What Makes Me Happy

This is about a client I had when I first started this job. I may have reflected on this story before in my blog, so bear with me if it sounds familiar.

He had been in the system for years, and had previously been supported by a coworker who left for another job.  He was a young man with schizophrenia and developmental delays.  He lived with his family (who wanted the best for him) including his grandmother who brushed his teeth for him even though he could do it himself.  It is fair to say there was a lot of learned helplessness going on.  

I was a little more eager and a lot less experienced then.  This man was more ill than anyone I had worked with previously.  My normal tactics did not work.  We were down to real basics - getting him to remember who I was, and remember his appointments.  Our appointments consisted of me trying desperately to make some kind of conversation while he was more interested in watching soccer or getting me to take him out for pizza.  All the while granny is knitting in the background and making me hyper aware of my youth and inexperience.  

I don't remember what the incident was, but somehow he ended up in hospital.  The family and I worked with the doctors to get a med review and he was started on Clozapine.  While he was still admitted I advocated to get him in with our ACTT program (Assertive  Community Treatment team - a more intensive level of support than what I provide) and he was accepted, so I never really saw him after his discharge from hospital.

Until one day I was in the waiting area of a psychiatrists office with another client.  I recognized this man's sister and then he came out from his appointment.  He looked me straight in the eye and said "Hi Nectarine" and then proceeded on his way.  

That was it.  But it was so much!  This person, who had met me at the door with a blank face week after week, giggled when he couldn't remember my name for months over a year prior at this time had said HI and addressed me by name!  He now attends one of our drop in programs and I see him over there from time to time.  Every time this same thing happens.  He says hello to me the same way, and then walks away.  It's all I'm likely to get, but it's so much.  It makes my day every time.  

Will this client continue to recover?  Probably.  Will he recover to a level that other people find "normal"?  Probably not, but to me, all the work he and his supports have done is so worth it to bring this human being out of the bubble his illness and medications had put him in.  I'm grateful to have been a small part of it.

System Shock

The thing that never happens HAPPENED. The system saved the day!

Allow me to explain.

My client is on long-term disability from his job due to his mental illness. His wife works full-time at a fast food restaurant. They have had subsidized daycare for their 6 year old daughter for the past two years.

They received notice recently that their subsidy would end as of September, as their daughter will begin attending full day school. They asked me to call Children’s Services to advocate keeping the subsidy, as they can’t afford the full rates. Children’s Services explained to me that once a child is past the preschool age, and in full day school it is presumed that they do not require the same level of care, and the parent should be able to manage this. Apparently, this is policy. She said she had never heard of any exceptions being made. I kinda see their point, but have these people never heard of P.D. days? Winter and spring break? Summer vacation???? There are many days when the little one will not be in school.

My client is doing well in his recovery, but is not yet able to take care of his daughter by himself for extended periods. He has appointments with various therapists, doctors, clinics pretty much daily, and has difficulty staying awake for long periods of time and handling stressful situations.

So today, 3 days before they are to be cut off the Children’s Services worker calls me back. Apparently the department has just finished approving a new policy which states that approved disability leaves will continue to qualify for supports beyond preschool age, and this already applies to this family.

Hallelujah! We must have saved up some good karma or something. I was all set to do battle with the higher-ups if need be, but they pre-empted me! Any of you readers who work in or receive social services will know just how rare an event this is indeed.

Not bad for a Monday morning.

Circle of Care

Earlier this week I joined a client during a CAS (Children's Aid Services) intake interview. It took over two hours. I was the one who had called CAS in. She was aware that I was going to do so, and was more or less okay with it. She's had involvement from them before, and wants to get the help that she and her kids need.

As much as she's on board with using services and accessing supports, I still can't help but sigh when she starts signing consent forms and there are 7, 8, 9 or more of them.

There is a fine line between helping, and invading somebody's life. I fear that line fell closer to helpers number 3 or 4. Maybe 5, but definitely somewhere way before 10.

Facts and Feelings

"[Client] has a daughter [name] who is in the care of [client's] mother in Thunder Bay. [Client] reports having no contact with his daughter, and states that he does not wish to have contact. [Client] has indicated that he thinks she is being well looked after and does not wish to disrupt her life."

This man's wife committed suicide in 1999.  She had schizophrenia, as does he.  I suspect any reminders of her are just to painful.

