Week 1 of my geriatric level I fieldwork COMPLETED

Today was day 5/10 of my geriatric Level I fieldwork at an Alzheimers Day Center…in other words, I finished my first week!

I realized I never fully explained how this place works. You walk in to a lobby and sign in. You take the patient to the giant room by pressing a button, and then help the patient find his/her name tag. Then the patient joins whatever is going on. There is one massive room plus several smaller rooms/areas, including one with a fish tank and one with a bird cage. They set up circles of chairs in these various crooks and have simultaneous events going on – one event is doing current events while another group is doing trivia or bingo or jingo or balloon ball or who knows. The biggest issue is noise level. Overall it flows smoothly and they try and do different things every day. They do breakfast, HOLY CRAP THE RAIN JUST SCARED ME HALF TO DEATH AUGH. Okay anyway, my heart is now beating ten thousand beats a second, okay so um, yeah, breakfast, then lots of activities, changing every 30 minutes to an hour, then lunch at 1230, activities, snack at 330ish, activities…And there is a TON of PCAs, I think the ratio is 1 to 4, so there is always a helping hand or a distracter or calmer.

Overall today was um, interesting, I guess I'd say. A little less ordinary in some ways. I kind of have some random stories so sorry if there isn't a lot of flow. I helped feed people, I helped people walk, I helped transfer people, helped weigh people, listened to people talk about things that made no sense, you name it. Helped pass out the food, get people to the tables…The only thing I don't do is help out in the bathroom. Mostly because I don't  feel ready, but also because I don't know these patients the way the PCAs do, as some of them tend to get combative in the restrooms. Since I don't have an OT to guide me and the point is to keep them calm, I think it's best that I not try to deal with that. The PCAs are very nice to me and help me with anything I ask about, but it goes without saying that they won't appreciate it if I go around accidentally agitating patients.

This morning a local preschool daycare came and I think it was impromptu, I don't know, but we were in a frenzy setting up. My nonstop talker/singer was obviously going to affect their singing, so I took him to the furthest corner of the very large room, near the birdcage. He did his nonstop talking although at one point he asked “How old are you?”. I was blown away by this because him being able to ask a question or say ANYTHING meant he had either been startled or had an INSANE amount of motivation. He told me he had a daughter named Bonnie that age before lapsing back into mumbling and singing. I think he really likes me (not in a bad way), but we've spent a lot of time together and I guess he feels safe around me.

So a few random stories…One of the things I think is silly is that there is this one woman who is ALWAYS worried about hunger. She asks for reassurance every few minutes about food coming. The food always comes to certain tables first, and the snack order happens to be opposite. People just sit anywhere, and I think the staff should work a lot harder to make sure she sits at those tables that get fed first, to save herself, the staff, and her seat-mates a lot of grief. That's one of those little things that actually makes a huge difference.

Let's see, what else. The anguished wandering lady is on medication that should calm her, but they didn't really work as expected. She was a mess today. She was so tired she was practically falling down as she wandered, and scooping up imaginary things on the floor, and muttering vulgar things about “knocking the *(#&(# out of …” etc. She is the only one there who truly breaks my heart. She lives in a world of anguish and despair and there is almost no way to ever reach her.

During a break, one of the PCAs was telling me how she got slapped in the face the other day, and how some of the people do occasionally get combative, especially in the restrooms, and do end up hitting them. Luckily nothing too serious, and since they don't have access to like, knives or scissors, so things are pretty safe.

One of the ladies I spend a lot of time with, who is a lot younger than many people there, appears to have some lesbian tendencies (although she was married at one time, according to the charts). She likes to hug and kiss a LOT, and put her arms around the girls. Today she had her hands on my sides and they were dangerously close to my :cough: breasteses, and I was like whoah nelly. One of the PCAs confirmed she'll kiss your neck or mouth if you don't watch out. lol.

I found some hand lotion that I used to do hand massage on a few people …I want to keep a small bottle of hypoallergenic hand lotion with me in my volunteer smock pockets next week so that as the opportunity presents itself I can spend some one-on-one time with participants touching them and giving them attention and learning more about them.

This morning, I walked into a room that was doing a session on current events from the newspaper. The PCA read “Today it is February 28th” and I said February?! And the PCA giggled because she had messed up, and one of the participants said “Honey, I think you and I need to change places. It is you that has this Allenheimers memory loss stuff.” lol

I realized on day 1 – but kept forgetting to share – that the tables are somewhat high and the chairs somewhat short. This means when the participants sit down, the table is practically at high-chest/neck level sometimes. At first I was puzzled, but it actually makes sense…it takes a lot less energy and a lot less mess to get food to your mouth if it's practically that high anyway. That's my theory at least. (They also wear little aprons backwards as giant bibs before eating).

There is one woman I haven't talked about before, who just wanders around silently. Her face is expressionless. She is a hoarder, and she'll hide things in her pants or put stuff randomly away somewhere. For example, I was in the art room when she walked in, and I watched her carefully. She picked up a small metal tray and walked around the room with it, and I saw out of the corner of my eye that she laid it down on the floor. When she left I went to collect it, and there was also a pile of badges there (it's kind of a spot where no traffic ever is). I had apparently found one of her squirrel spots, lol. It was interesting.  Oh and a girl found a clean diaper under a chair today, that that lady probably put there also.

