Sometimes I meet staff who have entered into a heightened safety awareness. They describe the people they work with as being dangerous and are constantly on their guard. They might remove anything that you could hurt yourself with or that might be thrown. I do not deny that people with major disabilities can be dangerous. I have met people with autism who head-butt the staff if they come too close, take stranglehold sometimes and bite and so on. Still the staff keep working with them.
I met a person with autism a decade ago. We mapped out how to work with him to avoid being kicked and head-butted. He had double staffing and lived in a small house of his own, had a small bus of his own and had many good days. But sometimes he went for the staff with a great force, and in ways that were actually dangerous. The staff wanted a method to deal with the violence, but what we did was develop a good structure and a good way to move around the room when working with him. In addition, we changed the attitude of the staff.
Recently I met him again. The plan we made many years ago still worked well, there were no violent situations if you just behaved correctly. But there was a feeling that the guy was dangerous. I asked how long ago it was that someone got a kick or head-butt, and was told that it had not happened for many years.
Actually, the guy is dangerous, just as it is dangerous to drive a car. If you don’t follow the structure of his everyday life, he becomes violent. There may be a few different reasons for not following the structure:
- The structure is not adhered to just like the driver who does not follow the traffic rules. We made up traffic rules for working with the guy by describing how to relate to him in the room (approaching from the side, not from the front or from behind, not be closer than one metre if you can’t stand diagonally behind him, etc). If you choose no to comply with the traffic rules, it becomes dangerous. Just as it is dangerous if the driver suddenly decide to drive on the left side instead of the right side of the road.
- You’re not focusing enough. This guy is like traffic: it does not run smoothly by itself. You must be careful and alert, and concentrate on your work. Just as the driver must concentrate on his job. Otherwise it might become dangerous.
So working in a care setting with this man is not dangerous if you are only alert and follow the traffic rules we have set. Just as it isn’t extremely dangerous to be a driver if you are alert and follow the traffic rules. The question is whether it isn’t more dangerous to be a driver than to work with this guy when it comes to the crunch. And then there is no reason to create scary images of how dangerous the guy is.