“During times of universal deceit, telling the truth becomes a revolutionary act.” George Orwell


Wednesday, February 25, 2015

Sherlock Holmes and the Happy Home

Sherlock Holmes and the Happy Home
By Jeff McNair
A family member had asked Holmes to visit a local group home in order to determine whether there was any likelihood of foul play in the choking death of a man at the group home. He and Watson arrived and walked through the residence, Watson chatting with the man who ran the home, while Holmes in his typical, keenly focused fashion, followed behind.
After the visit, they moved toward the door to leave, Holmes appearing irritated and disinterested in any conversation with the man who was the group home “parent”. Watson shook his hand cordially. But Holmes would not make eye contact staring at the door indicating his interest in leaving. As the door was opened, Holmes bumped it open further such that it pushed the man back and  he quickly walked out without a word. Embarrassed, Watson turned to the man.
“Please forgive my friend he must have something on his mind. Thank you for the opportunity to tour your home.”
“It was my pleasure” said the man with a quizzical look on his face as his eyes followed and stayed on Holmes who waited at the end of the driveway by a van too large for the typical family, obviously disgruntled.
Watson nodded, half smiled and walked toward Holmes slowly at first and then briskly as the door closed behind him.
“Why do you have to be like that?” he asked. “That was a lovely home and the people living there were obviously satisfied with their accommodations.”
“Was it? Were they?” Holmes responded his voice rising in tone. “You really thought that was a lovely home and the tenants satisfied?”
“Well, yes.  Weren’t they?”
“Watson you once again see, but you do not observe.” He responded. “We have had this discussion before.” His eyes riveted on Watson’s. “Have you learned nothing?”
“It is a government funded home, you cannot expect perfection. But the people there are happy, they have friends, you saw the Christmas cards, they experience community integration as evidenced by the award your friend received, and they seem to have the rights that would go along with living as an adult with an intellectual disability in the community.”
The look of disgust in Holmes’ eyes told Watson that apparently they had visited very different places.
“’Rights without opportunities are meaningless’ is how the reformer Irving Zola stated it. Must I describe to you every flaw of that place which anyone with minimal powers of observation would have clearly seen? Maybe you aren’t paying attention. Maybe you are satisfied because of your low expectations. Maybe you need to know some people like those incarcerated there. Maybe...” He paused and stared at Watson for a moment, then nodded as if reaching a decision. “No, in your case it is probably all of the above. But that is not a ‘home’ as you described it. Well it is a home, but I would propose not a home that you or I would choose to live in if we had the ability to make a choice which clearly those in the home do not.”
“I don’t understand why you are so upset.”
“That is obvious.”
“Well, are you not going to tell me what I overlooked. I believe you delight in that.”
“It is not that I delight in pointing out your inadequacies though myriad. It is that in doing so I might jar your slumbering mind into paying attention to the world around you, to which you are apparently oblivious.”
Watson stared back, ready for the onslaught which was typical of their interactions. With hands on hips he prepared.
“What time was it when we rang the bell?” asked Holmes.
“It was precisely 5:30.”
“Correct! How many adults do you know who are in the practice of wearing their pajamas at 5:30, ready to go to bed at 6. Why would adults go to bed at 6 when they are not ill? Likely for the convenience of those who care for them. Additionally, they all appeared to frequent the same barber who must have quite limited abilities as they all had the exact same haircut. It would be difficult to go into a public setting and gather 5 men who looked so identical.
“Then as we entered we were taken past the kitchen. There we observed the largest poster illustrating the Heimlich maneuver that perhaps I have ever seen. A bit late for the man who choked to death. A menu was prominently placed on the refrigerator indicating the fare for that evening was chicken breast with rice and vegetables. However, the dishes in the sink were soiled by what appeared to be peanut butter and jelly and at least one resident does not like bread crust.
“It was at that point that I recognized my friend from Ethiopia, I noted that his right ear was reddened as if it had been rubbed raw or perhaps struck. As the staff member/tour guide would approach Joe, another resident, clearly he did so with great care, particularly if approaching from his left side. It was as if he feared him. As I reached to greet my friend with a pat on the right shoulder with my left hand I noted the slightest flinch on his part. It was then I realized that Joe was my friend’s roommate, and concluded that he is physically aggressive and had been hitting him. The aggressive man was also left handed. Perhaps that is why there is a business card by the phone for a behavior specialist who refers to herself as, “an expert in aggressive behavior.”
