In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.
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Series: Culture of Cruelty:Inside Illinois’ Mental Health System
State-run facilities in Illinois are supposed to care for people with mental and developmental disabilities. But patients have been subjected to abuse, neglect and staff misconduct for decades, despite calls for change.
Kaleigh Rogers was in crisis when she checked into a state-run institution on Illinois’ northern border two years ago. Rogers, who has cerebral palsy, had a mental health breakdown during the pandemic and was acting aggressively toward herself and others.
Before COVID-19, she had been living in a small group home; she had been taking college classes online and enjoyed going out with friends, volunteering and going to church. But when her aggression escalated, she needed more medical help than her community setting could provide.
With few viable options for intervention, she moved into Kiley Developmental Center in Waukegan, a much larger facility. There, she says she has fewer freedoms and almost nothing to do, and was placed in a unit with six other residents, all of whom are unable to speak. Although the stay was meant to be short term, she’s been there for two years.
The predicament facing Rogers and others like her is proof, advocates say, that the state is failing to live up to the promise it made in a 13-year-old federal consent decree to serve people in the community.
Rogers, 26, said she has lost so much at Kiley: her privacy, her autonomy and her purpose. During dark times, she cries on the phone to her mom, who has reduced the frequency of her visits because it is so upsetting for Rogers when her mom has to leave.
The 220-bed developmental center about an hour north of Chicago is one of seven in the state that have been plagued by allegations of abuse and other staff misconduct. The facilities have been the subject of a monthslong investigation by Capitol News Illinois and ProPublica about the state’s failures to correct poor conditions for people with intellectual and developmental disabilities. The news organizations uncovered instances of staff who had beaten, choked, thrown, dragged and humiliated residents inside the state-run facilities.
Advocates hoped the state would become less reliant on large institutions like these when they filed a lawsuit in 2005, alleging that Illinois’ failure to adequately fund community living options ended up segregating people with intellectual and developmental disabilities from society by forcing them to live in institutions. The suit claimed Illinois was in direct violation of a 1999 U.S. Supreme Court decision in another case, which found that states had to serve people in the most integrated setting of their choosing.
Negotiations resulted in a consent decree, a court-supervised improvement plan. The state agreed to find and fund community placements and services for individuals covered by the consent decree, thousands of adults with intellectual and developmental disabilities across Illinois who have put their names on waiting lists to receive them.
Now, the state has asked a judge to consider ending the consent decree, citing significant increases in the number of people receiving community-based services. In a court filing in December, Illinois argued that while its system is “not and never will be perfect,” it is “much more than legally adequate.”
But advocates say the consent decree should not be considered fulfilled as long as people with disabilities continue to live without the services and choices that the state promised.
Across the country, states have significantly downsized or closed their large-scale institutions for people with developmental and intellectual disabilities in favor of smaller, more integrated and more homelike settings.
But in Illinois, a national outlier, such efforts have foundered. Efforts to close state-operated developmental centers have been met with strong opposition from labor unions, the communities where the centers are located, local politicians and some parents.
U.S. District Judge Sharon Johnson Coleman in Chicago is scheduled in late summer to decide whether the state has made enough progress in building up community supports to end the court’s oversight.
For some individuals like Rogers, who are in crisis or have higher medical or behavioral challenges, the state itself acknowledges that it has struggled to serve them in community settings. Rogers said she’d like to send this message on behalf of those in state-operated developmental centers: “Please, please get us out once and for all.”
“Living Inside a Box”
Without a robust system of community-based resources and living arrangements to intervene during a crisis, state-operated developmental centers become a last resort for people with disabilities. But under the consent decree agreement, the state, Equip for Equality argues, is expected to offer sufficient alternative crisis supports to keep people who want them out of these institutions.
In a written response to questions, Rachel Otwell, a spokesperson for the Illinois Department of Human Services, said the state has sought to expand the menu of services it offers people experiencing a crisis, in an effort to keep them from going into institutions. But Andrea Rizor, a lawyer with Equip for Equality, said, “They just don’t have enough to meet the demand.”
For example, the state offers stabilization homes where people can live for 90 days while they receive more intensive support from staff serving the homes, including medication reviews and behavioral interventions. But there are only 32 placements available — only four of them for women — and the beds are always full, Rizor said.
