Ummmmmmmmmmm I'm finally going to bed

Ok well it is almost 1am and I just finished my SOAP notes….today has been a very long day. I just want y'all to know that I replaced my ink cartridge this morning, and the black ink is running low already, because of how much stuff I've had to print in the last 12 hours, all for things due Monday or Wednesday. That's a lot of frikken ink & paper, yo.

One more day until conference!!!!!!!!!!!

You're Not You

Ummm comments I need help with?

58th is better than 59th…

update on my aughness

Ok. it's 3:15pm. I've been working for four hours and have  finalized all things fieldwork, cut down/printed journal, spent hours on Well-Elderly references and editing etc, and now I'm going to get ready to hit Target and a shoe place. When I get back, I plan to do nothing but work on SOAP notes for rest of note, interspersed with random chores. Tomorrow I need to just focus on packing and everything! Brooke, Meg, and I leave ridiculously early Tuesday.

Final day of fieldwork :)

Final Day, Day 10, of my final Level I fieldwork, in Geriatrics, at an Alzheimer's Day Center.

This was probably one of my quietest days. First of all, good news – the lady who was unresponsive at the end of Thursday ended up eventually responding and was okay, no ambulance needed.

In the morning, MsL, a talkative little woman, decided she wanted to sit with me/socialize. Unfortunately, my FixxyLady was in an extra talkative mood, and came over and monopolized the conversation, much to MsL's chagrin. When we ended up in a room for current events, FixxyLady would not be quiet, so I took her to the art room. On the way, MsD decided she wanted to join us. FixxyLady and MsD are exact opposites in looks and I hadn't really encountered MsD before, so I wasn't quite sure what to expect. I set up three rocking chairs facing the big glass windows (it rained steadily all day long), and then got babies for FixxyLady and MsD. We sat there and rocked and watched the rain for, literally, hours. We talked too of course. FixxyLady would say her random things and MsD was wonderful at talking to her normally. She was well aware that the dolls weren't real, but played along for FixxyLady's sake. MsD was quite with it in many ways, although she repeated her same thought every few minutes – Look at that rain. I sure could take a nap. I love napping with the rain. Look at how high those trees are. I remember when they were just tiny buds.” x 100. It was nice though.

At one point, when talking to FixxyLady, I asked her something overly complex, according to all the Alzheimer's books I've read recently. As her mouth struggled, I said “Sometimes it is hard to come up with an answer, isn't it” and she said brightly “Yes, ansy-pantsy!”. LOL. I laughed and so did she, it was so adorable.

During the afternoon, we had two ladies that were especially agitated regarding wanting to wait/look for their caregiver to get them. No amount of persuasion would allow them to relax. I asked for permission to drag a table somewhat near the front door, so that I could sit down with those two ladies and tell them we were right where their caregiver would see them, and still get them to do something besides wander. I got the tables/chairs set up, just 3 chairs, and then immediately MsR and MsE took over two of them…I was chagrined. I asked if they would consider moving because the table was set up for special reasons but one of them got grumpy and the other one said she was there to help me. I bit my tongue. lol. So I just dragged over more chairs and we all sat down.

I once again got out the pipe cleaners because they are pretty and fuzzy. I sorted them by color and handed one of the twisted ones to my agitater, MsY. I asked her to try and untwist it for me because I was having trouble. She obliged. Since MsY typically does nothing but watch and/or wander, I was glad she was doing something. I started twisting two different colors of pipe cleaners under the table in easy to fix ways, and then would incorporate them into her stack without her realizing. So she ended up with a large stack of twisties to unravel while I sorted. We chatted and had a nice time. The PCAs were impressed since MsY is hard to handle in general. But the only reason she is hard is that MsY requires one-on-one loving and that is something she can't get in a group. MsY is adorable and her smile makes me melt. She was convinced she still worked in a doctor's office and was ready to get back to work.

The other agitater, MsT, was not willing to sit down. She mostly wandered and looked upset. She had a bunch of fake Monopoly money clutched in her hand. At one point she sat down with us for a while and I asked her for her hand, but she refused to put the money down. She believed it was real money.

One of the PCAs let me know that one of the ladies “boo-booed”, as she put it, in the trash can instead of toilet the other day. It's fascinating how the brain works and confuses objects, huh.

My nonstop talker man who can occasionally state a single sentence, hugged me and said “You're in good shape” before lapsing into his random stuff. My other lady who appears like like females a lot, kept on adjusting my collar, touching my necklace, touching my hair, rubbing my arm…it wasn't overtly sexual by any means, but I was like ummmmm….do I stop her? Does it matter? I didn't really know the proper response.

My poetry lady really liked the Shel Silverstein poems I brought her, all of which are amusing within every line. She doesn't appear to have all her reading comprehension intact by any means, but there is some form of subconscious comprehension as she would laugh at some of the absurdities. Which is exactly why I picked his poetry.