“Through his family, I knew that my friend grew up in Addis attending the Ethiopian Orthodox church there and as I know there are no such congregations in this area I wondered whether he had found another faith group. In his room there was a stack of bulletins from St. John’s Catholic church, just down the street. The most recent bulletin was from 2012, two years ago. The oldest was from 1998 when my friend came to America and likely was placed in the home. So as recently as two years ago, he was a regular attendee at St. John’s. In preparation to come to this home, my research revealed that the company which runs the home had changed hands two years ago. If you recall, when I asked him if he was enjoying church, although from the bulletins I knew he hadn’t attended in two years, he responded, “We are taking a  break from church.” This is not the type of thinking that would be generated from someone who first, had a faith background going back to his time in Ethiopia and who would enjoy church to the point of collecting bulletins regularly for 14 years and second who had an intellectual disability. Obviously, those who now run the home do not permit residents to express their religious preference.
“However, as you know from your time in Africa, Watson, priests in the Ethiopian Orthodox church will carry a six inch cross in their pocket which they use to bless people who would come to them for assistance. Although my friend is not a priest, I noted that he carries such a cross. It is apparently always in his pocked as evidenced by the faded pattern on his jeans pocket in the shape of a cross. So, obviously these people are not being given the opportunity to worship as they would like.”
“As you quoted Dr. Zola, Holmes,” Watson responded, “ ‘Rights without opportunities are meaningless.’”
“Precisely.”
“But what of the Christmas cards and the community integration award?” Watson responded.
“Upon entering, I also observed the bulletin board where staff members would pick up their name badges when working at the home. The names of two women were among the 5 badges. Those same two names were on the Christmas cards that stood on the dresser of my friend’s room. He has no community friends. He has no one outside of those people who are paid to be with him.”
“...and the community integration award?” asked Watson.
“Yes, I wondered at that myself.” Holmes responded. “But like many of these places, they do not distinguish between community integration and community presence which are very different things. If you were to look closely at the award, the groups present at the gathering were homes or workshops for adults with disabilities facilitated by state disability agencies. Doubtless there was no one there with the adults, who was not paid to be with them. Would you call that community integration?”
“Clearly not!” replied Watson.
“So those who purport to facilitate community integration don’t know what it is.” Holmes paused, thinking.  “But there were other disturbing things as well. The actual house is nice, typical of this neighborhood. These places generally have spacious backyards, fenced in, where someone might get away for a moment to clear their mind or just enjoy being outside. As I looked, the grass in the yard had not been watered for some time such that it was dry and the ground quite dusty. Now I do not care about their garden, but there were no pathways through the dry grass, no places where it had been pressed down by people walking on it. I also investigated the shoes and pants of the residents and noted no dust or dirt like that in the backyard. So the residents, once they are home, never go outside. They are kept as prisoners inside the house. This might not be that sad if there were activities which might provide diversions of sorts for them.”
“There was a television.” Watson countered.
“Yes there was, but did you note a remote?”
“Come to think of it I didn’t see one.”
“It was there, however, it was out of reach of the residents on top of one of the book cases. There were several table games on the shelves but they don’t look as if they had been taken down for quite some time. So the residents don’t go outside, do not have control of the television and as I am sure even you observed.” Watson bristled but kept his attention on Holmes, “Their opportunities for amusement were Spartan at best with very little to divert them other than Joe beating on my friend.”
Watson shook his head sadly.
“As I walked to my friend’s room, I could just make out a name printed with a black marker that bled through his collar. At first it didn’t make sense as it was not his name till I realized that he doesn’t even own his own clothing but shares clothing communally with the others. I wondered how far that went, till he leaned over to pick up something off of the floor behind the headboard of his bed and a different name appeared on his underwear.
“The object that my friend picked up was a theater ticket that had fallen behind his bed. The dried out tape could no longer hold it to the wall. It too was dated prior to 2012. It was a 1997 performance of Les Miserables. I was glad that he got to see that because I know he has always loved music. But that brought no satisfaction as I lamented that perhaps the last time he was with a friend was that evening in 1997, with me Watson. I knew his family when they arrived here but lost track of them over the years as our lives went in different directions. It was I who took him to the play. But I wonder now if I would even be permitted to take him somewhere with the current oversight of his home.
"But the thing that saddened me the most was the half-moon shaped callous on his wrist. Did you notice that, Watson?” There was no response. “People will sometimes bite themselves in frustration, Watson. My friend’s callous, so distinct, so deep was communicating to me that his life has been hard. My hasty departure was only partly because of my disgust. I also feel as if I have failed him.”

