8 minutes
How we still make people smaller A lock, a standing order, and “for their own good” are how wellness becomes a smaller life.
What you’ll be able to do Identify the practical implication of “How we still make people smaller” and apply it to one live DHS decision connected to Health, Wellness, and Safety. Compare the responses to this question and explain your choice: What should happen before the work is locked? Document a next step for How we still make people smaller: Choose one live work object, name a change or formal escalation, assign an owner, and set the date the result will be reviewed. A latch can be a time-limited support. Without a review, it is the floor plan of a smaller life. The pattern is older than the protocol Minnesota wrote person-centered practice, HCBS rights, and positive supports into the work. Homes still lock food. Clinics still skip people who use devices. Teams still treat a prior incident as a lifetime ban. Direct support still gets blamed when the system left them with a rule that could not be followed on a Tuesday night.
This lesson is the history and the habit — so you can see your own plan in it.
In this lesson Name restriction-as-lifestyle as a practice, not a one-off.
See how trauma repeats inside “protocol.”
Separate a real medical order from a house rule with letterhead.
Spot the three usual shrinks: lock, delay, and blame.
How Minnesota named both duties Olmstead — Community is the point Living in the community includes the ordinary risks of a community life. A building that never has an incident can still be segregation.
245D — Rights and restrictions Licensing expects rights, dignity, and limits on coercive practices. A restriction has to be justified, not merely convenient.
Person-centered — Important to / important for DHS protocol: planning is not driven by professional opinion or the services we already run. Balance the life and the safety.
Positive supports — Not a hold as the plan Minnesota positive supports work treats respect, choice, and feeling safe as the floor — not after compliance.
Now — Culture of Safety After a critical incident, learn the system. Do not only redesign the worker. The same lens belongs before the incident: does this rule even work at 10 p.m.?
Three shrinks that still work The lock that never comes off A restriction after a scare. No fade-out, no skill-building, no date. The plan still says “person-centered.” The door says otherwise.
The delay dressed as assessment “After we hire.” “After the psych eval.” “After they show they can.” Some assessments are real. Using them as a queue is how a walk becomes next year.
The blame after the incident A direct support professional improvised at 10 p.m. because the plan was unworkable. The review starts with their character. Culture of Safety says start with the system. So does this course, before anyone gets hurt.
Health equity is also this room: who gets an interpreter, a device, and a clinician who waits. Mechanism: calm fills the vacuum If you do not put the life on the paper, the restriction will. If you do not name trauma, protocol will. If you do not date a review, last year’s scare becomes the house. Shrinks are usually omissions, not villains.
Myths that still sit in the room No incidents means they are well
It may mean they were not allowed to try. Wellness includes movement, relationships, food they chose, and care they can actually use.
Dignity of risk means we step back
No. It means we step in with support, information, and a plan — and we do not confuse a lock with a plan.
Behavior is the whole story
Pain, constipation, dental infection, trauma reminders, and no way to say “stop” get written as behavior. Health first, then the clipboard.
Trauma-informed is a training certificate
If new staff still enter without knocking, if holds are still the backup plan, the certificate did not land. Practice is what the body meets.
Same person, three readings Incident Compliance Well and safe
“They got burned. Lock it. Document it. Train staff on the lock.” The life after the incident is not in the sentence.
“When they follow the meal plan for 90 days, we can talk about cooking.” Wellness as a prize.
“Cooking matters to them. The burn was real. Here is support at the stove, a dated review, and what we will try before we ever lock the room.”
Which shrink is this? Community outings cancelled “until we are fully staffed,” month after month.
Choose a category Lock as lifestyle Delay as assessment Blame after A door latch with no fade-out and no review date.
Choose a category Lock as lifestyle Delay as assessment Blame after A DSP is written up after an unworkable night plan fails.
Choose a category Lock as lifestyle Delay as assessment Blame after “After the eval” is the only wellness step on the plan.
Choose a category Lock as lifestyle Delay as assessment Blame after Snacks locked for the whole house because of one person’s diet.
Choose a category Lock as lifestyle Delay as assessment Blame after Check matches Reset Next: the evidence of who is overprotected — and whose pain never makes the plan.
Put this lesson to work What you can change You control whether how we still make people smaller changes a live DHS process connected to Health, Wellness, and Safety or remains information on a page.
What to watch for The team completes the learning, keeps the same default, assigns no owner, and never checks who carries the burden.
Your next step Choose one live work object, name a change or formal escalation, assign an owner, and set the date the result will be reviewed.
Carry this forward A lock, a standing order, and “for their own good” are how wellness becomes a smaller life.
You control whether how we still make people smaller changes a live DHS process connected to Health, Wellness, and Safety or remains information on a page.
Choose one live work object, name a change or formal escalation, assign an owner, and set the date the result will be reviewed.
Completion is shown by a scenario decision, a knowledge-check response, a completed sort and a saved one-minute commitment.
Choose one live work object, name a change or formal escalation, assign an owner, and set the date the result will be reviewed.
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Previous lesson Next lesson Carry this into practice Safety that shrinks a life is not wellness — support the person to live, and still do the duty.
Return to the experience: What did you notice or try, whose perspective informed it, and what would you keep or adjust?
Participation and course completion in this program do not count toward DHS-required training credits unless management, a director, or DHS leadership expressly approves an exception.
