Tuesday, March 31, 2015

Day Hab Changes


Over the past several weeks, Mom has noted that Lyn comes out of day hab in one of two moods.  Either the day has gone perfectly and she's happy as can be, or something went wrong and she's ready to explode.  

A happy day is a result of the day hab schedule being kept 100% with no variations.  If they were to go out, they went out to the originally planned location.  

An unhappy day is a result of a number of things such as the weather was too nasty for the originally putting to be kept.  The day could also become a challenge if another client gets into Lyn's face and starts telling her what to do.  There are two women who are known to do this.  The staff will intervene but are not always aware of it.  The day could become a challenge simply because all 40+ clients show up and Lyn becomes over stimulated.  

Unfortunately, the unhappy days are starting to out-number the happy days.  This is a pattern with Lyn and something we witnessed when she was still working and again at her last day hab.  At this point, we pretty clearly see this as originating with her.  Yes, the in-her-face clients are a direct challenge.  However, Lyn is no longer able to let things go.  She doesn't have the mental flexibility to accept a change in schedule or the ability to tell someone to back off.  If there's even a minor disturbance, she's fixating on it.  For example, her period started an hour before Mom was to pick her up one day last week and Lyn hounded a staff member into calling Mom "just to let her know."  There was no accident or soiled clothing to worry about but Lyn couldn't move on until Mom was informed.  

So now what?  Something needs to change because the unhappy days lead to a miserable afternoon for both Lyn and Mom.  Lyn is routinely asking if she can stay home and not go.  The issue really isn't with the staff or the day hab facilities.  The issue is with Lyn and the changes resulting from her Alzheimer's.

One of the two clients who get into into Lyn's face will no longer be attending.  (To be clear, they have not been singling Lyn out.  They just want to be in charge of everyone and everything.  I don't believe this is malicious.  It is just not something with which Lyn can deal.)  A 50% reduction of that tension will help.  

Mom reached out to Lyn's behavioral therapist to get a second opinion of what's happening at day hab and what is needed for Lyn.  The assessment of them both is that perhaps Lyn should attend fewer days of day hab.  Lyn will soon switch to attending day hab three times a week instead of four or five.  Additionally, the therapist conducts her visits with Lyn at day hab and will work with the staff to help them be more aware of Lyn's body language as well.  If they notice she's getting stressed or over stimulated, they may be able to direct her into one of the many spaces designated for quiet activities and out of the busier rooms.  

As Mom and Lyn were telling me this over the weekend, Mom clearly stated several times that this also means there are going to be quiet, at home days.  Lyn should not expect to go out every day that she stays home with Mom.  If they need to go out, they will but Mom's not going to create an excuse to go out every single day.  Lyn surprisingly didn't object to this.


No comments:

Post a Comment