How to care for residents with mental illness and mental retardation? The clients in your home care agency come from a variety of backgrounds, have different life experiences and have unique personalities. Some are easy-going and cheerful. Some may like to argue. Some are very active. Others are relaxed and content. In addition to the basic differences, many may also have impaired mental abilities, whether it has been a condition all of their life or a more recent onset. As a direct care staff person, it is important to have a good understanding of each resident with whom you will be working, including those who have mental deficits or impairments.

        In this session we will look at the three main causes of cognitive impairment. You will be able to identify the symptoms, describe some of the behaviors common to these conditions and identify methods of interaction that are most effective in dealing with challenging behaviors.

        Every person is different, and everyone has good days and bad days. It will be important to get to know each resident and develop your skills in working with each resident as an individual.

Mental retardation:

        What is mental retardation? A person with mental retardation has lower intellectual functioning – meaning his/her IQ is significantly below average. He/She may need help with the daily living skills needed to live, work and play in the community. These include communication, self-care, social, leisure and work skills. Mental retardation can be caused by any condition that impairs development of the brain. Some common causes of mental retardation include genetic conditions, problems during birth, alcohol and drug use by the mother, some childhood illness and exposure to toxic materials.

        The abilities of people with mental retardation vary. Most people with mental retardation are mildly affected and are able to learn new skills. With appropriate supports all individuals with mental retardation can live satisfying lives in the community.

        Clients with mental retardation have social interests and needs that match their age. Keep this in mind as you consider the music they like, the clothes they want to wear and the activities they enjoy. It is important to get to know the abilities of each person and allow as much independent decision-making as possible. It is also important not to talk to or treat a person with mental retardation like a child. She/he is an adult who likes adult activities and has adult interests.

Mental illness:

        What is mental illness? A mental illness is a disturbance in behavior, mood, thought process, social skills or interpersonal relationships. There are many different types of mental illnesses and different levels of severity.

        A client with a mental illness may be younger and in the home due to his/her care needs, or the client may be elderly with a mental illness. These will be important issues to know about each individual. A client with a mental illness may feel deep sadness, may hear voices, may be very suspicious of others, may change moods quickly or may have emotional highs and lows. These are symptoms of mental illness and not a person’s choices or bad behaviors.

        Many people with mental illness are treated with medication under the care of a doctor. These medications can greatly reduce the symptoms of the illness, but many often have unpleasant side effects. It will be helpful to you and the client if you take the time to learn what medication is being taken, and the side effects. You may also notice that there is frequently a cycle that occurs with some mental illnesses. A person can be doing quite well for a period of time, and then start to slip into some of the symptoms of their illness. This can be a challenging time for everyone. There needs to be a re-evaluation by the doctor and possibly an adjustment in medication or in the person’s program or environment. As a direct care staff person, you are part of the team that observes behavior. If you are noticing changes in behaviors, be sure to follow the home’s system for reporting and documenting. This will be very helpful to others in considering treatment options.