Too many people, she said, enter a state-run institution for short-term treatment and end up stuck there for years for various reasons, including shortcomings with the state’s discharge planning and concerns from providers who may assume those residents to be disruptive or difficult to serve without adequate resources.
That’s what happened to Rogers. Interruptions to her routine and isolation during the pandemic sent her anxiety and aggressive behaviors into overdrive. The staff at her community group home in Machesney Park, unsure of what to do when she acted out, had called the police on several occasions.
Doctors also tried to intervene, but the cocktail of medications she was prescribed turned her into a “zombie,” Rogers said. Stacey Rogers, her mom and legal guardian, said she didn’t know where else to turn for help. Kiley, she said, “was pretty much the last resort for us,” but she never intended for her daughter to be there for this long. She’s helped her daughter apply to dozens of group homes over the past year. A few put her on waitlists; most have turned her down.
“Right now, all she’s doing is living inside a box,” Stacey Rogers said.
Although Rogers gave the news organizations permission to ask about her situation, IDHS declined to comment, citing privacy restrictions. In general, the IDHS spokesperson said that timelines for leaving institutions are “specific to each individual” and their unique preferences, such as where they want to live and speciality services they may require in a group home.
Equip for Equality points to people like Rogers to argue that the consent decree has not been sufficiently fulfilled. She’s one of several hundred in that predicament, the organization said.
“If the state doesn’t have capacity to serve folks in the community, then the time is not right to terminate this consent decree, which requires community capacity,” Rizor said.
Equip for Equality has said that ongoing safety issues in these facilities make it even more important that people covered by the consent decree not be placed in state-run institutions. In an October court brief, citing the news organizations’ reporting, Equip for Equality said that individuals with disabilities who were transferred from community to institutional care in crisis have “died, been raped, and been physically and mentally abused.”
Over the summer, an independent court monitor assigned to provide expert opinions in the consent decree, in a memo to the court, asked a judge to bar the state from admitting those individuals into its institutions.
In its December court filing, the state acknowledged that there are some safety concerns inside its state-run centers, “which the state is diligently working on,” as well as conditions inside privately operated facilities and group homes “that need to be addressed.” But it also argued that conditions inside its facilities are outside the scope of the consent decree. The lawsuit and consent decree specifically aimed to help people who wanted to move out of large private institutions, but plaintiffs’ attorneys argue that the consent decree prohibits the state from using state-run institutions as backup crisis centers.
In arguing to end the consent decree, the state pointed to significant increases in the number of people served since it went into effect. There were about 13,500 people receiving home- and community-based services in 2011 compared with more than 23,000 in 2023, it told the court.
The state also said it has significantly increased funding that is earmarked to pay front-line direct support professionals who assist individuals with daily living needs in the community, such as eating and grooming.
In a statement to reporters, the human services department called these and other improvements to the system “extraordinary.”
Lawyers for the state argued that those improvements are enough to end court oversight.
“The systemic barriers that were in place in 2011 no longer exist,” the state’s court filing said.
Among those who were able to find homes in the community is Stanley Ligas, the lead plaintiff in the lawsuit that led to the consent decree. When it was filed in 2005, he was living in a roughly 100-bed private facility but wanted to move into a community home closer to his sister. The state refused to fund his move.
Today, the 56-year-old lives in Oswego with three roommates in a house they rent. All of them receive services to help their daily living needs through a nonprofit, and Ligas has held jobs in the community: He previously worked in a bowling alley and is now paid to make public appearances to advocate for others with disabilities. He lives near his sister, says he goes on family beach vacations and enjoys watching professional wrestling with friends. During an interview with reporters, Ligas hugged his caregiver and said he’s “very happy” and hopes others can receive the same opportunities he’s been given.
While much of that progress has come only in recent years, under Gov. JB Pritzker’s administration, it has proven to be vulnerable to political and economic changes. After a prolonged budget stalemate, the court in 2017 found Illinois out of compliance with the Ligas consent decree.
At the time, late and insufficient payments from the state had resulted in a staffing crisis inside community group homes, leading to escalating claims of abuse and neglect and failures to provide routine services that residents relied on, such as help getting to work, social engagements and medical appointments in the community. Advocates worry about what could happen under a different administration, or this one, if Illinois’ finances continue to decline as projected.
