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Working with parents before they die keeps children out of the state's care afterward. It involves denial and death - and success stories.
By SARAH SCHWEITZER
© St. Petersburg Times, published February 11, 2001
TAMPA -- The little boy stares straight ahead, his amber eyes purposefully steered away from the gaze of the woman next to him.
Shyness propels him, but so does fear. Tears are hard to keep back when the topic is the mom you lost to AIDS on Dec. 6 and the dad you lost to AIDS on Dec. 5 a year earlier.
"You think much about mom?" the woman asks. The boy shakes his head. "You miss mom?" The boy nods his head. "You glad to be with Tim and Ann?"
This time, the 8-year-old turns his head and a smile creases his face at the thought of the aunt and uncle who have taken him in to their small South Tampa apartment.
Coreatha Larkins won't push him to confront feelings about his mom on this day. For now, she sends the boy skipping off to the corner store, a dollar bill in hand for chocolate doughnuts that will hopefully add weight to his slight frame, stunted by HIV and nearly swallowed by a polo shirt and shorts.
If the boy is a survivor in the wake of wreckage left by AIDS, Larkins is his rudder.
For the past two years, Larkins has charted the lives of nearly 45 children left behind when a parent has died from AIDS. It is a job that often begins at the bleak precipice when the illness saps a mother's energy.
The mother's denial must be overcome. Then comes the task of revealing what in many cases has been a terrible secret. And then, the real work: finding suitable homes for the children and securing legal clearance for the placements.
"The point is to keep them out of the state's care," said Larkins, 40, who works for the Family Enrichment Center, a non-profit agency.
Her services are in increasing demand. The number of women, particularly minority women, afflicted with AIDS continues to rise, even as the total number of reported cases in Hillsborough in recent years has fallen.
There were 66 cases of women afflicted with AIDS between 1981 and 1990 and 778 such cases between 1991 and 2000. Meanwhile, the total number of AIDS cases has fallen from 441 in 1994 to 205 in 2000, according to the Hillsborough County Department of Health.
Larkins' work is a unique commodity. Experts say there are only two other cities, New York and Chicago, where such services are offered.
Giovanna Welch, director of development at the Family Enrichment Center, said the idea hatched when she and others noticed a growing number of children enrolled in the center's respite program, which provides daylong child care for families impacted by AIDS.
Unlike the program in Chicago, the Family Enrichment Center determined it would not tell mothers what they should do with their children. Instead, it would present choices and let the parent decide.
"We came to it with the idea that you indicate to someone (that) we help you make the plans, but you steer this." Williams said. "You're the driver."
For Larkins, a Tampa native who handles the touchy situations of her job in a direct but unobtrusive manner, the position is an extension of earlier work.
She worked for the Department of Children and Families in Pinellas for seven years, investigating complaints of abuse in foster homes and later training parents in adopting special-needs children. She began to work at the Family Enrichment Center in 1997 as an adoption specialist and, in October 1998, shifted to working with AIDS orphans.
She lost her father when she was 7. But it is her 76-year-old mother, with whom she still lives, who propels her work, she says. "She was always very active in her church," Larkins said. "We always saw her doing for other people."
Larkins' work requires a mixture of pursuit and relentless nudging. Although they have sought out her services, clients often are not happy about needing them. She is a reminder of a sad trajectory, one that will end with the relinquishment of their children.
A recent afternoon found Larkins perched on a couch in a client's home watching the woman whirl in circles, searching for something but not finding it. The woman rummages through a hallway closet. Frantically, she peers behind dozens of figurines that dot shelves, hoping that the objects of her search somehow slipped between the angels' wings.
But the family photographs, the ones full of smiles, reminders of when she and her husband had faces flush and full and T-cells that had never before been counted, are nowhere.
The television blares; her son bellows for another bowl of Froot Loops. In the chaos, she despairs. If she can't find photographs, how will she find the right place for her children to live when she's gone?
"Come and sit down," Larkins beckons. "We need to work on your plan, for when the time comes."
Larkins draws answers from the woman. Her 18-year-old daughter, the woman says in a clipped, wounded tone, has agreed to adopt her three other children.
"Good," Larkins says. "You know this means that your children won't have to go to the state, and you can keep them together."
The woman jumps from the couch to begin the search for the photographs anew.
Worse are the visits to the homes of women near death but still refusing to explain the situation to their children.
"It's so frustrating, but I can't say anything," Larkins says as she leaves the home of a woman who refused entreaties to tell her 14-year-old daughter why the veins in her arms bulge and why sores pock her skin. "I'm bound by confidentiality."
Larkins says that of dozens of placements she has made the past two years, none has collapsed, a testament to the value of early planning.
Tim and Ann Boyd are one example of such success, she says.
The couple took in their nephew after his parents both succumbed to AIDS, a condition the couple learned about when the father died. The boy has been with them for a year. He calls them Tim and Ann, not Mom and Dad.
"I want that until he's more secure in knowing that I'm not going anywhere," said Ann Boyd, 28, a homemaker with two children of her own.
Larkins worries that the boy has suppressed his feelings about his loss. It could surface later, she tells the Boyds during a visit, and cause problems when he is a teenager. She urges the Boyds to allow him to take part in group counseling. The Boyds agree to think over the offer.
Larkins wanders into the boy's bedroom. Two items sit atop his dresser: his AIDS medication and a framed photograph of his parents.
Larkins is taken aback by the photograph. "That's his mother?" she says quietly, for once revealing the pain of witnessing the destructive path of the illness. "She didn't look anything like that when she came into the office. Wow."