2 comments:

Jeff McNair said...

The below are a series of comments from a friend and colleague for whom I have great respect, that were on Facebook regarding this posting. I thought I would include them here and then hopefully allow the discussion to continue.

Jordan Varey Very interesting. As someone associated with group homes I can see some of the complaints but also think it is a bit one sided. Many group homes in my neck of the woods are working toward greater inclusion.

Jeff McNair Agreed! This is based upon a SoCal context and is largely based upon real experience. It is also based on research I have recently done with a student indicating that the homes surveyed were pretty clueless about community integration as were the state regulating agencies. Couple that with the Baca and McNair article in Journal of Christian Institute in Disability called Almost Friends and once again for our context the story is not far from the truth.

Jordan Varey Is there a way to do group homes ethically? This is an honest question. If not, what are the alternatives? Taking into account the number of people in group homes, the cost of care, current labor market realities, etc. has someone proposed a workable alternative that you are aware of?

Jeff McNair That is the pivotal question I believe, Jordan. Does someone live in a community based residential facility or do they live in a home. If it is truly their home like my home is to me, then it belongs to me on some level, not to those who are running the group home business. In my home, I have personal property that is mine. I have freedom to move inside and outside and engage in recreational activities of my choosing. I have choices like the color of my walls, what hangs on them, who my roommate is, what my food is, what my appearance is and whether or not I go to church. I have a lot of input into my life rather than having my life dictated to me. To have that type of opportunity for people living in a community residential facility removes administrative convenience from the delivery of services. You kind of get the impression that those who run some facilities feel they are doing their residents a favor rather than providing them with a real home.
At least in America, I think a lot of the reason that homes are not really homes is the fear of litigation. If I keep you locked up with minimal contact with other people and the dangers of moving through the world, I do not expose myself to being taken to court, where you will definitely be treated as uncaring by those who have no idea of what it is like to live a regulated life.

Perhaps the solution is to develop class action suits on the basis of failure to integrate. If that type of suit was juxtaposed against those which are filed against group home owners who desire to facilitate integration, then perhaps a middle ground might be found. Under our current system, without significant changes, it will be extremely difficult to have the integration piece in most homes. They fear it, don't know how to do it, and the State of California (in my case) is just as oblivious about what integration is. Maybe things are different in Canada, but that seems to be a significant part of the problem here.

jordan V said...

5. I think it is much more beneficial to think of life in terms of comes interrelations rather than a striving to be "independent". This, in my opinion is the unique voice that Christianity can offer. L'Arche is an often cited example of what an attempt at a different way may look like. Notice that L'arche is still,in every measurable way, a group home.

6. You mentioned class action suits as a potential way. That may be, but it is not the way of Jesus. We, as Christians, have become good at criticism without action. Jesus was good at criticism by action. I think Vanier is the same. His existence is a Christian protest. Practically speaking I think this looks like radical discipleship. We need to bring people in apart from the system. We need to be an inclusive community in the face of government action toward the same. You will never legislate the kingdom into being. That is the scandal of Jesus.