Sometimes when I stop to actually read what I record in my notes it just makes me sad.

Telling

Written assessment answer from a client...

Alcohol: does drinking cause you any problems?
        Not mine, but other peoples around me.

The Snow Day that Wasn't

If your boss sends out an email on Tuesday warning of an oncoming snow storm and advising that if the schools are closed the office will be too, that should be taken as a definite sign that the office will be open on Wednesday. The warning email officially “jinx’s” the chance of a snow day.

Oh, it snowed alright. All night too. Just not quite enough to close things down. More than enough however to turn a 25 minute commute into a 75 minute heart attack.

On a happier (personal) note, my niece was born last night! Kiddo was excited because it was the day she picked in the baby poll. Apparently the whole family is doing well, and hopefully the roads will be cleared enough for us to go meet her tonight!

Stupid Stories from Work and from Home

#1 – Work

A co-worker – let’s call her “Kimberly” – was back to the office for the first day after her vacation. Kimberly had an appointment scheduled with “Jeremy J” at 1:00.

At 10:00, Jeremy J shows up to meet with Kimberly. He’s early, but she makes time to meet with him anyway. They sit for about an hour talking about the program supports she can offer, and the type of help that he is looking for. He's really enthusiastic and feels this is "just what I need!" They schedule a follow up appointment for the following week.

At 1:00, Jeremy J shows up to meet with Kimberly. Ah, wait a minute…you’re not Jeremy J, he was already here, and you don’t look a thing like him! It sinks in for Kimberly that she MET AND ASSESSED THE WRONG PERSON with a very similar name. We’re still trying to figure out how this happened, and now she has to do an assessment report for both and figure out just what we’re going to do with Jeremy J #1, since he hasn’t really even been referred to us! Welcome back Kimberly, vacation’s over.

#2 – Home

For some reason, AM decided that he really wanted Five Alive fruit punch at dinner. Dinner was only a short way away, so he put the can of concentrate out on the counter to thaw.

All three of us are hanging around the kitchen waiting for the vegetables to finish roasting, and AM decides that the juice is likely thawed enough to get out of the can. He pulls the little plastic tab and pops the metal top off, but the juice is still pretty frozen and doesn’t want to come out.

AM cleverly decides to hold the lid back on the can and give it a shake to loosen the juice so he can dump it in the jug. Somehow while completing this action (the details of which will be debated in the family for years to come, no doubt) the juice EXPLODES out of the can, landing on just about every single surface in our rather small kitchen, including a dollop on the kiddo’s head, and a good portion in my hair, clothes, and down my neck!

It took one dishcloth, two showers, and three times mopping the floor to (almost) clean up the mess. AM will forever be held responsible for the “Five Alive Attack!” (unless I come up with a better title. Anyone?)

Sibling Slip-up

When I meet clients for an intake assessment, I make notes on an unofficial “intake form.” It has prompting questions under headings like “medication” and “family history” with boxes giving me lots of space to write. I use it as a reference to complete the proper assessment on our electronic database later on. I often end up jotting things down in random boxes, as clients don’t always stick to the script.

So sometimes this happens:

Q: Are there any current family/marital issues?
A: brother, step-brother, step-sister.

Family Dynamics

So last week I received a referral from one of the hospital social workers for a new client. I called the social worker, because sometimes the client is still in the hospital, and we can meet them there. It tends to really increase our chances of a successful follow up.

This client had already been discharged, but the social worker gave me some additional background and his impressions of the client (patient in his case, I guess). He tells me that this client was recently diagnosed with schizophrenia. He’s a truck driver, lives alone, his family is all in the US, but they are very supportive.
His father is a psychiatrist. His sister is a doctor. The other sister is a social worker. His brother is a development worker.

And I can’t help but wonder how the onset of a serious mental illness would play out in the family dynamics. Is it more frustrating than usual for the family to feel like they can’t help him? More importantly, how will this affect the client? Will he feel that understanding and support from his family, or perhaps like a failure and an outcast?

I know that it is not unusual for families to be challenged or seriously disrupted by something like schizophrenia. Feelings of failure and disappointment crop up on both sides of the equation.

I know that most of us have someone in our network of friends/family/acquaintances who has a mental illness. I have people close to me who live with/have survived eating disorders, alcoholism, SAD and more.

This case just struck me as particularly potent.