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No downside to upside risk

February 1, 2013
by Judah Ronch, PhD
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One of my previous blog posts talked about the idea of risk and how we have a strong bias toward managing downside risk (the likelihood that things will come out worse than expected) in aging services. It seems that as elders become more dependent and need more services, the issue of upside risk is treated as an impossibility, except when someone is in a rehabilitation setting following a stroke or bone fracture, for example.

Dr. Bill Thomas, founder of the Eden Alternative, and I have been talking about this approach as creating a culture of surplus safety, and we are very pleased that a great deal of thoughtful conversation has begun that is appropriately considerate of all the issues and ramifications in this regard.

I recently heard a presentation about a new program at University of Maryland, Baltimore County (UMBC) that takes a new approach to upside risk with a population that once was treated as having little or no upside potential. I’m referring to individuals with intellectual disabilities, who were believed to be best served by living in institutions or other sheltered environments where the risks posed by their limitations could be cared for using models and methods that provided safety with little or no intellectual challenge. With the advent of deinstitutionalization and more enlightened care, the majority of persons with intellectual disabilities became residents in the general community living in small houses. However, their vocational and educational horizons were still largely limited to basic community living skill education and sheltered workshops doing routine, simple work.

The program, SUCCESS, run by the Shriver Center at UMBC, provides a four-year, post-secondary, noncredit college experience for students with intellectual disabilities, the first of its kind in Maryland. It is a new and unique realization of UMBC’s commitment to being a diverse community (we have students from 147 countries) and a tribute to Gov. Martin O’Malley’s vision to make Maryland the leader in public education. The students experience college life alongside our degree-seeking students and interact with their peers through a wide array of inclusive, educational, social and recreational campus-based activities, including participating in first-year seminars, initiating and leading service learning projects and others (see the news report of this program for more information).

SUCCESS was introduced to the university’s senior leadership group (of which I am a member) in a remarkable and stirring presentation featuring the students talking eloquently (that’s right) about how excited they were to be able both to enjoy the thrill of anticipating being college-bound while they were high school seniors and now to be a college student. Each person was asked what he or she liked best about college life.

One young woman’s response was resonant to an issue we in the nursing home world have begun to address. She said: “I like going to the dining hall and choosing whatever I want to eat.” That freedom encapsulated her new life: She was free to make her own decisions. Nobody was there to tell her what to eat or serve her a tray of food. She was like everyone else. What a victory!

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Judah Ronch

Dean, Erickson School, University of Maryland Baltimore County

Judah Ronch

http://erickson.umbc.edu/

Judah L. Ronch, PhD, is the dean of and a professor at the Erickson School, University of...