This is a paper I wrote on my experience last April of spending eight hours interviewing and learning about different ways of working to educate adult students with disabilities. It has been heavily edited for privacy concerns. I absolutely fell in love with this facility and I am grateful for the time I spent there. Without further ado, here it is. :)
Throughout this class we have discussed the many ways that education happens and how diverse challenges can be addressed to promote social parity and learning advancement in students. Our classwork has focused on school age individuals, public education, and uses and access to literature as many of us hope to work in the public education system. I was interested in how nursing or primarily medical facilities dealt with trying to stimulate and educate older individuals. After some research and discussion, I chose to observe and participate with teaching at the Birchwood Living Center located in Ellsworth, Maine. It is a program under the management of Yesterday’s Children, Inc. and is an inpatient nursing facility for individuals with intellectual disabilities and unique medical needs. The residential program can accept up to 15 clients at a time and the facility caters to all their medical, dietary, and educational needs. The clients that I observed in this facility were varied in diagnoses and medical needs, however, many were non-verbal and limited in many aspects of physical expression/ movement due to their specific disabilities.
I visited this facility on two separate occasions and participated in a few different activities- I will focus on day treatment and on understanding how this facility addressed the educational needs of its clients as well as the individuals specific medical needs that impact educational success (occupational therapy, sensory integration), as well as physical health.
All inpatients attend the Day Treatment program in a nearby building and this is where most of the group activities happen. A ratio of four staff members to eleven clients is maintained and it is this that makes this particular facility very different from other facilities who might care only for immediate medical needs. Clients are removed at different times from the group to complete some forms of therapy. I watched as a large group of clients was seated around a table making some get well cards for missing staff members. Some members were in regular chairs and some in specialized chairs while one slouched forward nearby wearing a helmet for their protection from potential falls. The majority of the physical work- picking up stickers and sticking onto card paper, bending, folding etc.- was completed by support staff. I observed questions and choices of stickers and designs asked by staff to different members of the group and eventual choices were made based on feedback received from group members. I am not knowledgeable enough to recognize how each member’s level of attention was focused. What I did observe was that I could start a conversation with someone, give them a marker or a pen, and suggest drawing, and I would get appropriate physical responses to my requests- a name written, a picture scribbled together. I rarely got verbal responses; if I did they were not usually words, but laughs, shrieks, and other noises. It was very apparent that the staff members could interpret correctly what was being said even if it was not clear to me; I still feel a bit of awe and wonder from watching that. I saw no behavioral difficulties that were out of the norm for each person- for some clients, aggression or self-abuse are common to their diagnoses and it is watched and redirected when appropriate.
Each individual who was removed from the group for therapy was removed for only a short time to a side room with a worker. Therapy available includes occupational and physical therapy to help promote functionality, mobility, and fitness for these individuals- many of whom are confined to specialized chairs due to poor physical independence. I watched therapy given to promote relaxation and encourage muscle use and development as well as sensory processing. Sometimes it was obvious that the person didn’t have any interest in participating in their therapy that day and they would make that abundantly clear in both physical and verbal ways. Redirection was kind and thoughtful and modifications in materials were sometimes made to achieve compliance without complaint. It is not required that all individuals must be in the group the whole time and I observed some patients removing themselves from the group for periods of time for their own comfort or privacy. Even with these wanderings (which were quietly supervised), it seemed that full inclusion was achieved to the best of each individual’s ability to participate.
As a potential future educator, I found this facility to be well- organized and primed to do the very best they can to help their clients progress in all aspects of their lives. Aspects of successful classroom activities were easily discernible in most parts of the facility: student pictures, artwork, and statements of patient rights were hanging on all public walls; teaching and therapy aids were easily seen and accessed; the day treatment facility has lots of natural light and appropriate ambient temperatures. There are areas for individual and group meetings, instruction, or medical or physical needs that are easily accessible. I also appreciated the other modifications that I saw all over the facility – such as color and areas for personal belongings- to attempt to soften the harshness and institutional flavor of what is an inpatient, residential facility- a difficult feat to achieve and not one that the center fully accomplished as evidenced by the obvious signs of institutional care and not home living. I look forward to learning more about this facility and its role in my community through future interactions.