Also, this afternoon, I implemented the first part of my art project. They have a big art room with lots of art supplies and huge glass windows overlooking the (currently barren) garden. I had Miss um, lets call her Marjorie, come with me to start decorating construction paper flowers and other garden-like scenes, to be taped onto the glass windows. She spent almost 2 hours in there. She was content and I learned a lot about problem solving and conversation by watching/interacting with her (she is one of the highest-functioning people there). I also was busy cutting up things to prepare it for people. I wanted to get a rudimentary garden scene up so that I could have people come in and see it and grasp it, so that we could work on making more flowers for it, or bugs or whatever, and also hot air balloons. It could be graded easily up or down, but honestly, even the highest functioners could probably not do much more than color in a flower, unless I was alone with them to really assist. This Marjorie made a star and moon and apple even after a lot of talk about it being a garden scene, so I think it's going to be a rather interesting garden scene, but you gotta start somewhere, and she enjoyed it. It took her forever to make these few items, but she was happy. I asked her about drawing at home and she said they didn&#3
9;t have any crayons. I told her they sell really cheap ones at the dollar store, and she got excited about that and said she'd ask her daughter to go this weekend and that she hadn't thought about the dollar store having them. That would be great as a leisure occupation for her at home. Yay!

I continued to get to know the people, and I really enjoy them. My nonstop talker clearly tried to get my attention quite a few times, and in the afternoon when I went over to him, he was clearly somewhat agitated and was wanting to do something with me. He ended up sitting down with me in a quiet corner…I actually tried to take him into the glow light room and he paused and said “We can do this here” and sat down outside there. I acquisied (sp?) but I was like ????. I just sat with him and had no idea what he was trying to get across to me. I normally hate noise, but for whatever reason, his nonstop talking/singing doesn't bother me. Unfortunately, my FixxyLady also wanted attention, and she is also high maintenance so I couldn't handle them both at once. It worked out in the end because a PCA took him away. He was talking about us doing something together, and I really couldn't understand. He seemed to want to go fishing together. I don't know. I said goodbye to a lot of people as I went and everyone is so sweet.

You know, while I think I would have learned a lot by shadowing an OT, I think in some ways I've learned more by NOT having anyone. By having somewhat of a caregiver perspective (basically being a mini PCA) while dealing with a population that was totally alien to me, I've gotten a lot of insight. I also love how easy it's gotten to completely lie to people (ie go along with what they say or ask). “Is my dog inside?” — “Yes of course it is, I just checked on it”. lol. I think what I love about these participants is that they are soooo random and frequently inappropriate, JUST LIKE ME! lol

I have many goals for next week including finishing up my SOAP notes, getting as many people as possible into the art room to work on the garden scene, gentle hand massaging as an interaction tool, writing up a list of basic things that could be easily changed to help things…etc. Honestly they do a pretty great job.

By the way, I got a comment tonight that said she always wanted to work in pediatrics but my posts were inspiring her to consider older populations. That meant a lot to me. I too only say I want to do babies, but I'm really enjoying these patients. I don't think I could handle nursing homes, but assisted living and/or day care centers like this one, are pretty awesome. I plan to drop by occasionally to visit with the people even after fieldwork. They could really use someone to just sit and listen and hold their hand and nod/go along with things. If you are looking for an informal volunteer opportunity, this could be a great one. Or if you have little kid groups that would love an audience to sing to or whatever…consider calling up adult day care centers.

So anyway I got off at 4pm, then went straight to go pick up my little 13 year old friend.We went downtown to Peabody Place (like a mini mall), where we played at the ridiculously overpriced Jillians game area. Or rather, he played and I watched. Then we got mint malts at Maggie Moo's. Then we walked to the river, down the steps and actually against the river, where he practiced skipping rocks, and I kept warning him not to get his feet wet. It was cold outside and it was a long walk. He, a typical boy, wanted to just skip rocks in the water and make logs drift. We then went to eat sushi, he got a ton of it and he ate it all. He ate raw fish and wasabi and anything, the little freak :). Then we got Baskin-Robbins (hello growing double chin). Then I rushed home to see if my Internet was still down (it was), because it was 8pm and I work at 9pm. I spent some time with tech support and THANK GOD, it was fixed. I told the tech dude I fell in love with him. I meant it too, at least that second. I have to say this – I hate Comcast with a passion and would like to see the company fry in acid, BUT, their wait time has been really short and their tech people nice, and I appreciate those aspects. It makes their ridiculous policies and high prices a little more worth it. ::vomits thinking about Comcast:: okay moving on

ANYWAY just finished working my shift…well 30 minutes ago that is. I need to get to bed, gotta be up early to hold babies! In the afternoon, I have plans with several friends, plus a lot of project work to do of course.

Gooooooooooooood night.

Mar 29, 2008 | Category: Occupational Therapy | Comments: none