Adam Dzialo

Adam Dzialo
Our son, Adam Dzialo, age 30

Friday, March 18, 2011

Guest Post: Comments on "Crimes Against Humanity" Blog Post

       An old (literally and figuratively) friend of mine, Richard Ruel, posted a comment on my last blog , "Crimes Against Humanity" which was a response to a New York Times article about abuse in group homes for the disabled and the inaction of officials.  Google comments rejected the comment because of length, so why not turn it into a guest post?   Richard is as nursing instructor at UMASS in Boston and well as a clinical investigator of the Department of Mental Health, one of the good guys.  I thank you, Richard, for these comments and for sharing them with all.

Richard Ruel
      I investigate abuse/neglect of persons with disabilities for a living, and I was pleased with myself that I was not too jaded (after 17 years working in the field) to be absolutely and totally disgusted and sickened by the inhumane treatment of the developmentally challenged in state run residences as reported in the NYT article. In fact, I could not get through it the first time around, and the day that I am not totally repulsed by these horrible accounts is the day that I quit my state job. I would love to assure Phil and his following that nothing approaching the magnitude of the mistreatment of human beings as reported by NYT occurs in our beloved state of Ma., but I can at least say that our state officials in charge of human services take abuse/neglect of disabled persons, children, and the elderly very seriously. The least I can do is to inform residents of Massachusetts who may be unaware of certain public services available to them how to access a number of agencies designed to help Ma citizens to recognize, report and respond to abuse. First a few comments about Phil’s blog:

 As far as unions go, they do not usually impede the investigations process, which is where I run into them. Workers, even those not accused of anything, e.g. witnesses get nervous with the process and might have a union rep or another adult i.e. supervisor or attorney present with them during interviews with the investigator to assure due process, and no one has a problem with that. In fact, it is a clearly stated right that they have access to representation. Investigators are trained to be objective and professional, and we don’t conduct kangaroo courts where alleged abusers are presumed guilty. However, I have found that unions can make it extraordinarily difficult for management to terminate especially bad employees at times. Also, bad hiring practices by management contribute to the problem by hiring some of the bad apples in the first place. Once hired, union reps have to do their job and represent any and all of their members.

Such emphasis on the rights of workers! How about the rights of those under their charge, the most vulnerable in our society? First of all, there is no substitute for an advocate, be it a family member, appointed guardian, etc. Those with the most vigilant and vocal advocates are less likely to be victimized by way of abuse and/or neglect. Also, ongoing training of workers is vitally important but often overlooked due to time and financial constraints. Every facility and community residence is supposed to have a human rights officer. Sometimes the human rights officers who are supposed to represent the disabled/alleged victims belong to a union, the same one as the alleged abuser, and we may have a conflict of interest or at the very least, the appearance thereof. And for my final comment, I have this alert for you! Be forewarned that abusers and exploiters can circulate through the system and end up working with a different population. For example, someone working with the developmentally challenged can resurface working with the elderly and exploit them financially, an easy target for wolves in sheep’s clothing because this demographic can be so very trusting and desperate for any kind of assistance. 

So what can we do to protect out loved ones from abuse and neglect? In Massachusetts, to report suspected abuse and neglect of disabled persons between the ages of 18-59, you should contact the Disabled Persons Protection Commission (DPPC) at their 24 hour hotline 1-800-426-9009. As Phil pointed out, some of the abuse in NY State was criminal. Please be advised that a member of the State Police Detective Unit (SPDU) assigned to the DPPC reviews all reports of suspected abuse/neglect made to the DPPC to determine whether a crime may have occurred. Civil investigators assigned to cases can request the SPDU to rescreen the complaint when new information/evidence gathered during the investigation suggests criminal activity.

To report suspected abuse/neglect of persons under 18, you should contact the Department of Children and Families at their 24 hours hotline 1-800-792-5200. To report abuse of elderly persons (60 and over), call the 24/7 Ma. Elder Abuse Hotline 1-800-922-2275. Protective services, including counseling, legal services, home health, transportation, and safety plans, are available. Protective services are also provided by the DPPC and DCF. Should the abuse occur in a nursing home, you should contact the Ma. Department of Public Health. (DPH). Reporters of potential abuse/neglect are protected by law. There are also laws to protect reporters against retaliation from alleged abusers, employers, family members, etc. Some of you, by virtue of your profession (as a nurse, I know I am), may be mandated reporters, and you are required by law to make reports of suspected abuse. All of the above agencies have websites that can easily be googled, and once there, you will find details of their services and information regarding statutory and jurisdiction criteria with regard to abuse/neglect.  


