The ACCS Program Director oversees the clinical, financial and administrative operation of a GLE/SIE program that is designed to promote independence, community integration and full functioning of adults receiving mental health services. Based out of a Group Living Environment (GLE) or Supported Independent Environment (SIE), the ACCS Program Director will create a helping environment in the residence in which all are welcome, respected and valued by upholding Vinfen and DMH policies, supervising staff and coordinating clinical services within the program. Keywords: mental health, behavioral health, developmental disabilities, intellectual disabilities, ABI, acquired brain injury, care worker, care giver, social services,...

As an Awake Overnight Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life.   Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living.      

The ACCS Lead Residential Counselor (IGLE)  provides direct service to adults with mental health conditions in a Intensive GLE (IGLE) residential setting. The Lead Residential Counselor helps persons served in the residences to overcome barriers to, and prepare for, living independently. The ACCS Lead Residential Counselor (IGLE) Implements Treatment Plan support interventions as assigned by the Clinical Program Director. In addition, the ACCS Lead Residential Counselor (IGLE) assumes administrative officer roles in the program to support the Program Director in performance of their duties and responsibilities. The Lead Residential Counselor also: - Liaisons with families as needed. - Supports Persons Served in obtaining and understanding medical and...

As an Awake Overnight Counselor, you will provide direct support to people with Brain Injury or behavioral conditions in either a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living. Additional responsibilities include nightly cleaning and filing. Keywords: mental health,...

As a Per Diem Day Program Activities Assistant, your direct care and instruction will support adults with intellectual disabilities, developmental disabilities or behavioral challenges to achieve goals, overcome barriers, and build life skills in a Day Program or Day Habilitation setting. In contrast to a traditional classroom setting, Day Programs serve as engaging professional care settings in which individuals can receive direct care, individualized therapeutic services and health services all while socializing with their peers for a part of the day. On a typical day, you may assist a small group of individuals at a time with varying levels of need through direct care and facilitation of rehabilitative activities. Your work may focus on...

As a Job Coach at Vinfen, you may work with people who have psychiatric conditions, intellectual and developmental disabilities, brain injuries, or behavioral health challenges to support their career goals. Job Coaches make a big difference in the lives of the people we support. You are a cheerleader, helping people strengthen their confidence. You are a teacher, helping job seekers gain skills that will help them succeed on the job. You are a mentor, helping people take pride in their work and achieve greater independence within their community. Your support and guidance will help individuals achieve goals, overcome barriers, and become more independent. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to...

As an ACCS Awake Overnight Residential Counselor in a Residential Group Living Environment, (GLE), you will provide direct support to people with psychiatric conditions in a residential Group Living Environment designed to assist in fostering independence. ACCS Awake Overnight Residential Counselors are vital to ensuring that Persons Served are able to receive quality services regardless of the time of day. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. In this role you will have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing...

  As a Per Diem Residential Counselor, you will provide direct support to people with Brain Injury or behavioral conditions in either a small group home or an individual living arrangements. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Per Diem Residential Counselors have a range of duties include administrating medication under the Medication Administration Program (MAP), implementing treatment plans, and assisting people with activities of daily living, such as household...

  As a Per Diem Residential Counselor, you will provide direct support to people with Brain Injury or behavioral conditions in either a small group home or an individual living arrangements. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Per Diem Residential Counselors have a range of duties include administrating medication under the Medication Administration Program (MAP), implementing treatment plans, and assisting people with activities of daily living, such as household...

  As a Per Diem Residential Counselor, you will provide direct support to people with Brain Injury or behavioral conditions in either a small group home or an individual living arrangements. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Per Diem Residential Counselors have a range of duties include administrating medication under the Medication Administration Program (MAP), implementing treatment plans, and assisting people with activities of daily living, such as household...

