Case Study: Jaime
Jaime is a 38-year-old man of mixed Caucasian and Cuban descent. He currently lives in a large, long-term residential facility for adults with developmental disabilities in Miami, FL. Jaime is one of 45 adults who currently reside in this facility. He is primarily cared for by a rotating staff of direct care workers with only basic training in behavior management and teaching life skills to adults with developmental disabilities. There is frequent staff turnover at Jaime’s current facility; however, the facility’s consulting psychiatrist, behavior specialist, and two of the nurses have a long-standing relationship with Jaime as they have worked at the facility since Jaime’s arrival at the age of 19.
Jaime was diagnosed at age 5 with moderate mental retardation and also has a medical diagnosis of cerebral palsy. He is able to communicate verbally with others, although at times he can be difficult to understand. He can also read his own name, and is able to identify letters and numbers accurately. Jaime’s diagnosis of cerebral palsy affects his rate and fluidity of movement, meaning that he often appears uncoordinated or clumsy and takes longer to move from one place to another that most individuals. Jaime is able to walk and get around for short periods of time (approximately 20-30 minutes), but then requires a break of about 10 minutes to recover his muscle strength.
For the last 11 years, Jaime has been transported in a large van on weekdays to a sheltered workshop facility about 20 miles North in Ft. Lauderdale, FL. There he works on an assembly line, sorting different small items, such as nails, screws, nuts, and bolts, for later packaging and shipping with ready-to-assemble furniture. Jaime sits in a chair at his workstation for most of the day, and is able to do this work effectively without much supervision. Jaime doesn’t mind his job once he is there, but really dislikes riding in the large van. He often acts aggressively towards the driver and other staff when they assist him into the van, especially if he is not able to sit on the outside (aisle) in the first row near the door. Because this van picks up individuals from different locations, there are often others seated in Jaime’s preferred spot. He also dislikes small spaces in other locations, such as bathrooms, and tends to act aggressively towards his direct care workers who assist with hygiene tasks. Although Jaime has the cognitive and self-help skills to do a number of things for himself, he does require assistance for certain personal hygiene tasks as his poor muscle tone and incoordination make it difficult to clean himself thoroughly.
In regards to his personal and social life, Jaime has only a couple family members nearby. These include his elderly mother, age 70, who has early stage Alzheimer’s Disease and lives in an assisted living facility about 12 miles away from where Jaime lives. Jaime’s mother used to visit him frequently until two years ago, when she began having trouble remembering appointments, driving directions, etc. Jaime’s older brother lives about 75 miles away in Jupiter, FL. He and his family come to visit Jaime a few times a year, but his brother worries that such visits are stressful and confusing to his preteen children.
Jaime is quite inactive once he returns home from work, and dislikes his current living arrangements. Many of the other residents are significantly older than he is and are in their late 50s and 60s and seem more impaired than he is. He does however, enjoy when a volunteer comes to visit them every Sunday with her therapy dog, a yellow Labrador. Jaime wants to be able to have a girlfriend and get married like his older brother and have a dog. He often asks his direct care workers and others with whom he comes into contact if they are married and have a dog. Jaime also enjoys swimming, although he requires close supervision as he fatigues easily in the water. Lastly, Jaime really looks forward to trips into the local community, especially when they involve eating rice and beans at a local Cuban restaurant. Unfortunately, Jaime and the other residents only make such trips into the community a few times per year.