“I acknowledge the commitments that this administration has made. However, because we had so far to come, we still have far to go,” said Kathy Carmody, chief executive of The Institute on Public Policy for People with Disabilities, which represents providers.
While the wait for services is significantly shorter than it was when the consent decree went into effect in 2011, there are still more than 5,000 adults who have told the state they want community services but have yet to receive them, most of them in a family home. Most people spend about five years waiting to get the services they request. And Illinois continues to rank near the bottom in terms of the investment it makes in community-based services, according to a University of Kansas analysis of states’ spending on services for people with intellectual and developmental disabilities.
Advocates who believe the consent decree has not been fulfilled contend that Illinois’ continued reliance on congregate settings has tied up funds that could go into building up more community living options. Each year, Illinois spends about $347,000 per person to care for those in state-run institutions compared with roughly $91,000 per person spent to support those living in the community.
For Rogers, the days inside Kiley are long, tedious and sometimes chaotic. It can be stressful, but Rogers told reporters that she uses soothing self-talk to calm herself when she feels sad or anxious.
“I tell myself: ‘You are doing good. You are doing great. You have people outside of here that care about you and cherish you.’”
This article is republished from ProPublica under a Creative Commons license. Read the original article.
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Survival of the Prettiest – by Dr. Nancy Etcoff
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Beauty is in the eye of the beholder, right? And what does it matter, in this modern world, especially if we are already in a happy stable partnership?
The science of it, as it turns out, is less poetic. Not only is evolutionary psychology still the foundation of our perception of human beauty (yes, even if we have zero possibility of further procreation personally), but also, its effects are far, far wider than partner selection.
From how nice people are to you, to how much they trust you, to how easily they will forgive a (real or perceived) misdeed, to what kind of medical care you get (or don’t), your looks shape your experiences.
In this very easy-reading work that nevertheless contains very many references, Dr. Etcoff explores the science of beauty. Not just what traits are attractive and why, but also, what they will do for (or against) us—in concrete terms, with numbers.
Bottom line: if you’d like to better understand the subconscious biases held by yourself and others, this book is a top-tier primer.
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Should You Shower Daily?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I read an article that daily showering is “performative” and doesn’t really give any health benefits, what do you say?❞
We looked to find the article you might be referring to, and this seems to be about a BBC article that was then picked up, rehashed in fewer (but more sensational) words, and widely popularized by the New York Post (not the most scholarly of publications, but it seems to have “done numbers”).
Here’s the BBC article:
BBC | There’s no need to shower every day—here’s why
Looking for the science behind the “Experts say…” claims, none of the articles we found linked to any new research. One of them did link to some old (2005) research:
We also see (in the dearth of scholarly research to cite), a Harvard Health article being cited quite a bit, and this is more helpful and informative than the flashy news articles, without requiring to read through a lot of hard science.
To summarize, Harvard’s Dr. Shmerling says daily showering can:
- Cause/worsen dry skin
- Make skin more permeable to pathogens
- Upset our natural balance of bacteria that are supposed to be there
- Weaken our immune system
Read in full: Harvard Health | Showering daily—is it necessary?
But what if I like showering?
Well, don’t let us stop you. But you might consider using less in the way of shower products. We wrote about this previously, in answer to a different-but-related subscriber question:
10almonds | Body Scrubs: Benefits, Risks, and Guidance
PS…
Handwashing, though? Most people could reasonably do that more often:
Would you like this section to be bigger? If so, send us more questions!
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How Aging Changes At 44 And Again At 60 (And What To Do About It)
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As it turns out, aging is not linear. Or rather: chronological aging may be, but biological aging isn’t, and there are parts of our life where it kicks into a different gear. This study looked at 108 people (65 of whom women) between the ages of 25 and 75, as part of a longitudinal cohort study, tracked for around 2–8 years (imprecise as not all follow-up durations were the same). They took frequent blood and urine samples, and tested them for thousands of different molecules and analyzing changes in gene expression, proteomic, blood biomarkers, and more. All things that are indicators of various kinds of health/disease, and which might seem more simple but it isn’t: aging.