There is something called anosoagnosia, that is mercifully a common symptom in dementia/Alzheimer's. It basically means the person is unaware of their own mental shortcomings. This is a blessing in some ways, because it's heartbreaking for the participants who DO understand their brain is deteriorating. One lady said faintly to me, “I don't understand why I can't find the right words” and I told her, “I'm sure you're tired. We all lose our words when we're tired”. She nodded.

When I left, I told all the participants I was just going for the weekend, because I realized it would be too hard to explain I was leaving and probably they'd forget my existence by Monday anyway. Those who were higher-functioning already knew I was only here two weeks. A few wanted to exchange phone numbers and I promised we would the next week. I look forward to going back after next week's AOTA conference, even if none of them remember me. I feel like even if they don't technically have any real recognition of me day to day, that the feelings of comfort I give some of them stick with them enough that deep down they associate me with kindness. Maybe that's arrogant, I don't know, but it did seem like the ones I spent a lot of time with got more and more comfortable with me over the course of two weeks.

I really love babies, but I was surprised at how much I enjoyed working with patients with dementia. It's FASCINATING to see what parts of their brain function and how their minds compensate for discrepancies. I plan to keep visiting as frequently as I can. 🙂

Oooooooooh goodness gracious today will be an occupational dooozy

So…yesterday was a fun day, but now it's time to stress out!

Here is today's to do list, it's pretty whiny:

1. Not hold babies 🙁
2. Write a ton of SOAP note stuff due tomorrow. A lot more work than I realized, oopsie doopsie
3. Finalize well Elderly Project due tomorrow including type in all the references APA style, I'd rather slam my fingernails in a door and then rub lemon and salt into them, and then hang upside down for six hours. And I'm not a drama queen.
4. Put final entries in blog journal, then cut down my blog journal to smaller size to hand in tomorrow (it's supposed to be handwritten, but you know what? I have too much to do – I'd rather get a few points off than spend hours handwriting something. Sorry. “Oh, I wanted to help you all with this important task, but actually I need to be laboriously copying my typed journal into a handwritten one, because spending hours of my time copying is a really great master's level thing to do, so sorry, I can't help you!” I know the point was to just handwrite in the first place, but homie with a blog and atrophied handwriting muscles don't play like dat…)

5. Find out if anything else is due tomorrow beyond what I said above, and if so, repeatedly slit my wrists with a paper clip, emo-style.
6. Go through my seventy emails to make sure I deal with the important ones asap before leaving for conference
7. Inform my grandmother that her plans to see me in Long Beach at AOTA conference will not work out, and be guilt-tripped (I'll be back in June for weeks!).
8. Make sure that the hawaiian punch powder I snorted up my nose last night by accident doesn't disintegrate my septum.
9. Start packing.
10. Go to Target across town to buy some cheap tops because I have lots of nicer pants but very few nice tops.
11. Go to Designer Shoe Warehouse further across town to buy some comfortable black shoes with no heels and no scuffs.
11.5 Fill up gas tank
12. Wonder why I have procrastinated on all these issues.
13. Participate in a special chat room meeting tonight regarding communications and the ASD meetings, coming up at AOTA conference.
14. Clean my messy house because somehow it gets messy DAILY?
15. Feel guilty about not exercising.
16. Call my daddio to check on him since he is having some medical issues, boo!
17. Scream and rip my hair out because I have too much to do in a single day. Cry.
18. Just kidding on #17.
19. Well, kinda.

Thinking out loud here….
Ok…I'm gonna start with fieldwork journaling and cutting that down, since I do best starting with easier stuff. Then I'll finalize well Elderly. Then hit Target/DSW/Gas station. Then come home and work a lot on SOAP notes. Do everything else during breaks of SOAP notes writing since I'm betting it will take me many many hours. AUGH.

::Deep breathing:

Wooo

Today was my final day of fieldwork. I loved my experiences. It's 2:43am so I better go to bed instead of sharing them. I had a wonderful visit from newly 18-year-old Sarah and her date, post-prom, from midnight to 2am, so I'm thinking I'm going to go to bed instead of writing a blog entry! It was fun. 🙂 I could go hold babies tomorrow but I think I'll wait until Sunday so I can catch up on sleep. After holding baby dolls so much for the last few weeks, I need me a real baby! LOL

I better get ready for AOTA Conference too! Funnnnnnnnnnnnnn 🙂

Good night….

Poker chips….

Yesterday I had one participant, Ms. M, who really just wanted to focus on waiting for her husband. She seems very kind and “with it”.  I pulled out poker chips used for Bingo, to try and legitimately sort them out, while spending time with her. She decided she'd help me while she waited. Sorting by color was no problem, but then counting (which was really not needed, but a way to pass time) – went very awry, and it was really interesting. I tried to explain we could stack them in tens, and she could do that – 10, 20, 30, 40 etc. Yet she wasn't willing to let them get put in the bag once counted – she felt each stack was separate and needed it's own place. While I was away hunting for ways to separate them in order to keep her happy (she was stubborn), she decided that in fact, each stack was 25. And then somehow it became a 100, so she had decided we now had 1,000 chips instead of 100. I just went along with this. I had to go get grocery bags and tissues and wrap each stack individually for her. Later, once out of her sight, I had to unwrap them again to put them in the bag together. If it had just been her, this wouldn't have been so hard.

