WORKING WITH PEOPLE WHO ARE
OLD AND MENTALLY RETARDED
Mary C. Howell
Our work with people who are mentally retarded encourages us to challenge and question what we take for granted as given and fixed in human capacities, potentials, and yearnings. Watching the growth and development of a developmentally delayed child, we can observe--teased apart and proceeding at different rates--both the interdependence and the separateness of cognitive competence, affective maturity, social skills, communicative adaptability, neuromotor abilities, and other skills. In a similar manner, as we observe the developmental progress of the adult and aging person who is retarded, we become aware of separate threads of change in the raveling fabric that represents the approach to the end of life.
Erik Erikson, writing about the stages of the life cycle, proposes that in each stage there is a predominant conflict between two forces-- one positive and one negative. We all resolve these conflicts in some fashion and to some degree, and from the resolutions we acquire certain strengths. In Erikson's last stages of Adulthood and Old Age, respectively, the conflicts are between generativity and stagnation, and integrity and despair. Out of the resolution of these conflicts will arise, if we are lucky, the strengths of care and wisdom. Erikson always reminds us that he speaks of a life course of cycles, each stage spiralling and overlapping with all the others over and over again. He also speaks of epigenesis, a concept that brings to mind both the progressive differentiation and diversification of the embryo, and the formation of mineral crystals--structures of increasing orderliness and complexity--in response to external pressures.
It is useful, in work with people who are mentally retarded and old, to think about progressive differentiation and unfolding; about the interaction of external forces and given potentials; about becoming