Linda S. Corman, Thomas V. Barbera Jr., Stephanie Bowen , Deborah Jennings, and Lucille Sanford
Two programs now functioning at the Fernald State School in Massachusetts will be described in this chapter. The Senior Enrichment Program is a retirement program that provides a variety of life enrichment activities for individuals whose skills are at a prevocational level, people who are sometimes called "severely" retarded. The Health Focus Program is for individuals who now have Alzheimer's disease, who previously functioned at a variety of levels of cognitive competence. The age of clients in these two programs ranges from 53 to 83 with an average age of 68.
Many of the individuals in our two programs have physical limitations. They have visual and hearing difficulties, and other losses of function, that are part of normal aging. Some have heart disease, arthritis, hypertension, pulmonary disease, anemia, Parkinson's disease, osteoporosis, stroke, seizures, or tardive dyskinesia.
Most of the people in these two programs have spent a good part of their lives in institutions. Some of these individuals were not specifically diagnosed with mental retardation when they entered an institution 50, 60, or 70 years ago. Some were clumsy or disruptive, could not hear or see well, and perhaps had emotional problems. Because of the nature of life in institutions, many people did not receive appropriate training.
Our rationale in dealing with the needs of people with mental retardation who are old begins by recognizing that our first and foremost responsibility is to develop a normalized setting. Many in our programs have had limitations of choice due to their history in the institution. We recognize that the most important skill for many of these individuals is to develop an ability to make choices. Choice can be as simple as a decision to use red paint instead of blue paint to make a