  1. Nothing personal but this quote had a quiver go down my spine, "There are also laws to protect reporters against retaliation from alleged abusers, employers, family members, etc. Some of you, by virtue of your profession (as a nurse, I know I am), may be mandated reporters, and you are required by law to make reports of suspected abuse."
    When it is a nurse either perpetrating the actual abuse or turning a blind eye to it to not rock the boat those safety elements will not work. Obviously that should be a tiny minority of cases, certainly I am not familiar with the statistics but I have seen it happen.
    Training as to appropriate behaviour is inadequate in my opinion particularly since dealing with the frustrations that mount with working in such settings is not addressed, which can be only partially helped by proper hiring.
    Some things are considered commonsense until you discover the fact that people have an entirely different concept of what that is.
    I've seen the head of a highly regarded and well established advocacy organization for compromised children say that his son sometimes needs a good smack because he is so stubborn.

    As well it is so well established that the number of reported cases represent a small portion of actual abuses. Even family members will let things slide so as not to let their children suffer further repercussions. Also the awareness of family members is often either not very acute or hampered by the "inaccurate" reporting by staff.
    I've seen staff change their stories in police investigation out of fear for losing their employment. If the care in the US is unionized, protecting the transgressor, then God help the children.

    I continue to view the social issues of keeping severely compromised children at home in the United States as some twisted bizarro world of what goes on in western Europe. It is absolutely Fubar, with a capital "F".

  2. Well put and quite poignant, Eric. I, too, have seen much of the same. I have had much difficulty with the relegation of care of our children and adult/children to institutions and government approved programs. It appears to be a cultural phenomenon.
    When we travel to Montreal for our ABR evaluation and training every six months, we meet many people from Latin American. Care of the disabled and elderly is a role of family and extended family. It is embraced to such a degree that I have not widely seen in North America. It is never perceived as a burden.
    When we moved three years ago, after Adam completed his stay in school and was 22, we visited three state funded day habilitation centers for the disabled near our new home. Our fantasy that these state funded centers would give Adam some social connection, variety in his life, etc. We looked for just a few hour a day respite.
    While exteriorly, the administration was warm and kind; interiorly clients were warehoused. Smells of bleach, unattended clients, clients performing the same routine tasks every day of life, no therapies, huge client staff ratios, etc. Legally no one was hurt or abused, but I felt the indifference to individuals was an abuse at the core. My wife simply cried, I wanted to tear down the structures. Our resolution for Adam, never here: not for a day, not for an hour.
    This is a problem of societal proportions which is not solved by institutions, group homes, day habilitations, state placements. The role of governments is to provide parents with the tools and resources to provide care and love in the home. Period.
    This will not solve all abuse, as parents can be abusive also. Chances are higher for success than through government programs.

  3. Phil, Thank you for bringing this ugly subject into light, for those of us that did not read the NYT report. There is so much abuse going on behind our backs towards the disabled and elderly, it sickens me so... I have seen abuse in one of the top rated nursing homes in MD, where my grandmother lived for quite some time. I was young and I did report the abuse I saw.

    I have a family member who works in couple of the local state group homes in MA, and she has been happy with what she has seen, and I do trust her.

    However, as long as I am alive I will care for my son Cj, at home. Ryan, his younger brother, loves Cj so much I feel he will take careful measures on his care. I am trying to train him, so to speak, how to treat your family members as the Latin American people do. I agree with you Phil, after observing how they take unconditional, extreme care for their injured child and ederly at the ABR center. I saw a few famlies bring the entire family with them, grandmothers, aunts, uncles...amazing love!

    Thank you, Richard, for the great resources to report abuse.

  4. Thanks for the feedback, Lisa. It's wonderful that Cj has Ryan. We too are working on Aimee, but I am hoping to live until I'm 125 so that it won't be an issue. MA does have the better programs compared to many other states, but still a way to go. Hope to see ya'all when you venture down to the Cape in warmer weather. In the meantime we are heading to Montreal at the end of the month as Leonid will be there...we need our cheerleader!

  5. Thank you, Phil, for hosting me on your blog, and thank you Eric, Lisa and Phil for your comments.

    Phil, I will never figure out for the life of me why any rational person would even contemplate cutting funds for home care. It is clearly the best and most cost effective care on the planet, and those who choose to do it should be given all the tools they need by the government.

    Eric, I am particularly haunted by the water rationing (so that kids would not wet their trousers) practice that you described in your comment in Phil’s original blog about abuses in NY State. Especially the police detective who said that rationing water was not an assault. Maybe not, but depriving children of water so that they don’t urinate is first all neglect, besides being medically dangerous, stupid, cruel and inhumane. I ran into this once on an inpatient psychiatric unit. A patient was being denied water because, according to some of the nursing staff, it was supposedly contraindicated by her current medical condition and medications that she was taking. Now there are medical conditions i.e. chronic heart failure, low sodium level, that may require fluid restrictions, but the patient had no such condition, nor was she on any meds that called for water rationing. When it became clearly evident to me that that staff were denying the patient water because they had grown tired of changing her clothing and bed, I confronted the medical director and asked him if his staff were “dumb or mean or both”. He did not have an answer, insisting that he knew nothing about it, and he had never written an order for fluid restriction

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