However, another participant, Ms. E, decided to join us, and woo-ie is she interesting. She couldn't do the sort by color, or follow the simplest instruction, even though she is a nice person who can handle a normal conversation. She somehow, as far as I can tell, decided that somehow we were just kind of trading around chips so that there could be a pile for her to take home versus the normal pile. She kept mixing up colors which was irritating Ms. M. Plus another participant, Ms. G, decided to help, and she first put them in stacks of 10 and I was like yay, she knows how…but I glanced back a minute later and there were now stacks of 5 and such. Trying to keep all three of them happy when all three of them were wrong and were critical of each other, was HARD. I had to do things like slip bags aside when backs were turned, quickly think of ways to let something happen the way the person wanted it done, explain away errors, etc. I was worried about the bag of chips that Ms. E had decided were now hers. I kept an eye on her, waiting for her to let the bag go because I knew she would forget it once it was out of her sight. Luckily one of the PCAs managed this, and Ms. E never realized. That's one really nice thing – you can “fix” things without upsetting the participant, with a little cleverness.

Ok. So. I finished my Well Elderly Project, minus just basic editing of typos, and fixing references. I helped finalize Draft 2 of our Tai chi Paper FINALLY (it's my fault it took so long to get back out), I finished the basic Communications Proposal for an Assembly of Student Delegates proposal…

Today was Alzheimer's until 4pm, Virginia's at 430 to 5 to discuss stuff and return Alzheimer's books…5 to 610 was at Sarah's working on Tai Chi, 630 was Bingo, and then 745 to now (past 10pm) I've been at OTS Kerri and Brent's house along with a first year DPT student, Shannon, who is my new best friend even though she doesn't know it yet. I've been working on my Tai Chi final and blog posts while they played Settlers of Catan. A game I'm really, really bad at. Speaking of things I'm bad at, I totally believed there were flying penguins….grrrrr

Moving on, Now I need to focus on my initial eval + three SOAP notes and getting ready for Conference next week, as well as basic finalizing of everything…

Things are lightening up! I've been staying up late trying to get things done and feeling overwhelmed, but I'm starting to feel better. I need to figure out what to WEAR and pack for conference, print out the itinerary, and decide what sessions and such I am most interested in.

If any of y'all are going and want to meet up, pleeeease let me know. So far I'm gonna try to meet up with Emily and Chris of AOTA awesomeness (and by meetup, I mean, get within 20 feet of them, lol). Plus meet with Linda R, who moderates the Gerontology Special Interest Section Listserv thing. Plus um, well, anyone who says anything. 🙂

Good night!!!!!!!!!!!!!

B I N G O

Tonight I volunteered in an Assisted Living Facility, helping with Bingo – mostly just walking around and glancing at cards and primarily just being the prize gopher. I enjoy the people a lot and it was definitely interesting to compare Bingo in the Alzheimer Center vs Assisted Living. The AL people needed very little help – maybe just pointing out a number the person had overlooked.

On the other hand, I had NO IDEA that there were so many ways to mess up Bingo. I've been flabbergasted at some of the things I've seen. I'm not ridiculing the participants, just pointing out that there are more ways than you can possibly imagine, to have things not go as planned.

1) Ask repeatedly whether color of the chip (casino chips to cover item), mattered. [ I tried to fix this by sorting chips but they re-integrated them, grrr].

2) Stack like 15, 10, 2, 3, whatever you feel like, on the item.

3) Cover every single item with a casino chip right away, and then spend the rest of the session just listening. (This is surprisingly common/popular).

4) Cover items appropriately, but then, when a new item comes up, move chips to see if that new item happens to have appeared under a chip for something else).

5) Cover items that remind you of things.

6) Cover random items.

7) Pick up Bingo card  (thereby losing all chips) to look on the back to see if an item happens to just be on the back. Repeat. Repeatedly.

8) Take everything off card to examine card.

9) Sit there.

10) Put chips down passively based on where the PCA points you to place the chip.

11) Skim for items, but almost always overlook it.

12) Not have the item, and loudly announce this, implying the card is defective.

I truly love working with patients who have dementia of varying severity. I'm not making fun of them with the above list. It's just truly amazing how you can think there is only one way to do something, only to be proven wrong in many creative ways. You definitely have to be able to think quick on your feet, and to have flexibility. Instead of getting irritated when a person plays wrong, just let that person play wrong – it doesn't harm anyone and it keeps that person happy.

Oooh so that reminds me. Ok, new blog post.