PREPARING FOR THE FUTURE- a suggested method in answer to the question: ”What will happen to John when we are not around?“ (Chakraborti, 1981)

MARTIN WRIGHT, Teacher, Brunswick Beech School, Newcastle-upon-Tyne formerly Craft Instructor, Westerhope Adult Training Centre

Iniroduction Consider the following:

A man living alone with his mother. A quiet secure environment, in which he is settled into a routine o f being provided for. Then unexpec- tedly his mother dies. Suddenly he is removed from this safe environment, taken to a larger building. Here is noise, new routine, strange faces, constraints, demands. In total, a frighten- ing confusion.

Why?, you may ask. Because he is mentally handi-

This happened to John* when 1 worked as a teacher at an adult training centre (ATC) in Newcastle. John was not an isolated case. I discovered, in one centre alone, 18 other trainees who were in danger of being subjected to the same frightening confusion. It was with these people in mind that 1 first devised the scheme 1 am about l o describe.

Having decided on the aims of the scheme I next con- sidered who would most benefit from being included in it. 1 selected four gmups using the following criteria:

capped.

(a) The priority group (A) were handicapped people living with one surviving parent over the age of 70 years, and no relatives willing or able to take responsibility. (b) The second group (B) was comprised of handicapped people living with one surviving parent over the age of 60 years. (c) The third group was made up of handi- capped people living with two parents over 70 years. (d) The final group consisted of handicapped people living with two parents over 60 years.

These groupings were purely arbitrary. As such, they were flexible, and ensured movement of individuals into suitable groups for those whose circumstances changed or who showed evidence of the greatest need.

The (A) group followed an intensive structured pro- gramme. Each of the other groups followed successively less intensive programmes.

Main aims underlying the scheme 1. To prepare mentally handicapped adults for the environment into which they would be taken following the death of their parent(s) or guardian. The short-term priority was to enable handicapped people to feel secure in a not-so-strange environment at the stressful time of a bereavement. The long-term priority was to integrate them into a new system. 2. To ease parental stress, by involving them in the scheme and thereby erasing their fears of the future. 3. To prepare hostel staff for new residents, ensuring

*The name has bccn changcd to avoid embarrassment.

they understood each individual’s home background, specific needs, and skills.

Method I . The tirst objective was to make a home visit and initiate contact with the parents. As I had no counselling training or experience, these visits were conducted in- tuitively. The aim was basically to raise with the parents their fears for the future, offer a solution, and then seek their co-operation.

2. The next step was to arrange for parents to visit all the local authority’s hostels for mentally handicapped adults.

3. 1 then arranged to take the handicapped people in the (A) group to all the local hostels. Initially these visits were designed to be fun. Facilities such as television, pool tables and record players were made available. Cups of tea and biscuits were provided. These visits were made during the day-time and were purposely arranged to take place when the hostel residents were out. Thus the (A) group members were able to develop a sense of belonging and identity with the hostels. 1 considered this important in lessening the feeling of being an intruder in the established residents’ domain.

4. It was ensured that existing hostel residents and (A) group members mixed together at the ATC. The aim was to cultivate friendships while in a safe environment. This practice ran concurrently with step 3 above.

5. At the next stage the parents were invited to bring their handicapped “children” to visit particular hostels. The aim was to enable each parent and child to become familiar with one specific hostel and its staff. Again, the visits were largely social in nature and, in a relaxed atmos- phere, any problems and reservations could be discussed and, hopefully, resolved.

The major problem was in giving a guarantee that, in the event of an emergency, the handicapped person would be admitted to the preferred hostel. Because of the possibility of administrative difficulties, the best we could hope for was a tacit agreement. As a result of this I con- sidered it necessary to generalise (A) group’s experience by organising regular social visits to all local hostels.

After these preliminary steps had been taken it was my aim to concentrate on the long-term plans for integration of the handicapped people into hostel life. These were based on the resources of the hostels, and the skills of the individuals.

The training programme Training of (A) group members took place during three

visits per week to the chosen hostel. Staff on these visits included myself - responsible for co-ordination of visits and planning of skill learning programmes, an auxiliary from the ATC if necessary, and the residential hostel staff. This enabled the group to work with the hostel staff and

98 Menial Handicap, 1982; 1 0 3

for good teaching ratios to be established. This inter-staff involvement established very good relations between ATC and the hostel and ensured excellent co-operation.

During the visits, three major elements were covered. These were:

1. After an initial assessment of each group member, a series of socially realistic skill learn- ing programmes were devised. Here skills. such as folding clothes and using the hostel’s washing facilities, were broken down into objectives and worked on each week. Areas covered included independent functioning (use of local shop, to use of local transport), personal hygiene, and social skills, such as sharing and consideration for others.

