Scenario #1: Each time you visit with Mehki’s family, you notice cockroaches crawling around the floor and on the walls. You’ve had to swat them off of Mehki and away from yourself many times and are becoming increasing concerned. Mehki’s mother says that there’s nothing they can do about the bugs because the neighbor has roaches too and won’t treat his apartment. Besides, she says, they’ve learned to live with it. Working in the home with the roaches, however, makes you very uncomfortable. What do you do?
Scenario #2: Sofia’s mother tells you that she thinks the family has bed bugs because they have itchy welts all over them. She found a bug in her daughter’s bedding and shows it to you. You do some research and find out that it does appear to be a bed bug. You’re nervous about continuing to visit the home because bed bugs spread so easily and you don’t want to bring them back to the office or your own home. Sofia’s mother asks for help with treating the problem but is unsure if they have the money to have the home professionally treated. What do you do?
A Challenging and Sensitive Issue
Providing EI in the midst of a bug infestation is challenging, even for the most experienced service provider. It is typically complicated by concerns for the child and family as well as for oneself. It can be a sensitive issue to address and a difficult one to solve. Some families, like Mehki’s, will have learned to live with the situation and might not want help treating it. Others, like Sofia’s mother, might be more eager for help but need support to manage the problem. Still others might be actively treating the problem themselves. Whenever a family is in this situation, we have a requirement to continue to provide services so must think creatively about how we work together. Here are a few thoughts about how to approach the two scenarios above:
- Talk with your supervisor and document your concerns.
- Talk with family, expressing your observations and concerns in a sensitive, nonjudgmental manner. If you have specific concerns related to the child’s health, share those. For instance, if a child has a history of breathing problems, sharing information about the detrimental link between cockroach dander and asthma might be beneficial.
- Ask the parent if he or she would like assistance with the infestation.
If YES: Have a conversation about what the parent has tried to do to deal with the infestation and what she thinks needs to happen. (Try using your coaching skills to gather information.) If you are the service provider, enlist the assistance of the family’s service coordinator if additional resources are needed to help the family treat the problem.
If NO: The service coordinator can also be a great help here too. He or she can talk with the family separately about the problem and offer assistance and more information. This can be helpful if a family is embarrassed or uncomfortable talking about the problem with the provider whom they see more frequently. (The opposite can also be true.) If the family does not want assistance, and the infestation is severe enough to be a health hazard to the child, it is possible that a referral to child protective services could be warranted. Not every infestation requires a CPS referral so share your concerns with your supervisor if you are in doubt.
In EITHER case: There’s still the issue of the service provider’s comfort with working in the home. Since we cannot refuse to provide a service because of a bug infestation, and we also cannot require a family to relocate services, we really have to work collaboratively with them to solve this problem. Perhaps services can occur at a relative’s home or another community location where the family spends time until the infestation is under control. Maybe the provider can explore other activities the family would like to do with the child or places they would like to go. These locations would be determined together rather than solely by the provider or program. Exploring multiple settings and activities the family does or would like to do is good practice anyway, and might be really helpful in a challenging situation such as this.
How would you handle either of these scenarios? What have you done when you’ve worked with families who have had similar issues in their homes?
If you are local system manager or supervisor, how do you support your staff when they are uncomfortable visiting homes where there are bug infestations?