Flight of the Sparrows

Mornin. Everyone all good? We were in bed a little late last night. I am so clumsy with remembering to take the medicine on time. We’re going to have to go back to the rule that it is done immediately as we come in the door. *Sigh*

We had a full day yesterday, but we’re not getting done with as much as we would like. I think this happens often when we get in late from our Dr. M. appointment. But, I LOVE my appointment with him first thing Monday morning, so I won’t complain.

The time continues to be going well under the helm of Sister Janice. Really the major things that are being accomplished by the Sisters is just to be a presence. There are just a few tasks they are directly responsible for. Sister Flo does the special service in the morning and Sister Janice helps with the lunches. Other than that ... and locking/unlocking doors, if I were honest, I’d say they resemble a couple of simply happy people "playin" in Sr's office :).

Yesterday, we had another talk as far as what is to happen when Sr. is gone. Mostly, I try to stay out of it, but I was a little nervous after hearing Sister Flo’s plans for her service and her decision to feed the clients each her homemade bread.  This is against a specific rule that Sister Tess has established. I needed to ask, "Umm, you are going to do all this before Sister gets back, right?" She really had a lovely plan ... just pretty sure Sister wouldn’t like it at all. Sister Flo correctly defended her position ... She basically said that since she was in charge and Sister gone, there was no reason not to do it the way she sees best. Shoot ... I for one, sure am not going to complain. Just have to deal with my own intimidation set in place by Sr. Tess. I also saw that they’d invited guests at the end of the night and were entertaining in the staff room. Thought ... just close your eyes, walk away.

Otherwise, it was a pretty busy time. We slowly turned the next page on our CARF project, but it seemed we were being called out a little more often than usual to be taking care of client problems. One of the individuals was having a particularly bad day and it seemed to have affected some of his peers. I worried about the DSP in that ... she just wanted me to take the individual out of the room, so he quit interrupting her session. On the surface that sounds fine, but with this kind of action ... she doesn’t learn how to take care of the "interruption," and she doesn’t realize the "interruption" IS the lesson sheshould be on. It’s not really about the task in front of her, but in taking care of the group member’s needs, which this individual definitely has. It’s a bad philosophy to just ignore the problems or schluff them off to someone else.

Again and again, we repeat. Most problem behaviors seem to come from the need for attention or an avoidance of something that is difficult or unpleasant. I think in this particular room there are an abundance of boundary issues that complicate the situation. People seem to be allowed to gripe and bully each other. There is a lot of anger and frustration being exchanged. Thing is ... I’m not in the room every day, so this is only a theory that has to be checked out. I believe the correct thing to do is going to be reestablishing boundaries, reasserting the DSP’s power and ability to maintain order, and deciphering where all this anger and frustration is coming from.

I did take the apparent instigator out yesterday. The first thing we did was establish our own boundaries with him. He’s a big guy and when I came into the room, he attempted to reach out and grab both of my arms. That was like a BIG no-no. I reasserted my space in holding him an arms distance away while saying, not to be touching people. I would have wished to say something more positive and affirming.  He was like way out of control. The next thing was for him to reestablish his own ability to control. So, we went outside the room and I had him doing the exercise where he was able to stop and start by cue while walking the length of the main hall.

He only went 6 lengths before he had broken into a sweat and he needed four stops for water and two to the bathroom to blow his nose. I stopped the timer when he took the longer break, so all in all the timer read about 10 minutes. We'll leave a reminder to check with his father in regard to diabetes testing.  He was following along with only 66% accuracy. His two most common problems were in wanting to stop before he was asked and wanting to start after turning around before the cue had been given. He did better with no talking during the exercise, but we give him about a minute and a half between each round to ask questions or make assertions. He has a great amount of difficulty with pressured speech.

We would start the conversational part by asking him, "How are you doing?" or "How do you feel?" He did ok for the remainder of the time between12:30 and 2:00, but then he was to join the rest of the clients in the multi-purposeroomand that was too many people. He had to be asked to leave the room. In these cases there is four seats in the hall, two immediately outside the glass windows to the Administrator’s office. I think that the secretary might have said something to him, because when she returned to her office, right next door to the Administrator’s, the individual thought she was calling his father. He gets very scared because he doesn’t want to upset his Dad.

Apparently, he went in the office and tried to wrestle away the phone from the secretary. Another Big no-no. Again, he was displaying boundary problems. This time, we chose to sit down with him and find out a little more clearly why the problem, or at least what was on his mind. Usually, the desperate need to talk quickly stems from having too much sugar in his system, but we couldn’t clarify when or how this occurred. We focused him on two tasks ... first, he had to wait in between each of his comments and questions for us to respond. The second thing was to slow down his words.

Given those two rules, he could say anything that he needed to, but instead of answering the questions directly, we returned his questions with the question, "What do you think?" Very surprisingly, he was able to respond with very good answers. His rapid speed in processing his thoughts was actually quite amazing. I was also impressed with the number and variety of thoughts he was having. It used to be that we’d go over the same questions/statements over and over again.

I think his mind is like a big puzzle with all kinds of locks and dams. When the thoughts/water build up too much (extra sugar/rain) they flood out into the community. Boundaries (locks and dams) need to be reestablished. And he needs to conclude or check the levels in each lock. This seems to occur after he gets past surface thoughts to be processing deeper thoughts that carry more validity and truly concern him. Could be simply a matter of validation. In reality he actually has thoughts that are fairly profound.

One of the other clients I talked to was the last one to leave for the day. As I had walked past him, he had walked into the Administrator’s office and appeared to be intimidating the Sister’s in his gestures and confused speech. This one we nickname the Gentle giant, but he was clearly riled up. Normally, the clients don’t enter Sr. Tess’ office without her invitation. So, we called him out and asked if we could sit down and talk with him.

He had builtup quite a bit of anger in regard to the other client. He couldn’t understand why he was acting so bad and he had problems with one of the troublesome female clientsin his room. Apparently, he didn’t think the staff had done right in fixingthe problems. This client is commonly thought to be lower functioning, because a lot of his world is abstract, but in this situation, he had read the room very efficiently and with heart AND, he’d gone a step further in figuring out how things should be. Was really quite proud of him and the ability to think coherently.

We asked him in the end if we could check out the things he was talking about the next day. He seemed very pleased that we might. So, that is the big agenda today. I think we need to do something concrete. Not sure what yet. This was the third group whose staff had brought up in the training that she was having trouble with behaviors in her room. You want to be able to help without overstepping boundaries.

I’m not sure but, we’re thinking we can step in without taking over control, but I think in the near future, she might need to see a direct addressing of boundary issues in the room. It would be done by paying very close attention to the words used by each of the members. The attention would have to be shifted back to staff rather than poking and jibing each other. Think this is possible :) Have to remember her group has the attention span of a sparrow!

Yikes! Needs to be going ... Have a good one!!