  As a Per Diem Certified Nursing Assistant (CNA), you can either assist in daily routine or episodic daily nursing aide care to adults with Brain Injury on a per diem basis. Your work will be in a clinically intensive program that is tailored to meet the needs of a unique specialized population who have been diagnosed with brain injuries and complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Per Diem C.N.A. duties include administering medication under the Medication Administration Plan (MAP) guidelines, assisting individuals to become more a part of their communities, and helping the...

  As a Per Diem Certified Nursing Assistant (CNA), you can either assist in daily routine or episodic daily nursing aide care to adults with Brain Injury on a per diem basis. Your work will be in a clinically intensive program that is tailored to meet the needs of a unique specialized population who have been diagnosed with brain injuries and complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Per Diem C.N.A. duties include administering medication under the Medication Administration Plan (MAP) guidelines, assisting individuals to become more a part of their communities, and helping the...

  As a Per Diem Certified Nursing Assistant (CNA), you can either assist in daily routine or episodic daily nursing aide care to adults with Brain Injury on a per diem basis. Your work will be in a clinically intensive program that is tailored to meet the needs of a unique specialized population who have been diagnosed with brain injuries and complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Per Diem C.N.A. duties include administering medication under the Medication Administration Plan (MAP) guidelines, assisting individuals to become more a part of their communities, and helping the...

  As a Per Diem Certified Nursing Assistant (CNA), you can either assist in daily routine or episodic daily nursing aide care to adults with Brain Injury on a per diem basis. Your work will be in a clinically intensive program that is tailored to meet the needs of a unique specialized population who have been diagnosed with brain injuries and complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Per Diem C.N.A. duties include administering medication under the Medication Administration Plan (MAP) guidelines, assisting individuals to become more a part of their communities, and helping the...

  As a Per Diem Certified Nursing Assistant (C.N.A.) or Per Diem Home Health Aide (H.H.A.), you will assist in providing daily routine or episodic daily nursing aide care. Your work will be based in a clinically intensive residential program tailored to meet the needs of adults who have either have brain injuries or behavioral cinditions in addition to complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Your duties include assisting person's served with ADLs (Activities of Daily Living) administering medication under the Medication Administration Plan (MAP)...

  As a Per Diem Certified Nursing Assistant (C.N.A.) or Per Diem Home Health Aide (H.H.A.), you will assist in providing daily routine or episodic daily nursing aide care. Your work will be based in a clinically intensive residential program tailored to meet the needs of adults who have either have brain injuries or behavioral cinditions in addition to complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives. Your duties include assisting person's served with ADLs (Activities of Daily Living) administering medication under the Medication Administration Plan (MAP)...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents'...

The Registered Nurse will assume overall responsibility for nursing and medical area of the Youth Community Crisis Stabilization (CCS) Program. The Youth Community Crisis Stabilization program is designed to meet the needs of individuals ages 13-18 who have behavioral health symptoms that require 24-hour per day care in an unlocked treatment setting. The Registered Nurse will oversee nursing and medication administration services, provide health promotion training and access to medical care for individuals receiving services. The Registered Nursing will work to support each individual's treatment goals using rehabilitation values, principles and techniques, including skills training to help individuals overcome barriers to living independently. The Registered Nurse will...

The Clubhouse Administrative Assistant will oversee the clerical and administrative duties within one of our Vinfen's Clubhouses for adults with psychiatric conditions. The Clubhouse Administrative Assistant will welcome clubhouse members and visitors as they come in and also maintain service, billing, utilization management, and program administrative protocols. The Clubhouse Administrative Assistant will also be responsible for: - Answering telephones and direct calls to proper party. Assist with phone messages as required. Check messages. Maintain corporate phone listings, as required. - Directing inquiries and questions to proper parties. - Maintaining the fax machine, send faxes as needed, and distribute...

The Director of Learning and Development leads the Training Department in the design, development, and delivery of training and employee development activities. Act as consultant to management regarding training and development issues. 

