CARE PARTNER

 

The ''CARE PARTNER''

 

---During my time spent working in the ''helping'' profession, I was asked, ''What part of my story are clients interested in hearing?'' This question was seriously posed by one of the psychiatrists who sincerely wanted to know. My answer was not well thought out, at the time, and I wish to convey the following.

---Clients or Residents are not interested in your story unless it has some bearing on there own situation. By this, I mean, they want to know if the person in front of them (psychiatrist, ''CARE PARTNER'' or whathaveyou) is able to know what they, themselves (the resident/patient,) are going through. Will they be understood? So, the provider tells his story and communicates to the resident the amount that he knows of himself and of ''life in general,'' and the relationship between the two. .                                                                                                                

---The ''care partner'' brings his own understanding, from his arsenal made up of ''where he's been, his story, which leads to the 'care partners' own level of self-knowledge and his/her ability to communicate this.'' It must be remembered that each ''resident-care partner'' relationship has its own unique differences, so what works with one resident may or may not work with another.

---What always works is increasing the self-knowledge of the resident. We want to increase his ''arsenal,'' also. We can help him with his self-knowledge and how he sees ''life in general.'' We help with his communication skills and help him articulate how he sees his relationship to this ''vision'' of himself and his ''new'' situation.  We try to increase his relationship to his ''creative-self'' and his ''sense of oneness'' with all things and people, trying to increase his/her relationship with ''life in general'' and ''existence,'' Itself.

---We want to be sure we are not just passing along our own set of hang-ups and neuroses. So, when I say ''life in general,'' be very sure that your own ''vision'' is not tainted. That you see things and understand things ''clearly'' and you are basically happy and bring a sense of well-being to the table. Be honest with yourself and be responsible. Half-truths and misconceptions are not what the ''resident'' needs a whole lot more of. In fact, these very things, probably, have a lot to do with the reason why this person is seated before you. It surely has much to do with his ''Frustration.'' Be Well.

 

ORIGINALLY WRITTEN IN MARCH, 2006.

JOKE!

''RESIDENTOLOGY 101'' - Frank's Dilemma

 

 ''RESIDENTOLOGY 101''

Frank's Dilemma

 

---Recently, Frank A., had a dilemma in his life. Frank, in case you don't know him, has a robust Irish brogue and a presence that fills a room. One of the  reasons that Frank is at Laguna Honda is that one day he acquired a fever, and lost his eyesight in the process.

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''He's Blind''

 

---One of the ways that Frank communicates is in  writing notes to his friends. Frank's dilemma was one in that, being totally blind, the writing, itself, was hard to read. He would print in big, block letters trying to be clear, but as soon as the pen left the page, the problems would begin. Being blind, he would put the pen back where he thought it belonged, but it always was NOT in the correct spot. The reader ALWAYS found reading Frank's notes a challenge, at best. Even his children.

---Frank was determined to be heard along these lines. Writing notes and communicating his ideas, were very important to him. Thankfully, Frank was heard...and was hooked up with Occupational Therapy. Gina D., is his therapist. It took a little time, but, the improvement is there. The before-and-after of his writing is, comparatively, like day-and-night. It is so much clearer and easier to read. The squeaky wheel GOT its grease. It was ALL viable. Frank's onetime dilemma, is now a Real Success.  Frank was heard and taken seriously. He can, now, leave that frustration behind. He can, again, communicate with his notes. Frank + the Residents'/Patients' wish to congratulate Occupational Therapy and Gina D., for all their efforts. Thank you. Take Care.

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(From the archives.)

The STARFISH STORY-

TEACH HIM TO FISH!

Old Saying

---We can apply this old saying of Lao Tzu to what is now happening in our times and situation. We can substitute many things in the ‘’teach him to fish’’ part. It seems that making folks…’’self-reliant’’ is the call of the day. People without skills seem to be called to the wild.

