Up until recently (quit due to long-covid and being over-worked), I was a caseworker for adults with severe mental illness who lived in residential care facilities (RCFs). The RCFs are not 'old folks homes' but they would generally have some older residents. Average age was about 40-50s. I was a 3rd party and not associated with the various RCFs themselves, but rather an outside agency. I was also a mandated reporter, which put me at odds with the shady operated RCFs.

These RCFs in my region could best best be imagined as a 'retirement community'/ALF, but the people they would house would range from 18 to any age older. There would be people who were housed for mental illness, developmental disability, substance use disorder, and a lot of revolving door DOC (Department of Corrections) folks. Almost like assisted living meets half-way house, and the next step up is a level II locked facility.

Starting out, it was like walking into a whole other world. Walking thru privately (and often poorly..) operated RCFs was like stepping into another country and having culture shock. It's quite a different world when things like being screamed at, barked at, threatened, witnessing manic and psychotic episodes and aggression/fighting/violence erupting spontaneously become routine and feel mundane.

At any given time, I could have on my caseload 50+ year old adults who have the cognitive abilities and personality of children 8 - 14, and a psychopath who did 20+ years for murder. To be honest, the DOC folks were usually my favorite to work with. Their regimented lives and direction from authority figures made them easy to work with, but you've also got to be keen that they're not working you. But they usually had good senses of humor and we'd have fun working together. I was the person on my team given all the clients the other caseworkers were afraid of (my supervisor's words).

Once I was experienced, I remember always being amused by new people (whether my agency or RCF staff, outside nursing/home care, etc.) and witnessing their culture shock. The thing is, it wears off pretty fast. Well, that is if you're one of the type of people who stick around. Those positions have a very high turnover rate. I loved working with the population I did. I hated my eventually exploitative working conditions and collapsing healthcare industry that nearly killed me. I want to continue working in this field, but the healthcare industry in the US is such a nightmare right now....