Reacting to housing availablity: Response to Decker, et al
response after reading From the Streets to Assisted Living: Perceptions of a Vulnerable Population (Journal of Psychosocial Nursing, v44, n6. June 2006. Decker, S., Krautscheid, and Cary.)
The article describes the experiences of homeless adults who moved into a permanent housing facility where they have access to medical care. The facility is located in the neighborhood where most of the residents used ot live.
My initial response is similar to every other article describing life in a homeless shelter—it resonates positively. That is a validating feeling. It also makes me read less critically.
This article made me think most about Wintergreen PSHP; but, the points are applicable to any long-term congregate living facility. When working with a group of older adults I learned that it is difficult to move from one’s home and independence into assisted-living, or higher, level of care.
Earlier today I transcribed some notes from a recent crisis training that are relevant here. Basically, those notes dealt with the adaptational tasks of aging and the re-adjustments necessary to maintain positive self-image. They describe a process of change. Change is available to us; however, we often view it as a series of crises. Change can induce crisis and result from crisis. What tends to tie people up is reacting to change as an event in an orderly system. When they can view change as natural and orderly in itself they are better prepared to “roll with the punches”.
The article you sent describes reactions to change in a population with acute symptoms of homelessness and mental & physical disorders. Focusing on the reactions to change in the consumers. It does neglect that those consumers did come from an environment where they had achieved a measure of success in negotiating the environment. The article does report results of interviews post-one year residence in the facility.
I found most interesting the description of “relocation stress syndrome”—an acute adjustment disorder—and “fitting-in syndrome” where consumers took a passive approach to acclimation. The authors also described interventions that care-givers can make to counteract negative mindsets of consumers.
Interestingly, while it is my goal to create a family atmosphere and force residents to work together in problem-solving, the authors’ research indicates the paradox of consumers being happy with the little social interaction they choose. This also resonates truly. The paranoia required to survive on the streets does nothing to make trust building easy. Again we are faced with helping residents manage change. Social isolation is also a protective factor for homeless persons, persons with mental illness, and persons with histories of addiction.
All this is timely. In a recent conversation with Wintergreen staff there was discussion of creating goals that address the implicit need of the consumer as opposed to the explicit statements that are being made. I suspect that other supported housing programs could be enhanced by addressing some of these issues. Housing programs that expect consumers to be thinking like people who are actively progressed in recovery—head on straight and acting like a “reasonable person”—are doomed to a low success rate.
I am interested in your reactions.
