One small step, one large leap...I apologize that this post is late. The story is still good regardless of the date!
On this day, I was working with a client who has severe dementia and is nonverbal, meaning she doesn't say more than a grunt or moan here and there. I had been working with her for two weeks at this point, mostly splinting, but today was the first time I did a feeding activity with her. It was early in the morning and my client was ready to eat. I had already splinted both of her hands, so the rest of the time we focused on seeing how much she would eat. Her appetite was spotty nowadays, according to the nursing staff. Normally, my client keeps her eyes closed, but today she peered out from beneath her eyelids to examine her plate for a few seconds before returning them to their caves. We were taught in school to lead your client through a situation when they have no sight. Even though my client still had hers, she obviously didn't use it very much and I wanted to make the experience as pleasant as possible and reduce the "shock" as much as possible. As the feeding session began, I would ask my client if she wanted eggs. No reply. I would ask if she wanted sausage. No reply. Finally I hit the jackpot -- would you like some oatmeal? My client peaked at the oatmeal, closed her eyes while simultaneously raising her eyebrows to signal she was willing to taste the hot cereal. I warned her it was coming and she slowly opened her mouth. Mmmmm... After that, I couldn't get food onto the spoon quick enough! By this point also, my client was no longer interested in her eggs or sausage, rather she only wanted the biscuit with jelly. I fed her nearly all of it and she was already starting to fill up. I had one last shot to get more protein into her stomach before she waved the white towel at me. Of course, with each bite I provided a prelude to the upcoming spoonful so my client was not caught off-guard by anything. Unfortunately, I made the mistake of switching out the jellied biscuits with a sausage and egg mixture -- boy, did she not like that! Her eyes flew open and her mouth turned into a grimace. She slowly chewed on the mixture, trying to determine whether to swallow it or spit it out. Not only was my mistake written all over her face, it was plastered across mine. I'm sure my eyes looked like saucers and my mouth formed into a hard line. After a moment, I finally told her, "I'm so sorry, I should have warned you I was switching it up. I messed up didn't I?" I looked down to get the napkin ready to put to her mouth to let her spit the mixture out when she replied, "You sure did." BOOM. And just like that, I was shocked that I got a response, but I was floored that she VERBALLY replied to my mistake. Aside from the nurses who worked with her 24/7, I was the first therapist to hear her make a verbal comment to someone in her current state. Talk about pumped up. I was STOKED that she even bothered to give me a verbal reply. Although it may not seem like much, it made me feel as though we were on a new level as student-practitioner and client. I was steadily building trust and rapport -- at least enough for her to verbally say something to me! Anyway. Back to the story. As I stared at her (in disbelief, of course), I told her, "It won't happen again." and yet again, she stunned me: "It sho' won't." O____O <--- literally my face Not only did she respond to me today, she responded to me TWICE in the same conversation! (Bonus: She didn't spit the food out either, woo!) Of course, nobody was around when all of this happened, but I definitely told everyone about it as soon as we cleaned up her food tray -- it was just too cool not to share it with someone! Once again, this may not seem like much, but when someone is selectively nonverbal (meaning they choose not to talk), then that is a major accomplishment to get that person to say a few words to you. It was encouraging and I hope to continue to build confidence and rapport with my clients every time I work with them. Even if it's unintentionally done. Stick around for more funny episodes from my fieldwork experiences! -Lauryn E. Hill, MOTS
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AuthorI am an occupational therapy student at The University of Tennessee Health Science Center in Memphis, TN. The purpose of this blog is to demonstrate competence in my graduate-level program through journal reflections pertaining to one of the four main competency areas. Through practice, I hope to become consistent at journaling so that I can help my future clients to the best of my professional ability. Archives
August 2017
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