Changing Perspectives on Independence for People with Intellectual and/or Developmental Disabilities

I have been working with and providing services to individuals with intellectual and developmental disabilities for most of my life. Although my experience has largely been in the area of providing employment assistance, I have recently transitioned to supportive housing services in my current position as Executive Director of Banchero Disability Partners in Seattle, Washington. A new, stronger perspective on “client choice” has been introduced to me at this new location. First of all, did you know that the definition of developmental disability is a group of conditions that affect a person’s physical, learning, language, or behavior and which condition happened during their developmental period? Usually, these conditions last throughout their lifetime. The agency where I now work provides supportive living services to adults with intellectual and/or developmental disabilities.

I love the focus of the mission, which is very strong on “client choice”. What does that mean, exactly, in the true sense of the words “client choice”. I struggled with this when I first started. The first time a person who has Down Syndrome and is a diabetic said “No, I don’t want my insulin shot”, I thought…”but they need that to stay healthy and alive”. Do I take that choice away from them? Or am I responsible to educate them about the consequences of not taking the injection. The fact that they might get sick, they might have to go to a hospital, they might die; all these issues need to clearly be explained to them. If they still say “no”, we can go back in 15 minutes and ask them again, if they are now ready to take their insulin. But do we have a right to force them; take their decision away from them, if they have been tested and been found to have the cognitive ability to understand the consequences for their decisions? I vote for “Client Choice”. Their body, their choice.