Gabriella Ramos (not her real name) is a participant in the Adult Family Care (AFC) Program, a MassHealth-funded program designed to help elders and adults with disabilities maintain community living. In May, 2003, Gabriella was matched with care giver Maria Sanchez (also not her real name). Gabriella was excited to move in with Maria and quickly hit it off with Maria and her family.

Gabriella, who is now 54-years-old, has moderate mental retardation. She experienced sexual abuse as a child and is prescribed medication to control her psychotic disorder. Gabriella was born and raised in Puerto Rico and speaks only a few words of English. After her father’s death, Gabriella moved to Springfield with her cousin and his wife. Five days later, Gabriella’s cousin admitted her at the Springfield crisis center: Gabriella had not been taking her psychiatric medication, and she was acting delusional, aggressive and violent. Gabriella was referred to a local outpatient mental health center where she received medication and counseling. A year and a half later, Gabriella’s cousin moved away and Gabriella was enrolled in the AFC program.

When Gabriella arrived at Maria’s, she was facing not only the challenges of a developmental disability and an abuse history, but she was struggling to adjust to a new culture. Maria is bi-lingual and she was immediately able to translate for Gabriella. Living with somebody who shared her language, her cultural heritage, and who could help her adapt to American social customs was very helpful for Gabriella. After a few months, Gabriella had adjusted well to living with Maria. Her inappropriate behaviors, like asking strangers for gifts and magazines, had decreased. Finally, she had found a place where she belonged. Maria provided the structure and support that Gabriella needed to help her blossom into the person she is today: A healthy, active member of society.

The AFC program provides a daily stipend for care givers as well as monthly nursing and care management oversight. Some participants live with their own family members while others, like Gabriella, are matched with a host family. Participants are encouraged to remain active in their communities. Some attend day programs and some have jobs. Like many other participants who are appropriately matched, Gabriella entered easily into the daily routine of her host family and she now attends an adult day health program.

Gabriella and Maria travel together to places such as New York City and Mystic Seaport. In August 2006, they traveled to Puerto Rico. They rented a house and visited the town where Gabriella used to live. It was a healing experience. Gabriella was able to reconnect with her brother, and now Maria encourages her to have regular phone contact with him. Sometimes, Gabriella has flashbacks. Maria knows to expect this from time to time and she watches for the signs: Gabriella acts distracted and has restless sleep during the night, with occasional calling out. The flashbacks usually last about three days and then disappear.

Five years have passed since Gabriella’s arrival in Maria’s home. She is well known and well liked within their network of family and friends. Gabriella accompanies Maria to Christmas parties, birthday parties, and they often go out to eat together. Maria throws a party for Gabriella’s birthday every year. For her 50th birthday, over 40 family and friends attended. Every Valentine’s Day, Gabriella and her friends go to a local Chinese restaurant and exchange gifts. Gabriella also enjoys spending time with her respite provider, who knows how to cook Gabriella’s favorite Puerto Rican dishes. As Maria puts it, “Gabriella is loved by all, including her medical providers. Gabriella lives a full life. She is not just a person I care for. Gabriella has become part of the family. Hopefully, Gabriella’s life is enriched as much as those of us who provide for her.” As evidenced by her smiles and her words of affection, Gabriella loves living with Maria, too.

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