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Saturday, Apr. 19, 2014

New home for medically fragile DD clients

Monday, July 2, 2012

(Photo)
The Arc of the Ozarks has a new facility in Springfield to address the needs of the developmentally disabled and medically fragile individuals in the agency's 21-county area. Pictured above, from left, are: Patti Holt, of Monett, the newest board member for the Arc of the Ozarks, and Julie Guillebeau, of Springfield, chief advancement officer for the agency. The Springfield house is serving as the state model for the paraclete model of behavior modification.
The Arc of the Ozarks has a new facility in Springfield dedicated to medically fragile individuals with developmental disabilities.

"We make it as homelike as possible," said Julie Guillebeau, chief advancement officer with Arc of the Ozarks. "The rooms are large and wheelchair accessible and each room has a door leading to the outside."

The trend toward group homes for individuals with developmental disabilities is on the decline as more and more clients seek individual supported living (ISL) accommodation with either a roommate or staff member to help as needed.

"Most people don't want to live in a group home with five or six other non-family members," Guillebeau said. "Those individuals can usually go into an apartment or duplex quite well."

That left a gap in services for those with chronic illness of other injury who are not able to take care of their own daily needs.

"There are about 5,000 underserved individuals in the state that fall into that category," Guillebeau said. "Those are the needs that the Arc is trying to address."

This first-of-its-kind-model is already full, with one room remaining for crisis management, an individual coming out of the hospital for short-term care before returning to ISL.

"The home was originally built to house seven to eight people, Guillebeau said. "It's furnished by the Department of Mental Health, and everything in the room is on the client's name. From the lease, to cable or Internet, they are learning to spend their Medicare dollars responsibly."

The home has a maintenance staff to keep the facility and landscaping in good repair.

"Arc homes are often the best looking homes on the block," Guillebeau said.

The homes have licensed practical nurses (LPNs) on staff at all times to see to the medical needs of the residents. There is also a registered nurse manager and a part-time registered nurse on staff. Staff to client ratio is 1:3, allowing for close monitoring of the residents and their particular medical needs.

"This is a model for the state," Guillebeau said. "We use the paraclete model in guiding our clients to positive behavior."

In Greek, paraclete means "one who consoles or comforts, one who encourages or uplifts."

"We had one client who continually kicked holes in the wall," Guilleau said. "We tried to get to the root of the anger issues that made him want to kick the wall, and we installed a steel 'kick plate,' which is his designated kicking spot.

"He now only kicks the steel plate when he is angry and we're not having to repair the wall," she continued. "And he seems to be kicking less."

Guillebeau said many individuals with developmental disabilities have anger issues because they have been brought up or schooled in a negative environment.

"Often the individual has been told no or given negative reinforcement for certain behaviors," she said. "With the paraclete model, we reward good behavior and give a lot of positive reinforcement. We work with the patient to find out what they like to do and do it."

Socialization is an important part of the program.

"Years ago, individuals with developmental disabilities were never seen in public," Guillebeau said. "They were institutionalized. Parents would leave their hidden developmentally disabled children at home when they and the other children went out.

"We had a lady callus not too long ago that lived in a very rural part of the area and who had had a stroke," Guillebeau continued. "She had a 30 year old son at home with no one to care for him. He had nowhere to go."

For many with developmental disabilities, change to the environment is tough.

"Elderly parents who have adult children with disabilities still living at home need to be concerned about getting those children into an ISL or a home for the medically fragile," Guillebeau said. "They need time to acclimate to the new environment before something happens to the parent-caregiver."

Guillebeau said parents can establish a special needs trust and choose how their child will be cared for in the event of an illness or tragedy.

"As we are able to establish more homes for those with developmental disabilities, we can assist them in learning about nutrition, spending their Medicare dollars wisely and making sure they are supervised either on a daily, weekly or monthly basis."

The homes for the medically fragile will have professional staffers on hand to oversee the medical equipment and other special needs.

"These homes are not federally or state funded," Guillebeau said. "We raise the money locally for all of these buildings."

The homes also feature scheduled activities in which the clients may participate if they choose.

The homes are usually located in an area within walking distance to bus stops or trolleys for transportation to stores and shops.

"In five years, we believe group homes will be completely phased out," said Guillebeau. "Our goal is to support these individuals in ISLs or in more supportive environments like the home for the medically fragile. Down the road we will be seeing a lot more of these types of homes."



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