Blue and Beautiful

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“How are you feeling today?”

“A little blue.”

“What’s wrong? Cheer up!”

“Nevermind…”

***

Most people who work in a healthcare settting have a fairly caring heart. Most of us don’t want to see anyone suffer, but invalidating someone’s feelings isn’t going to help much either. Nobody is expecting us to keep every single person on the unit happy and smiling at all times.

Just listen. Just be there. As much as possible, support the individual’s desire to share and accept his/ her feelings in a safe and healthy manner.

After all, a little bit of blue can be beautiful.

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“You Don’t Understand…”

Whether we are willing to admit it or not, our clients are probably right.

The feeling of being misunderstood or that nobody understands (Note that these two are different!) is probably MUCH more common than we’d like to believe.

In a perfect world, we have the job we currently hold because we happen to be good listeners that truly understand.

Well, the world isn’t perfect.

In a perfect world, I would have caught it and steered us back on track immediately.

Didn’t I just tell you the world isn’t perfect?

Besides, we can’t control how they feel or perceive things.

Over the years, I have had “You Don’t Understand” dished out to me in a garden-variety of ways. They were not pretty most of the time (Thankfully, I’ve never been shoved against a wall for that reason…yet) but these moments of “outburst” could be “productive.” In a way, it was better than having someone nod incessantly while feeling more confused and alone than ever.

Perhaps I will never understand. Perhaps you don’t understand what you’re trying to understand either. Perhaps it doesn’t matter whether I “really” understand or not.

My goal is to show you that not everybody will freak out or run away when you try to express your frustration, disappointment, or hopelessness (Well, unless a chair is coming my way or you are aiming for the window…)

We can’t always afford months of silence before rebuilding what was lost. Long-term care settings and family relationships sometimes give us that psychosocial context to “try again.” In outpatient settings, the window of opportunity is much smaller.

I hope there’s still time for us.

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I Want to Live

There is something in the air to tell us summer is near. This is the time of the year when people want to live– to laugh, to love, and to laugh some more.

Some will live, others will not. Sometimes we think someone’s time is up. The next day he bounces back again…

Time after time, never failing to inspire.

***

He asked me for some fairy dust, because I was the one with Pixie hair. This was the closest to a magic wand I could find–

I told him it’d be a perfect gift to his wife. The both laughed.

Perhaps he will live through another summer, through another anniversary.

Who knows?

 

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Low Maintenance

It’s been a year since one of our residents died. She’s not the first and definitely won’t be the last. Every single one of my clients has taught me something special but it’s my brief encounter with this individual that drove home the importance of paying attention to “everyone.” Sometimes we become so focused on “putting out fire” that we forget about those who are “low maintenance.”

Just because they are always sitting there quietly doesn’t mean they ought to be the last ones to be served every time. Just because they never complain doesn’t mean they aren’t hurting.

I wish I had been a better advocate, even though it wouldn’t have changed the fact that her time on earth was up. I did try to fight harder since her death. I hope it’s made her proud to realize that it’s kept history from repeating, at least for a while.

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Accommodate or Segregate?

We’re putting on a musical about breaking down the wall of segregation in a theater fully-equipped to welcome any patron. We have accessible elevators and ramps, places to “park” wheelchairs, special hearing devices for those who need them. We even had volunteers sign on stage in one production last winter. The irony is that backstage some people were whining about “those in wheelchairs” or “those old folks” who “were really slow to get to their seats.”

My grandmother is in relatively good health for her age, but she doesn’t move as swiftly as an 18-year-old these days. She tries to make sure she sets aside extra time if she were to go to a show. She doesn’t want to hold anyone up. When I was working at a facility, we used to bring residents in a wheelchair to an activity first for the same reason, even though it meant they had to wait patiently for a much longer time. I am not saying that there aren’t people who choose to “abuse” the “privilege” that comes with their health limitations but there are also many others out there who don’t.

While we may be thinking that our society is being very “accommodating” to those with “special needs,” we seem to have forgotten that a good number of these individuals are acutely aware of the “trouble” or inconvenience they may bring, to the extent that they’d rather give up certain opportunities. Convincing my grandmother to go to a show or travel with me was at times more challenging than participation in the event itself. More often than not, individuals with health limitations are the ones who are the most “accommodating.” After all, it is expected of them; they don’t get credit for being “considerate.”

When I was a child, people in a wheelchair or with physical limitations were hardly visible in the “real world,” let alone being in a theater. Times have changed, or so I thought….

Some theaters have special shows for certain “vulnerable groups.” Logistically, it may be easier to bring in all the physically and mentally “challenged” patrons at the same time. In practice, this seems to further encourage segregation. It clearly took more than striking down the “Colored” bathrooms to bring people of different skin colors together. It will take more than just the infrastructure to break the barriers created by physical or mental disabilities. Years of research suggests that actual social contact that involves working towards a common goal may be the most effective. One of the very few things I liked about my elementary school education was how students with special needs were “mainstreamed” into “regular” classrooms. While this might not have been the best for us academically, it certainly had taught us something very important about “harmony in diversity.”