  As a RN Nurse Liaison, you will function as a nurse educator and consultant in collaboration with other clinicians regarding health promotion and maintenance, medication administration, and acute and chronic medical / psychiatric crisis management for persons served. - Functions in role of Medication Administration Program Consultant (as described in MAP Consultant description in Vinfen MAP Policy & Procedure Manual) to assigned sites. - Trains staff to receive MAC Certification. - Monitors program adherence to medication administration policies, procedures, and regulations. - Reviews medication policies and occurrence reports. - Performs regular reviews at site(s) regarding implementation of MAC. - Retrains staff...

As an ACCS Awake Overnight Residential Counselor (IMGLE), you will provide direct support to people with psychiatric conditions and behavioral health challenges in an intensive residential Group Living Environment designed to assist in fostering independence. ACCS Awake Overnight Residential Counselors are vital to ensuring that Persons Served are able to receive quality services regardless of the time of day. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. In this role you will have a range of duties include administrating medication under the Medication Administration Plan (MAP),...

As an Awake Overnight Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living. Additional responsibilities include nightly cleaning and filing.

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

The Senior Lead Executive Assistant will provide direct administrative and project management support to Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Analytics and Performance Officer (CAPO) by: managing schedules and arranging meetings, creating and preparing agendas, taking and producing minutes; creating presentations, documents, and spreadsheets;  tracking action items; managing calendars; managing communications with key external stakeholders, including state officials; making travel arrangements; preparing reports; and, identifying issues, conducting research, developing options/solutions, and providing advice and recommendations. The Senior Lead Executive Assistant serves as the primary contact for the...

  A Residential Counselor II provides direct support to people with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. He or she works together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAC), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. He or she also strengthen residents' connection to their community...

  A Residential Counselor II provides direct support to people with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. He or she works together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAC), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. He or she also strengthen residents' connection to their community...

  A Residential Counselor II provides direct support to people with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. He or she works together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAC), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. He or she also strengthen residents' connection to their community...

  As a Clubhouse Counselor I, you provide individual and group support to adults with psychiatric challenges in an engaging and active Clubhouse setting. Clubhouse counselors work in partnership with Clubhouse members to improve life skills and self-determination within the established skill building units of the Club, as well as in social and community activities. Clubhouse staff are generalists, meaning that anyone can help out any unit in the Clubhouse at any time. Staff should remain flexible, be aware of the larger picture of the needs of the Clubhouse, and make themselves available should anyone need support. The generalist role is one of the most important aspects of the Clubhouse ensuring that the Clubhouse remains focused on the big picture while assisting...

  As a Clubhouse Employment Coordinator, you will provide individual and group support to the members of the Clubhouse. Through assessment and development of Action Plan goals, you will work in partnership with Clubhouse members to improve life skill and self-determination within the established work areas of the Club as well as in social and community activities. Additionally, the Clubhouse Employment Coordinator will oversee and engage membership in employment components of the Clubhouse such as work units, transitional employment, supported employment, vocational training, volunteerism, and employment assessments. What is a Clubhouse? A Clubhouse is a day time operated community setting developed as a part of a proven international...

The HR Operations Administrator performs a variety of HR administrative and technical tasks related to the lifecycle of employment, including a regular data auditing, participating in and teaming with the HR Operations Coordinator functions, oversight over HR Coordinator communications with stakeholders, and escalation point for HR related matters. This role is responsible for performing data maintenance in Vinfen's modern human capital management system (HCMS) and related systems. Typical duties include assisting in employee onboarding, background checks, reviewing and approving employee changes, and electronic document management and personnel file maintenance including credentialling and TB testing. - Partners with recruiters, HR...

  The Program Director I oversees the clinical, financial, and administrative operations of specified programs. Ensure proper standards and regulations are adhered to as set forth by the funding sources. Ensure programs meet the quality standards and provide value to the public. The Program Director I has a range of duties including: - Direct and manage the activities of program staff. Hire staff appropriate to the position. Utilize staff appropriately with the goal of optimizing effort and achieving operational and financial goals. - Manage staff performance. Provide direction, training, and coaching; implement recognition and rewards programs; conduct performance planning and review sessions; provide guidance on career development. Responsible for...