2. The group members were encouraged to make use of leisure facilities. This overlapped with the social skills programmes to a certain extent, but the emp‘lasis was mainly on enjoying the use of the facilities. We felt this would help individuals to identify the hostel as not only a secure environment, but also a desirable one. We hoped they would convey this enjoyment to their parents, and thus further allay any fears they may have for their child’s future. 3. The final major element that was intro- duced during these visits was meeting the hostel residents. This involved the (A) group members spending an afternoon in the hostel, engaged in one of the activities outlined in 1 and 2 above. They then stayed a t the hostel as the residents returned home and all had a meal together. This was followed by a social activity before the visitors wqe transported home in the evening. I envisaged these meetings as being gradually prolonged until they developed into irregular overnight stays, and occasionally full weekend visits. I wanted these stays to be irregular rather than part of a fixed routine, as a routine would be broken a t the time of a bereavement.

To conclude Unfortunately at about this time 1 left the ATC to take

up a post in a special school, so that 1 am not in a position to comment on how the sfheme has fared since my departure. However, 1 can outline the proposals that I had planned for the scheme, even though I did not see their fruition.

I . The (A) group rogramme should last

time each individual should have at least five overnight stays. (1 also hoped that initially a separate room would be made available for “separation anxious” parents).

approximately 25 wor R ing weeks. During this

2. At the end of the 25 weeks the time spent on the scheme should be phased down to a maxi- mum of one visit a week and one overnight stay every three weeks.

The period of 25 weeks was chosen largely arbitrarily - with the notion that during that time an individual should have become familiar with routines, been accepted by other residents, and have learned basic skills to enable a degree of independence. After this length of time I hoped the refresher course would be enough to maintain these achievements.

My hope then was largely to withdraw from the scene and return the handicapped adults to their parents, enab- ling them to enjoy their remaining years together secure in the knowledge that the future, to a large extent, was settled.

References Chant, J. Social service provision for the mentally handicapped.

Apex, 1. Brit. Inst. Ment. Hand, 1981; 9 : I, 10-12. Strachan, J . Reactions to Bereavement. Apex, 1. Brit. Inst. Ment.

Hand. 1981: 9:1, 20-21. Chakraborti, D. What will happen to John when we are not

around? Apex, 1. Brit. Inst. Meni. Hand., 1981; 9:1, 34-35.

Continued from page 97

became eligible to do so public anxiety could well be aroused. In practice, mental handicap hospitals can now list patients who are not suffering from mental dis- order for inclusion in the electoral registers. Hospitals have the opportunity to prepare such patients for their new privilege of voting, by teaching them what voting is about and perhaps holding mock elections to educate them.

The gradual and responsible introduction to voting. of patients who can learn to understand it, will enable hospitals to show that mentally handicapped people in hospitals can be given the vote and can use it properly. This will strengthen the case for the wider and more general enfranchisement of mentally handicapped people in hospital.

References Department of Health and Social Security. Health Seri.icer

Manugenlcnt, Electoral Rcgi.>tration in P,cycltiotric Hospittr~s. Health Noticc HN(76) 180. London: DHSS, October 1976.

Heaton-Ward, W. A., Mentul Suhnormulity (3rd Edn.). London : John Wrieht and Sons. 1967. 063.

Hilliard. L.-T., Kirman,’ B. H.’ Mental Deficicwcv. (2nd Edn.).

Gostin, L. The Right to Vote. Mind Out , June, 1981; No. 50, p5. London : Churchill, 1965, p442.

Continued from page 85

rewarding) eye of the skilled observer. Similarly, no matter how intrinsically rewarding free water play may be, it is still necessary to introduce structure at some point. A good programme should be one incorporating various types of play, and one which stretches the trainer’s abilities in creativity and exploration to the full. If you become bored what hope does your student have?

References Brandes, D.. Phillips. H. Game.rter.c Hurzclbook : 140 Gnme.t for

7‘euclier.c and Group Leut/cr.v. London : Hutchinson, 1977. Department of Health and Social Security. Helping Mentcrlly

Htrndictrpped Pevple in Ho.rpilal - A Report to the Serrctnry of Stale for Sociul Service.\ by the DelJarlmetrt of Health cind Social Secrtrity. London : HMSO, 1978.

Lowc. M.. Costcllo. A. Symbolic Play lo .> t - Experimental Edition. Windsor: NFER -- Nelson.

O’Shea, G. The Use of Gamcs in Adult Litcracy. Adult Literacy cind Basic Skill.\ Unit . (London) Newdetter N o . 2. 1980.

Stevens. M . The Educationti1 Needs of Severely Subnormal C‘ltildrcn. London : Arnold. lY71.

Tov Libraries Association. Reporf of the Working Party of the Toy Lihr(1rie.c As.toricltion 1979-80. Potters Bar : TLA, 1980.

Ross. S., Bilson, A. Playing the Game. Community Care, 1980; July 31, 15-17.

Mental Handicap, 1982; 1 0 3 99