Promoting Community Participation
Scenario #3: Robert
- Age: 48
- Type of developmental disability: Down Syndrome
- Type of residence: Independent home with parents
- Demographic location: City suburbs
Notes and References
Robert is 48 years old, has Down syndrome, and participates in an adult day program for individuals with developmental disabilities.
The program is five days a week from 8:00 AM until 3:00 PM and Robert is typically driven by his parents or a driving service. The service is often late and Robert is embarrassed when arriving at the program late. Robert lives in Bryn Mawr, a city suburb of Philadelphia where there is an accessible taxi and bus service. On weekends and after 3:00 PM on weekdays Robert does not usually leave his parent's home in Bryn Mawr. Robert is very integrated in a community of individuals with developmental disabilities but does not participate in the community beyond that particular group.
Robert really enjoys the day program and is very sociable within the program. He needs some assistance with tasks during the day program but overall he is very independent. However, recently Robert has exhibited difficulty in executing tasks that he used to be able to do without any issues. The staff in the adult day program suspect that he may be experiencing a decline in cognitive functioning (planning and attention) due to the early onset of dementia.
Robert explains that he has recently fallen in love with a 36-year-old woman who participates in the same day program. Robert would rather his girlfriend assist him throughout the day than accept assistance from the support staff. He sometimes even gets upset and embarrassed when the staff refuses his request to "have some privacy with his girlfriend." Robert has explained to his parents that he has a plan to ask his girlfriend to marry him and his parents want this for him but are hesitant about this decision.
Take a couple of minutes to think about how you would help Robert become a more active community participant.
Suggestions for community integration:
When working with Robert, we could first take note of Robert's concerns. Robert is very embarrassed when he gets to the day program late on the days that he uses the transportation service. However, he may not have the resources to use the accessible public transportation. The public transportation options may be more timely than the driving service and may help him get around on the weekends. In addition, we could address the family's concerns about Robert's marriage through a family meeting. By addressing everyone's concerns and educating Robert about marriage, the family may be better equipped at making these decisions. Next, since Robert's girlfriend is a motivator for him, having his girlfriend included in the conversation may help motivate Robert to participate in community activities. We could suggest some activities for Robert and his girlfriend to do together in the community. Finally, as Robert exhibits signs of dementia, it is important to conduct yearly screening with Robert to document his functional ability and monitor any declines associated with dementia. We may also engage Robert in more physical and cognitive activities to delay the progression of dementia.