frustrated by these behaviors. I can train other skills, but I can't train the right disposition for this work.

Don't be lazy as an employer. Check the references. If the references don't respond, ask for more references. Recently, I almost hired someone, but thanks to a responsive reference, found out that there was a history of unreliability and decided not to hire the person as a result.

If driving is part of the job, take the time to check the driving record of the individual with the Motor Vehicle Adminstration. Any employer can do this by downloading the form from the MVA website and paying a $9.00 fee for the report. It takes a couple of weeks to get the report back, but is worth the peace of mind.

Don't leave a new employee alone until you and the employee are confident that they can handle the job without support. Drop in frequently, at unexpected times to observe care and interactions between staff and your family member.

Provide ongoing training to support the skills of your staff.

Ask questions every day about how the day went. Give your staff opportunities to ask questions or express concerns, both verbally and in writing.

Keep and attract good staff by paying them at the top of the market and by acknowledging good performance. A thank you from time to time can mean more than an extra dollar an hour. Be responsive to the needs of your staff and don't complain if they need time off for sick children or a vacation. Employees have their own lives and needs and won't remain in a stressful or unappreciative work environment.

Finding and training good staff is time consuming and a lot of work, in addition to expense from the budget to pay staff for the time they are in training. Your family member will benefit from stability in their care and routines if you hire and train carefully and then provide the conditions that make staff want to remain in your employ, even in areas of high employee turnover.

Another Good Local Psychiatrist Found for Medication Management

When KKI moved the outpatient clinic to a downtown Baltimore location, where a transition to and from a nearby parking garage would be required for appointments, I decided that it was time to locate new psychiatric services for V. I was not unhappy with the care that V received at KKI at all, but if she isn't excited about going to an appointment, the shorter the distance that we have to take her once we are out of the car, the easier things go. Once in the office, it is always possible that she will want to leave abruptly, and so using the valet parking would not be good for us since would then not know where to find the car if we had to quickly take her back to it.

Finding any doctor who takes medical assistance is challenging, but networking with other parents and the ARC of Montgomery County led me to Dr. Ghislane Fougy in Silver Spring. She does accept Medical Assistance and was accepting new patients. The travel time is about 30 minutes shorter than driving to the Greenspring campus of KKI was for us and that is good. I found Dr. Fougy to be pleasant and easy to work with. Since V is stable on her current meds, she is not trying to make any changes to them, which was a relief to me. V had soaked through her pull-up when we arrived, and Dr. Fougy was patient and helpful while we changed V into dry clothes, bringing us a plastic grocery bag to put wet items in and using the opportunity to observe V's abilities and responses. I had sent an email in advance of our visit to give her the background that I thought she would need, but that might be hard to give her if V were impatient, and Dr. Fougy had read the email and commented that she didn't need to ask a lot of questions because I had already answered most of them in my email. V will need to return in 3 months, but it is okay with Dr. Fougy if they support staff bring her, so I won't need to accompany her for that visit.

I was nervous about changing doctors, but happy with the outcome this time. For any local families that need med management, I would recommend Dr. Fougy.

Having a Vision

Many people have a vision of life as it could or should be. There are sayings like, "You have to believe it to achieve it." to promote the idea of a vision as a first step toward your goals. I am thinking about this because my kind friend says it was my vision for my child, and the energy to get behind it that has brought V so far in the past year. Thank you, Irene.
Someone has to have that vision of what the closest thing to a perfect life would look like, given what limitations are unavoidable. Then, that someone has to get others to believe that it is a goal worth working toward. One person starts the process, but can't achieve it alone. It is truly a team effort to make that vision a reality.
I apply to my daughter's life the same approach I apply to my own. I ask, what would a perfect day look like? What would the ideal partner in life be like? (That one I asked before I met my husband, and I wrote the answer down. About 2 years after I married, I found that description, and realized that the person I had described was the man I was now married to.) What do I want to achieve by the end of the next year? I really believe that you can't get what you really want if you don't know what you really want.
I don't believe that disabled people, or the families that care for them, have to accept only the options that currently exist if those options don't match the vision of the best life possible. If the ideal doesn't exist yet, then be part of the movement to create it. I could not count how many people have said to me, "I could not do what you have done." I don't believe them. No one knows what they can do until they have to. Sometimes it is just putting one foot in front of the other until the end of the day, falling into bed, and getting up to do it all over again the next day. The only option that I could never face, when it comes to my daughter, is giving up. I have feared failure, feared not having the strength to hold it all together, but never stopped actively pursuing something better. Good things in life don't just come knocking on your door, you have to go and get them.
The status quo does not like to be shook up. It is easier to live with what is, then to create something new. Some people's jobs depend on keeping the status quo. Be stubborn. Be persistent. Be persuasive. Be patient. Be flexible and keep an open mind. There is a way, it is just a case of finding it.
Talk to others who have similar concerns and work together. Gather your facts. Talk, write and call people who can make a difference. Believe that things can keep getting better!
Funny, I am talking about a better quality of life for disabled people, but these things really apply to almost any endeavor, don't they?