Here’s what they found:
Landmark waypoints
At 44, significant changes occur in the metabolism, including notably the metabolism of carbs, caffeine, and alcohol. A large portion of this may be hormone related, as that’s a time of change not just for those undergoing the menopause, but also the andropause (not entirely analogous to the menopause, but it does usually entail a significant reduction in sex hormone production; in this case, testosterone).
However, the study authors also hypothesize that lifestyle factors may be relevant, as one’s 40s are often a stressful time, and an increase in alcohol consumption often occurs around the same time as one’s ability to metabolize it drops, resulting in further dysfunctional alcohol metabolism.
At 60, carb metabolism slows again, with big changes in glucose metabolism specifically, as well as an increased risk of cardiovascular disease, and a decline in kidney function. In case that wasn’t enough: also an increase free radical pathology, meaning a greatly increased risk of cancer. Immune function drops too.
What to do about this: the recommendation is of course to be proactive, and look after various aspects of your health before it becomes readily apparent that you need to. For example, good advice for anyone approaching 44 might be to quit alcohol, go easy on caffeine, and eat a diet that is conducive to good glucose metabolism. Similarly, good advice for anyone approaching 60 might be to do the same, and also pay close attention to keeping your kidneys healthy. Getting regular tests done is also key, including optional extras that your doctor might not suggest but you should ask for, such as blood urea nitrogen levels (biomarkers of kidney function). The more we look after each part of our body, the more they can look after us in turn, and the fewer/smaller problems we’ll have down the line.
If you, dear reader, are approaching the age 44 or 60… Be neither despondent nor complacent. We must avoid falling into the dual traps of “Well, that’s it, bad health is around the corner, nothing I can do about it; that’s nature”, vs “I’ll be fine, statistics are for other people, and don’t apply to me”.
Those are averages, and we do not have to be average. Every population has statistical outliers. But it would be hubris to think none of this will apply to us and we can just carry on regardless. So, for those of us who are approaching one of those two ages… It’s time to saddle up, knuckle down, and do our best!
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Also, if you’d like to read the actual paper by Dr. Xiaotao Shen et al., here it is:
Nonlinear dynamics of multi-omics profiles during human aging ← honestly, it’s a lot clearer and more informative than the video, and also obviously discusses things in a lot more detail than we have room to here
Take care!
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Is there anything good about menopause? Yep, here are 4 things to look forward to
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Menopause is having a bit of a moment, with less stigma and more awareness about the changes it can bring.
A recent senate inquiry recommended public education about perimenopause and menopause, more affordable treatments and flexible work arrangements.
But like many things in life the experiences of menopause are on a continuum. While some women find it challenging and require support, others experience some physical and emotional benefits. These are rarely reported – but we can learn from the research available and, importantly, from people’s lived experiences.
Here are four changes to look forward to once you reach menopause.
1. No more periods or related issues
Menopause is considered “complete” 12 months after the final period of a woman (or person assigned female at birth) who previously menstruated.
Perhaps unsurprisingly, the benefit at the top of the list is no more periods (unless you are taking hormone therapy and still have your womb). This can be particularly beneficial for women who have had to manage erratic, unpredictable and heavy bleeding.
At last, you don’t need to keep sanitary protection in every bag “just in case”. No more planning where the bathroom is or having to take extra clothes. And you’ll save money by not purchasing sanitary products.
There is also good news for women who have had heavy bleeding due to uterine fibroids – common benign gynaecological tumours that affect up to 80% of women. The evidence suggests hormonal changes (for women not taking hormone therapy) can lead to a reduction in the size of fibroids and relieve symptoms.
Women who suffer from menstrual migraine may experience an improvement in migraines post-menopause as their hormonal fluctuations begin to settle – but the timeframe for this remains unclear.
For some women, no more periods also means more participation in social activities from which they may have been excluded due to periods. For example, religious activities or food preparation in some cultures.
2. Getting your body and your groove back
Throughout their reproductive lives, women in heterosexual relationships are usually the ones expected to be proactive about preventing pregnancy.
Some post-menopausal women describe a re-emergence of their sexuality and a sense of sexual freedom that they had not previously experienced (despite contraceptive availability) as there is no longer a risk of pregnancy.