As an Awake Overnight Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living. Additional responsibilities include nightly cleaning and filing.

Summary:The Restoration Center (RC) Nurse Manager leads a team of nurses and medical assistants in the provision of community-based services within a continuum of care, for people impacted by mental health, substance use and co-occurring disorders. The Nurse Manager provides supervision to the nursing team, collaborates with the nursing/medical staff in all departments of the Restoration Center and CBHC programs, administers medications, coordinates medical care, takes vital signs, conducts risk assessments including assesses for signs of substance use withdrawal using, standardized tools (COWS/CIWA/CIWA-B) and assists the team with care coordination and discharge or transfer planning. The Nurse Manager is an integral part of the development and management of a model...

The ACCS LPHA Clinician promotes the full integration and functioning of Persons Served (PS) needed to  live successfully in the community. Performs clinical duties including intake, assessment, treatment  planning and clinical interventions for assigned Persons Served (PS), whether living independently in the  community or in a Group Living Environment or Supported Independent Environment. Responsible for  determining PS needs for rehabilitative services as required by Medicaid Rehab Option for outreach and  GLE/SIE PS. Directs the delivery of Treatment Plan interventions by Team Outreach Workers (OW) for PS.  Oversees treatment interventions of PS in assigned GLEs/SIEs. Mentors and models for OWs appropriate 

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

The Lead Residential Counselor, provides direct support to people with with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. He or she works together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. The Lead Residential Counselor has a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. He or she also strengthen residents' connection to their community by providing...

As an Awake Overnight Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living. Additional responsibilities include nightly cleaning and filing.

  As a Per Diem Residential Counselor (Developmental Disabilities), you will provide direct support on an as needed basis to people with intellectual and developmental disabilities, brain injuries, or psychiatric conditions and behavioral health challenges in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Per Diem Relief Counselors have a range of duties include administrating medication under the Medication Administration Program (MAP), implementing treatment plans, and assisting people with activities of daily...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

  A Residential Counselor II provides direct support to people with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. He or she works together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAC), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. He or she also strengthen residents' connection to their community...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MED), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents' connection to their community by providing transportation on outings...

  As a Residential Counselor, you will provide direct support to people with intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. Residential Counselors have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living, such as household chores and cooking. You also strengthen residents'...

  As a Program Nurse (R.N.), you will participate in the comprehensive assessment of physical health of the people Vinfen serves. Your work will be in a clinically intensive program that is tailored to meet the needs of a unique specialized population who have brain injuries, intellectual and developmental disabilities, or psychiatric conditions, and complex health needs. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives.   As an R.N., you will function in a direct care nursing capacity. You will consult with other clinicians regarding health promotion and maintenance, medication administration and acute and chronic medical/ psychiatric crisis management for...

As an ACCS Awake Overnight Residential Counselor in a Residential Group Living Environment, (GLE), you will provide direct support to people with psychiatric conditions in a residential Group Living Environment designed to assist in fostering independence. ACCS Awake Overnight Residential Counselors are vital to ensuring that Persons Served are able to receive quality services regardless of the time of day. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. In this role you will have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing...

As an ACCS Awake Overnight Residential Counselor in a Residential Group Living Environment, (GLE), you will provide direct support to people with psychiatric conditions in a residential Group Living Environment designed to assist in fostering independence. ACCS Awake Overnight Residential Counselors are vital to ensuring that Persons Served are able to receive quality services regardless of the time of day. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life. In this role you will have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing...

As an Awake Overnight Counselor, you will provide direct support to people with behavioral conditions as well as intellectual and developmental disabilities in a small group residential setting or an individual living arrangement. In your role you will work together with the people we serve, their families, friends, employers, and other support staff to transform their lives by either building independence skills or increasing each person's quality of life.  Awake Overnight Counselors have a range of duties including have a range of duties include administrating medication under the Medication Administration Plan (MAP), implementing treatment plans, and assisting people with activities of daily living.