Anna London is 41 years old and lives with her mother. The first
of five children born to her mother and father, she was removed
from her parents' custody at 3 months and grew up in a foster home
with very little contact with her birth parents. Between age 14
and 19, she lived in two institutional settings, one of them a
school for children with mental retardation, purportedly so that
she could get medical care and educational services.
Anna went back to live with her foster parents in 1967 and stayed
with them until 1977, when both of them died. She then moved into
the YWCA, and later initiated contact with her birth family. In
1979 she and her mother began living together. They have moved a
number of times, and their financial situation is such that they
are barely able to make it through the month--but they do,
together. Anna still has a number of health problems, as does her
mother.
Anna sees herself as a person whose role is to help others. This
appears to be a meaningful role for her but causes others (mental
health professionals and volunteers) some alarm on her behalf; they
appear to view her family, who receive most of her help, as people
who use her without giving much back in return.
Anna's Helping
Anna has babysat daily for her brother's three children for 9
years, accepting whatever they have to pay her. She continues to
do so even though her brother and sister-in-law are getting a
divorce. She has stayed overnight five nights a week with another
sister's child for the past year. In the past, she has also
provided quite a bit of personal care (cooking, cleaning, etc.) for
her mother, who has serious heart problems, although they also have
a home health aide who takes care of the heavy work such as the
laundry. While Anna now has heart problems of her own, and may be
providing less of this kind of care, much of her time is consumed
in caring for various members of her family.
Anna also helps most of the other people with whom she comes into
contact. At church, she helps a woman who is blind so that she can
participate more fully. She helps the workers in the service
agencies with whom she interacts by calling and leaving "Good
morning" or "I love you" messages, and by opening up to them about
her feelings, as they urge her to do.
Human Services in Anna's Life
As a child, Anna was taken from her family by a child protective
agency. Probably because she had a cleft palate, she was diagnosed
as having "failure to thrive syndrome," and her very poor parents
were seen as unable to care for her. Therefore, she grew up as a
recipient of foster and institutional care, but carved an identity
as a helper of others within these settings.
Today, Anna is involved with a few community mental health
agencies, but appears to use rather than be controlled by their
services. At one time, she had regular appointments with a
therapist and a case manager. Now she and her mother are in
counseling together. She still sees her case manager in yet a
third agency that provides community support services to people
with psychiatric disorders. Anna listens to what these people have
to say, but makes her own decisions about her life.
Additionally, Anna has a volunteer who was recruited by an agency
to befriend her. Through this relationship, she has become
involved with a broader group made up of people with disabilities
and people who were recruited to become their friends.
According to the agencies that serve her, Anna "lives
independently" and "isn't crazy anymore." Therefore, they could
remove her from their rolls. They do not because, they say, they
want to continue to make available what one worked called an
"alternative community," made up of service workers and volunteers,
that Anna can turn to when she needs some time away from her
family. This worker views this "community" as an option for Anna,
as a way of giving Anna a choice beyond her family. Through this
agency, she could move into a residential setting and job
training.
Dilemmas and Perspectives
Anna's story highlights a number of dilemmas. There is a tension
between being helped and helping others. For many people with
disabilities, the role of helper is not available because the
people in their lives will not permit them to take on this role.
For Anna, being a helper as a valued identity, one around which she
has built her concept of herself.
The second dilemma arises from an ambiguity: when does a helper
become a person who is used by others? While Anna appears to see
herself as a helper who holds her family together, her service
workers and friends worry that she is being taken advantage of. To
change the balance, however, she would have to give up her "helping
career," and some of her family relationships, and instead move
into a human service world. Her workers and friends have resolved
this conflict by supporting her in the decision she makes.
Lessons Learned from Anna
Anna's life and identity are tied up in ability to contribute to
and provide real help to her family and others. She has been able
to use certain things from the service system, like money,
volunteers, recreational opportunities, and counseling, to support
a life she has chosen. The workers representing the various parts
of the system have learned to support her in the decisions she make
about her life.
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