CNA's in Psych settings

FutureRNMichael · Nov 23, 2003

Ive noticed of late there being a lot of jobs involving DD folks. What type of disabilitys do they have and what are the general population like in the DD area?

lmd32 · Nov 23, 2003

I'm going to try to make this relatively brief so as not to bore folks. Michael, you are welcome to pm me if you want more info. The Deparment of Developmental Disabilities in my state (Washington) serves mentally retarded children and adults. Their IQs range from 70 on down. Most were born with their disability, although some suffered accidents or illnesses that impaired cognition. As long as it occurs between birth and age 18, it's technically DD. As you probably know, birth defects cluster so a lot of these folks have seizure disorders, physical problems, and mental illnesses as well.

Nationally, there is a trend to de-institutionalize the mentally retarded (and the mentally ill). I believe that Oregon, among other states, has completely closed their state institutions. Washington is moving more slowly. I work for a large state institution. As the trend toward community placement has grown, we have moved out a lot of people. We're pushing the envelope now and we are moving out a lot of people who we would not have thought were ready for community living. People with intractable seizures, multiple medical problems, significant mental illness and behavioral problems. To our surprise and delight, some of them have done very well. The folks we are left with now are the ones we truly believe the community is not ready for.

So, in my state institution, you would find people with serious problems, either medical or behavioral (in addition to their MR). We have 4 full time medical providers (3 MDs and a PA), a psychiatrist, and several PharmD's. We have physical and occupational therapists and aides, speech pathologists, psychologists, and social workers. The nurses where I work see a variety of medical problems, both acute and chronic, as well as behavioral issues and mental illnesses. Most common chronic medical problems are seizure disorders, endocrine disorders (including diabetes), and lately, as our population is aging, dementias. We serve only adults. Our youngest is 19, he still goes to public school. Our oldest is in her 90's.

In a community setting (group home or tenant support), you would have generally more tractable folks. A lot of them would be more functional and just need some help with more complex skills such as money management.

Since there is more community support and acceptance now than there was 70 years ago when my place was built, children with DD are cared for in the community, either in their own homes or therapeutic foster homes. There are a few residential treatment facilities for children with mental illness.

And that's my story.

FutureRNMichael · Nov 23, 2003

That about answers my question. Thanks!

I have been doing some searching and I came across an article about the moving of DD persons to group homes. Sounds kinda scary to think about the conditions as I came across literally hundereds of articles on abuse of these DD indviduals. I almost accepted a job into a group home for DD but thank goodness another job opp came along.

Here is the link: http://www.psych-health.com/fresno1.htm