A participant in my research into women’s experiences of menopause described the joy of no longer being child-bearing age:
I’ve got a body back for me, you know, coz I can’t get pregnant, not that I haven’t enjoyed having [children] and things like that and it was a decision to get pregnant but I feel like, ooh my body isn’t for anybody now but me, people, you know?
For women who have chosen to be child-free there may also be a sense of freedom from social expectations. People will likely stop asking them when they are planning to have children.
3. A new chapter and a time to focus on yourself
Another participant described menopause as an unexpected “acceleration point” for change.
Women told us they were more accepting of themselves and their needs rather than being focused on the needs of other people. Researchers have previously tracked this shift from “living for others” to “a life of one’s own”.
Some women find the strength of emotions at this time a challenge, whereas others find their potency can facilitate liberation – enabling them to speak their minds or be more assertive than at any other time in their lives.
4. Increased self-confidence
A new sense of liberation can fuel increased self-confidence at menopause. This has been reported in studies based on in-depth interviews with women.
Confidence boosts can coincide with changes in career and sometimes in relationships as priorities and self-advocacy transform.
Life on the other side
It can be hard to think about what is good about menopause, particularly if you are having challenges during perimenopause – but these can get better with time.
In cultures where women are valued as they become older, women describe themselves as positively contributing to the community. They find they gain power and respect as they age.
We need to work towards more positive societal attitudes on this front. Our bodies change across the lifespan and are remarkable at every stage, including menopause.
Yvonne Middlewick, Nurse, Lecturer & Director of Post-graduate Studies in the School of Nursing and Midwifery, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What Happens To Your Body When You Plank 1 Minute Every Day
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Planks improve strength, flexibility, balance, posture, reduce chronic back pain, lower blood pressure, and enhance physique. But can we really get benefits from just 1 minute per day?
To the core
The benefits that can be expected, according to the science cited in this video, include:
- Within 2–3 weeks, daily planking of just 1 minute per day activates deep core muscles, enhancing balance, which helps in everyday tasks and prevents muscle imbalances.
- Strengthening core muscles through planks also helps alleviate lower back pain, with research supporting its effectiveness within 3 weeks.
- Posture is important for good health, and planks align the spine and hips, improving posture naturally, which also helps alleviate back issues. So, there’s a good kind of synergy to this exercise.
- Of course, many people exercising have the goal of a more toned body; regular planking leads to a toned core, sculpted shoulders, and leaner legs.
- For those who care more about mobility, though, planking enhances flexibility in hamstrings, feet, and toes within 4–6 weeks.
- Anything else? Yes, isometric exercises like planks are highly effective at reducing blood pressure, and, counterintuitively, more so than aerobic exercises.
The video also looks at a study in which participants did 20 minutes per day instead of 1, which predictably also significantly improved strength, endurance, flexibility, and reduced body fat.
However, another study cited gives the stats for just 1 minute daily, and that was not even a whole minute, so much as 30 seconds hold, 1 minute rest, 30 seconds hold—and still showed very good improvements.
For more on all this, plus links to three studies mentioned in the video, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Isometric Exercises That Are Good If You Have Osteoporosis (or if you don’t, but the point is, they are safe and beneficial for people with osteoporosis)
Take care!
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Tranquility by Tuesday?
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I Know How She Does It: How Successful Women Make The Most of Their Time
This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…
Laura’s 7 Keys To Productivity
Key One: Plan your weeks on Fridays
You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!
Key Two: Measure what matters
Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.
On which note…
“Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).
Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.
We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:
Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android
Dr. Greger’s Daily Dozen @ Nutrition Facts
Key Three: Figure out 2–3 “anchor” events for the weekend
Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!
Key Four: Tackle the toughest work first
You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.
Here’s one:
“If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”
Top Productivity App “ToDoist” has an option for this, by the way!
Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)
10almonds Tip:
“But what if something’s really important but not as pressing as some less important, but more urgent tasks?”
Simple!
Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.
Repeat each day until the important-but-not-urgent task is done!
The 10almonds Team
Key Five: Use bits of time well
If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!
- Use those few minutes before a meeting/phonecall!
- Use the time you spend waiting for public transport or riding on it!
- Use the time you spent waiting for a family member to finish doing a thing!
All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.
Key Six: Make very short daily to-do lists
By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up
Key Seven: Have a bedtime
Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!
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