---In our city…the NEW call seems to be much like the old TV show ‘’M*A*S*H’’ – patch him up quickly and send him back to the front lines. To make a long story short – many seem more equipped with psychological abilities to fight the Korean conflict then seem ready to do battle on the city streets.
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---I’m proposing a plan to address both scenarios, simultaneously, that makes those involved to be ‘’better people’’ on ALL sides of the equation. That would be to teach skills and abilities that increase the person in his realization that he is alright to begin with and he doesn't need someway to escape into being drunk or stoned or anything else for that matter. 
---Through this idea of teaching people skills + abilities that are relevant to our present society and can then open the doors to increased learning on the subject if so desired.  1] Folks would then be more self-aware and know themselves better THEREFORE less likely to wage war in the first place. 2] Folks would be taught to fish (taught skills) that help tame ‘’a Call of the Wild’’ DOWN TO ‘’a Call to Deal With the Present...Successfully.’’
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---I feel that a way to teach people to fish is to work with the decision-making skills. For years decisions were made for the resident (old + new hospital + living environment of both) depleting the resident/patients own decision-making abilities and skills in the meantime. Many folks are at LHH through addictions, excesses and other avoidable whatnot. Had they been taught which are the good berries to eat and which are poisonous berries…they, probably, would NOT have been here to begin with.
---I feel WE cannot strip folk of any decision-making skills that they may have had and send them out ill-prepared and naked…to face MANY or ANY of the newly evolving elements…as we see them today. I think a concerted effort to give the residents/patients some kind of skills and abilities makeover so he'll be better equipped to face what HE may face in the society at large. Any type of recitivism TOO SOON, just defeats the saving of money...that seems to be what we are trying to accomplish in the first place. Two negatives don’t make a positive in the way it is being done at present...in our city. It JUST increases the negatives.

''RESIDENTOLOGY 101'': Two Case Studies

Two Cases That Illustrate/Illuminate

‘’RESIDENTOLOGY 101’’

 

---I have two separate scenarios that illustrate the dilemma I stated in ‘’RESIDENTOLOGY 101’’. It is the situation that says: To Enjoy Living – We MUST Be Heard + Taken Seriously. If we are not heard and taken seriously we spend most of our time trying to be heard and taken seriously. When we feel that both are in place, then we can get on with the business of enjoying living.

CASE 1.] A woman who has bouts with dementia was looking for the elevator. Though I don’t have privy to her chart, I know that she wanders at times and doesn’t find her way back to her room. I’m sure that keeping her away from the elevators is a good thing. An important piece is that it was July 5 (Friday) and a skeleton crew only opens essential parts of the hospital.
---The woman was aware of a regular appointment she has on most Fridays. It was canceled due to it being the 5^th of July. She didn't know this. She wanted to go on the elevator to the appointment which had been canceled.
---She kept asking the duty nurse where the elevator was and she was always sent in a wrong direction due to her wandering history. The woman was becoming more labored, more frustrated and more confused in the process. I encountered her trying to find the elevator in my room. I said I’m heading there and noticed how out-of-breath she was. I was instructed not to show her the elevators and witnessed her being sent in the opposite direction.
(The Saving Grace) –  She showed up at the nurses desk with a ZEN Volunteer…who listened to why she felt she had to find the elevator. The charge nurse reassured her that her appointment had been canceled and that she was becoming frantic for no real reason. She was told, but may have forgotten. One could see how relieved that she was at the news. She, finally, could relax. She could enjoy life, again…as she felt her situation had been heard and taken seriously.

