Viona Williams doesn't like to complain. It's just that things can go wrong. She has problems with her colon. Her thyroid acts up. Arthritis grips her arms and legs.
But her biggest worry is her boy. At 42, Tyrone has the impish, open smile of a youngster. He has the loping gait of an adolescent, the life experiences of a middle-aged man and, when frustrated, the emotional responses of a young child.
"I am over 60, and I worry about him being out in the streets," said Mrs. Williams, a retired desk supervisor at the Enoch Pratt Library. "I worry because I don't know how long I will be here and how will he be taken care of if something happens to me."
Tyrone is mentally retarded. He is among the hundreds of middle-aged and older developmentally disabled Marylanders who will need a new home in the near future.
Thanks to improved medical care and better living conditions, men and women with Down's syndrome, cerebral palsy, mental retardation and dozens of other types of developmental disabilities are living longer than they did a few decades ago.
But the blessings of longevity present a challenge to public policy makers. In just a few years, the already strained state social service system will be stretched beyond capacity.
Many older adults, who have not received social services because they lived at home, will need residential care. Others, who had been helped by the state to live on their own or in group situations, will need more intensive care.
It's a problem that reverberates nationwide.
"We are at pre-crisis right now," said Dr. Edward F. Ansello, director of the Virginia Center on Aging in Richmond. "People with lifelong disabilities who might have died in mid-life are now surviving to older years in unprecedented numbers, and we don't have any public policy to deal with [the problem]."
Dr. Ansello, formerly associate director for the Center on Aging at the University of Maryland, notes Maryland was one of the first states to try to tackle the problem.
Since 1986, the state's Developmental Disabilities Administration has employed a specialist to develop and coordinate services for this growing population.
But earlier this month, Nelson J. Sabatini, director of the Maryland Department of Health and Mental Hygiene, warned of an imminent crisis. He said state programs, ranging from job training to residential care, currently aid 12,000 developmentally disabled people. Another 6,500 are on a waiting list for services and, of these, 1,400 are in a crisis situation. The crisis becomes an emergency, as 300 cases are expected to do this year, when a parent or guardian dies or becomes unable to care for the child.
