As you know, equality is a hot topic trending across the United States right now. So, while it’s on your mind, I thought it made sense to talk about another form of equality that needs to exist for people with disabilities. The ADA and other forms of legislation have worked hard to ensure equal rights for our folks. But, like any government sanctioned standard, behind it lies a more pervasive problem, namely attitudes concerning what people with disabilities should and should not be able to do. In its most basic form, people with disabilities should enjoy the same liberties that all Americans enjoy. But, do they? That is the important question.
In my experience, working with people who have a traumatic brain injury or acquired brain injury, there’s a double standard in regard to what the people should be able to do. It is similar to anyone that has any type of cognitive impairment. The general notion appears to be, “We will tell you what you can and cannot do!” And, the most prevalent areas center around alcohol and sex. The general consensus with alcohol is that people on various medications are not to partake of alcohol. However, that seems to be more of a medical decision, than a programmatic decision. Maybe a better question would be, how many people do you know that are on medications and yet still drink alcohol? Of course there is a danger of a harmful interaction with drugs and alcohol, and of course there is always too much of a good thing. But again, that would be a question better suited for the person’s treating physician. So, how can a program that provides residential support for people with brain injuries make an edict that alcohol is banned from the facility? After all, the person resides at the home and it seems should be afforded the opportunity to make his or her own choices. That’s not to say that every care facility has this unfair standard, but when it comes to people with cognitive impairments, it is generally the rule. Personally, I think this is a violation of the person’s rights. If a resident wants to have a beer after dinner and they live in a group home, why would we deny them?
Working in an administrative capacity, I fully acknowledge the potential liability introduced when alcohol is accessible. But that liability wouldn’t seem any greater than the liability all of us face when we overindulge and make poor choices. But the person in the group home has an advantage. There are staff there that can assist in managing the risk and making sure people remain safe.
The next taboo topic involves sex. Yes, that three letter word that runs the gamut from delightful to disgusting. There are more opinions regarding sex than most everything else due to assigned beliefs and moral upbringings. But sex, when you remove all of the inflammatory and exaggerated rhetoric is simply a biological function built into human beings. It is as necessary as eating food and drinking water. With some desire is strong, with others desire is minimal. But being an actual need, requires expression in most cases. Now enter the man or woman living in the group home… Their residence is the home. They have no other home. Generally, we don’t like to think that one of the residents may be having sex in their bedroom, but we have to ask ourselves, “What else would we have them to do?” “Where should they go?” “Where do we go?” Encouraging a lack of interaction sexually works at cross purposes with the human design. A person with a brain injury may have the same desire for sex that they had before their injury. In fact, there is no evidence to suggest that people with any type of cognitive impairment have a lessened desire for sex. Thus it seems as a staff responsible for the care of these good people, we should work to encourage it rather than ignore it.
As with anything that is designed to occur in private, we have to establish boundaries. For example, your bedroom is your private place, but the kitchen or the bathroom, not so much (smile). You would expect no different from your adult children who come to visit or your guests for that matter. But, who would think to inform adult guests that sex is prohibited while at residing at the home? I think you get the point.
When it comes to working in facilities and group homes for people with disabilities, your morality and mine are not the issue. The issue is the equal rights of the resident. Now there is the sticky wicket of a resident having a legal guardian and in that case our job is to reach out to the guardian and make a case for the person’s rights. We may not win the argument, but we owe the person that much…
At the end of the day, facilities and programs must consider the rights of an individual above all else. When they choose to do so, they are doing their part in making equality available for all.