CASE 2.] This is a scenario that involved me more directly. I was to have a floater on this particular day. My consistent care nurse had not come to work. The medication nurse was, also, not someone who I work with very often. Floaters, in general, do not know your routine and as far as rapport goes, you, the patient do not know their quirks and how they do things.
---I have been spending much time in bed, lately, dealing with potential bedsores gotten from spending too much time in one position in my wheelchair.
---I was informed by the medication nurse of how things are going to be and at what times they are going to take place. I mentioned how inefficiently things are being set up for me and according to her plan...I’ll be jumping in and out of bed (which isn’t easy for me to do) all morning. I said that if she would just hear me out…we can resolve this.
---I told her that when she feels it is her time to talk she finds it easy to dictate her way of seeing things to the resident/patient. She always has NO problem in telling him that it is his turn to listen. When the tables are turned and it is now, the patient' turn to talk…she immediately begins assuming and wants to end the conversation. I indicated that I didn’t feel that that is at all fair. I said that I do not always just blow smoke and have nothing of consequence to say. I then told her of times that would work better for me.
---We touched fists and I hope that we have a new respect...born this morning. I (somewhat) felt heard and taken seriously…and (somewhat) could then get on with living. I didn't spend the morning trying to figure a way to be heard and taken seriously by her…I felt that she in someway heard how I was feeling about it all (in a clear + calm manner) and I was in someway now freer from worrying about it. It seems that we have a longway to go, but some progress was made.

---From a RESIDENT'S PERSPECTIVE…I think that these are important points. I think that many times the resident/patient is not heard and taken seriously. He has a lot to say, but is very out of practice or simply never has told his story. And, the best that he has even makes MANY of the 99% avoid him. BUT…when this communication happens,  the resident/patient involved begins to grow and flourish. AND THINGS ARE CHANGING. I just hope that the fragile momentum he has...can withstand the nay saying that seems to come with most things. Be Well.

The Importance of the Decision-Making Process

Decision-Making

(Many Residents)
 

---Decision-Making is a very important function of the growth of the human being. We make choices all-the-time. When we find ourselves in that ''choiceless awareness'' where ‘’BEING HERE’’ is the buzzword...that's great. When we are being in the present moment and, basically, going with that...we feel like we are on top-of-the world. This, UNFORTUNATELY, doesn't happen all too often.

---Another form of being WITHOUT decisions is in an institutional setting.  It is militaristic in its way. All of the decisions are made by the higher-ups…and it is our job (as the underling)…to follow them. Much of the time it is ‘’NO questions asked.’’ This has a very controlling element.

--The second scenario is the one that LHH uses. As much as there is a claim to being resident-centered and a shift to a ‘’Resident-First’’ and ‘’Individualized Care’’ mindset…it is only lipservice and NOT put into practice…to any great extent.

---The long and the short of it is that LHH, DPH, OSHPD and the fire Marshall and everyone else seems to have a say in our living situation EXCEPT those who, actually, inhabit the facility.
---It is written in the literature that making decisions is an important thing. It opens the door to self-knowledge and self-awareness. That begins the journey that is most important to good mental acuity which seems necessary for seniors... especially.

---He then has increased self-knowledge (self-esteem) and is on his way to actually make more sound decisions that lead to self - confidence, self-reliance and more autonomy in ones life. All he has to do (for the most part) is to learn to make decisions. Over time he gets better at it and is more able to think for himself and he will be more wholly rehabilitated than just a mere physical fix-up and sent upon his way. He is more able to live in a place that ''spit'' him out...originally, if that be the case.

---There is some kind of mindset in the whole DPH system that says, ‘’if the resident gets too comfortable living in a/the facility…that is in someway wrong.’’ In my way of thinking, if a resident finally feels comfortable with who he is and can make positive life affirming decisions that promote life and betters living, he will find himself in a better way to recover. He will probably choose NOT to live in a nursing facility when there is so much of life to be lived. But, alas…we find LHH still going in another direction. Someday, I hope that it learns that its residents have to be properly rehabbed where growth of the whole person is its main concern. I thought the class on Coping Skills of a few years ago was the beginning of a new era. Though it needed much tweaking...I was HOPING. That has gone by the wayside in its way, also.
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(Another Paul H-Passive-Aggressive RANT)