This week I visited an agency in Massachusetts named the Seven Hills Foundation. This organization is helping us create and run our new unit, Webster House, which will serve children with both psychiatric and medical disabilities. The staff at Seven Hills have been universally generous, helpful, kind and knowledgeable with us. We visited the Seven Hills Pediatric Center, which provides long-term care. Children enrolled in their long-term care receive all the necessary medical, nursing, therapy, and leisure services to enhance their quality of life. Many residents come to them with a history of congenital birth defects, past infections, or trauma. Cognitively, residents are under the age of 12 months and non-ambulatory. The staff at SHPC has many years of experience working with residents who are ventilator-dependent, have tracheostomies, or require gastrointestinal feeding. For children who require additional monitoring, they have a state-of-the-art individual monitoring system. We also visited a group home in which six individuals live. This house looks like a regular house in a lovely neighborhood on the outside, but was specially constructed by Seven Hills to have space for reclining wheelchairs, tracks for lifts, special bathrooms and many other adaptations. The mission statement of the organization is “Dignity by Design.”
The children that are served in these two facilities are generally unable to respond differentially to life. A few may have the ability to signal yes or no. They may have some differences of responsiveness to people they have known a long time. Any positive changes in their condition are microscopic. They cannot say thank you or I appreciate what you did. It is not clear at all that what happens to them makes a difference in their experience.
Yet, the staff at these facilities are loving and interactive with the children. They constantly talk with them, interact with them. The children are well dressed, clean, and obviously cared for. Their rooms are decorated like any child’s room. They participate in school and make many trips into the community. When I asked where they go, I was told they go anywhere anyone else would go- the post office, grocery shopping, the hardware store. Staff was proud that the children had marched in the Memorial Day Parade this year. The children attend school, and the walls are lined with their art activities. When a child cooks or creates a craft project, that means that the staff moves their hand in order for them to do so. Yet these children’s lives are filled with activity, even though it is not obvious whether they can understand what is happening.
The staff was happy, friendly smiling and greeted us warmly. The facility was sparkling clean and attractive. It was an inspiring visit.
It seems to me that we can be inspired in our work by the work that Seven Hills does. We often tell staff to judge their day by what they did, not by how the kids responded. If they were caring, empathetic, playful, flexible, then it was a good day no matter how the kids behaved. At Seven Hills, staff have to do that. I am sure that they give each other a lot of support. But they cannot see immediate (or even long term) responses to their efforts from the kids. And they make the effort any way. How do they do that? How do they remain hopeful and find meaning in their jobs, when they cannot see results?
The second area is something I have written about before, in clear focus here. When a child has an obvious physical disability, we do not get angry at him for what he cannot do. We do not think that if we punish him for not doing it, he will change. Instead, we make modifications and change our expectations. At Seven Hills this is the essence of every activity. The staff finds a way that their efforts can make it possible for a child to do something or have a certain experience. They literally move the child’s hand so that the child creates art or food. They do not use rewards or punishments. If a child can get better, they gradually allow them to do more, in minute steps.
What if we could more clearly see the physical changes trauma has caused our children? What if we could see their damaged brains and body chemistry? Could we more easily lend them our brains, our thinking and planning, and provide them the support they need for success? Could we be surer that through positive experiences they would grow and that gradually they would become more capable?
Our visit to Seven Hills was moving and inspiring, and led to some thinking about how their philosophy could apply to the work we do.
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