When I went to see “Peter Pan” last Fall, I was surrounded by a group of very noisy kids. In front of us were adults with some “behavioral challenges.” Some of them were fairly loud during the show, but not physically threatening. Not only did the actors and audience not seem to be bothered by it, they actually tried to embrace it as if it’s part of the show. Nobody was asked to leave. Nothing turned violent. It might have been a little “disruptive” at first but it worked out in the end. I reckon things don’t always end this perfectly. It was an uplifting experience no less.

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“Mental Disability”

According to the World Health Organization, disability is a multifaceted concept that encompasses the interplay between personal attributes and environmental factors. Based on the social model, when appropriate modification and support is available, an individual with a different level of physical or psychological functioning may remain “functional,” if not highly “successful.”

When working with individuals with chronic or progressive health issues, other “team players” don’t always look at certain personal attributes the way we do. Particularly in the case of “mental disability,” we become the “annoyingly naive” people who are “wasting” our time and effort advocating for a “lost cause” sometimes.

I am sorry that despite years of treatment and supportive services, my otherwise non-psychotic, non-violent client who takes all of his psychotropic medications as prescribed remains initially “rude” and “sarcastic” whenever he deals with new faces and stressful situations. I, too, find it challenging to work with the resident who is very narcissistic and at times verbally hostile. But wouldn’t it be ethically and morally dubious if we gave up handing her the pills she needed just because she was “difficult” 90% of the time? What if she’s only difficult 75% of the time? Where do we draw the line, especially when she actually wants treatment?

As a society, we have made some progress in making “physical disability” a little less challenging in the past few decades. When it comes to “disability” sustained by cognitive, emotional, and personality issues, or the more “invisible” forms of disability, I am not sure if we have accomplished as much. Instead of attempting to change every single personal attribute that we don’t like, perhaps we ought to consider what healthcare providers could do to make things easier for the individual? I don’t want to justify anybody’s rude behavior but if we have already identified the situation or interpersonal style that usually triggers hostility, maybe we could at least try to better prepare ourselves mentally and behaviorally?

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The Way Home

Disclaimer: It’s all fictional, based on my personal experience, imagination, and observation over the years.

***

It wasn’t because Kayla was only five that she couldn’t understand her mother. Kayla thought that sometimes her mother simply wasn’t making much sense.

Take this morning as an example. When Kayla asked her mother why Grandma was living in that big pink place, her mother explained that Grandma was sick.

“But I don’t have to live in a big pink place when I am sick! I stay at HOME with Teddy and Bunny. And you and Daddy always come and read and sing to me until I fall asleep.”

Faye, Kayla’s 13-year-old sister, interrupted, “No, Kayla. Grandma is REALLY sick.”

“But Dr. Bob said she could go home once she’s stronger!”

“Well, that is her home now.” Kayla’s mother said matter-of-factly.

“No, it isn’t! I remember her house. It is small but it smells like roses!”

Faye rolled her eyes and said, “You’ve only been there once or twice. You can’t possibly remember!”

When her mother kept quiet, Kayla persisted, “Mommy, can’t we take her home? Our home?”

“That’s enough!” Faye shoved her little sister aside. “Last time you saw Grandma you got so scared you ran away. We’re not taking her home!”

“Hurry up, kids! You don’t want to be late for Sunday school!” Kayla’s dad waved from the car.

***

Kayla actually liked going to that big pink mansion. Her sister Faye said it was “de-la-pi-da-ted.” Although it was old and it had a funny smell to it, Kayla liked the frogs by the pond and the cornfield nearby. It was very pretty.

Most importantly, Kayla wanted to see her grandmother. She was not sure how long it had been since their last visit, but it was long enough that she finally had to ask her mother about it. Kayla didn’t understand why her mother always behaved strangely when she asked about Grandma.

Kayla loved her mother a lot. Sometimes she wondered if she would still love her mother a lot when her mother was her grandmother’s age.

“Mom, these are for you!” Kayla handed her mother a bunch of paper carnations after Sunday school.

“They are beautiful! Did Mrs. Wilson teach you how to make them?”

“No. I taught everyone! Mrs. Wilson wanted us to make something for Mother’s Day. Grandma showed me how to make flowers out of toilet paper last time, so I showed the other kids.” Kayla grinned.

Kayla’s mother held those flowers closer to her chest, “Thank you, sweetie. I am proud of you…”

Something was wrong. Kayla noticed the startled look on her mother’s face as her voice suddenly trailed off. That’s not the look one would expect from a supposedly proud mother.

“Mommy, can I send some flowers to Grandma?”

“Mommy? Are you listening?”

When they got into the car, Kayla’s dad commented on those flowers. “Good job, little girl!”

“Grandma taught me how to make them. I want to send some to her.”

Glancing at his wife and then his younger daughter, Kayla’s dad spoke in a soft, hesistant voice, “Maybe you can bring her some when we go see her next week.”

“We’re going there next week?” Faye removed her headphone and frowned.

“We’re going to see Grandma on Mother’s Day!” Kayla was the only one who seemed to be excited about it.

(To be Continued…)

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