Category Archives: Diary

I Found New Day Activities!

It’s becoming a cliche but I really want to write more regularly. Instead of actually writing, I’m looking at journaling guides on Amazon and buying some of them. They’re cool, but if you don’t actually sit down to write, nothing will flow. I started a private journal again on Monday, but didn’t get beyond that first entry. That’s usually how it goes. In that sense, it’s surprising this blog runs for almost five years already.

A daily journal could really benefit me, as I tend to omit many of the seemingly less and even more important things in life on my blog. For example, I never shared how I’d been doing looking for new day activities. Guess what? I’m starting at a new place soon!

I went to tour several day activities places in an area about 20km from my home on June 11. They’re with the same organization my current place is with but in a different area. I think I shared already that the more work-related places weren’t suitable, but a day activities center did sound suitable. It happens to be the closest by my home out of the four places in that area, which is good because of transportation.

On June 25 and 26, I spent the mornings there at the highest-support group. The first day, I was quite overwhelmed, but the second day was better. The staff are all really nice and accommodating. The next week, I spent each morning at the place and loved it. Granted, it was a lot quieter due to some clients being off, but I reasoned I’d probably get used to the noise I’d endured the first days.

This group is for people with severe intellectual disabilities, but most are at least partly capable of performing their personal care. By contrast, at my current group, all clients need help with toileting, most with eating and some need full care. The staff/client ratio is similar. As a result, the staff at the new place are usually more able to do activities rather than running from care moment to care moment. They’re also more used to challenging behavior, as several clients have behavioral issues.

The actvities are varied. They go for walks, some clients go swimming every other week and some go horseback riding (at the place I go to as well). On Wednesday morning, they do a cooking activity and on Friday they visit the marketplace. There also is a fenced yard attached to the group, which has cool swings and a rocking lounger. They have a variety of table-based activities too, some of which I liked and others I didn’t.

I had my “interview” for this new place on Tuesday and both I and the staff were really content. So I have a new “job”. I’ll start on August 6.

One thing that did bother me a bit is the fact that the staff didn’t see a need for a meeting with the Center for Consultation and Expertise (CCE) consultant. At least, that’s the impression I got. They also said we don’t need to involve the manager, as that’s not how things work there. Since with my current place, the manager was the one accepting me and the ultimate decision-maker on kicking me out again, I feared the same might happen the first time I’d have a meltdown there. According to my support coordinator, the staff are in fact open to meeting the consultant but this doesn’t need to happen before I start there. I understand that.

#WeekendCoffeeShare for June 16, 2018

I have seriously been meaning to write more and have had a few ideas floating around my head. Someohow though I could never find the energy or motivation to actually sit down and write a post. This week, a lot happened, so it’s about time I join in Alli’s #WeekendCoffeeShare again.

If we were having coffee, first I’d tell you all about the visit to a few possible new day activities places last Monday. There were four places that I would be visiting: a day center like the one I go to now, an industrial workshop, an arts place and a farm. The care consultant explained about each place and said the farm was pretty large and low-support, so I would most likely not be able to do much there. I don’t like industrial work, so I turned that one down too. The arts place, we did visit, but it didn’t turn out to be suitable. They mostly do textile arts, painting and drawing there, none of which I can do. They also do ceramics, which I can do but don’t usually like. It was also rather crowded and noisy there.

The day center consists of four groups, two of which are relatively high-support. I was shown around these two groups. The first one, which is the highest-support one, seemed really suitable. They have arund a 1:5 staff/client ratio, which is similar to my current group and is doable for me. The group seemed a little more structured than my current group. They go for walks regularly. They also have a garden with some swings and a rocking lounger. The center has a sensory room near this group. I spoke to one of the staff for this group, who happened to have seen me at the horseback riding school a few times. You see, some people from this day center go horseback riding there too. They also go swimming every other Tuesday. I assume this is only for peoople for whom a volunteer buddy can be found, but I hope that should I transfer here, I can do this too.

I was up front about the fact that I could have meltdowns if my irritability isn’t acknowledged and dealt with on time. I think though that if I transfer here, the consultant from the Center for Consultation and Expertise (CCE) can help us figure out a good support plan.

We also visited the other group, where people do mostly table-based activities. This group was a little more crowded and lower-support and I like walking and sensory activities more than table-based tasks. I ultimately chose to try out at the first group. On June 25 and 26, I’ll be spending the mornings there. We’ll be evaluating this on the 26th. I have decided to wait to potentially transfer till we’ve spoken to the CCE consultant on July 31.

I can’t convey through writing how excited I am about this possible new opportunity. I really hope it works out. Transportation may be an issue, but I have my hopes up that this will be sorted out.

Next, I’d be sharing about my next session of dialectical behavior therapy (DBT) with my nurse practitioner. It was good. We discussed rational, emotional and wise mind. Wise mind is like intuition, the integration of emotion and reason. One of the goals of DBT is to get into wise mind more often.

Last week, I had called the on-duty nurse at the psychiatric unit because I was close to a crisis due to feeling very lonely. I had initially felt really bad about having called, because loneliness is a common reason for me to land in near-crisis and need to call them. My nurse practitioner validated me, saying I don’t have their phone number for no reason.

If we were having coffee, I’d share about my weight loss this past week. I lost 1.5kg in just over a week. Now this evening we went to an all-you-can-eat restaurant, so I’ve probably gained it back, but I’ll lose it again soon enough. I also met the recommended daily step goal (10,000 steps) again on Wednesday.

What have you been up to lately?

#WeekendCoffeeShare for June 3, 2018

Welcome to this week’s #WeekendCoffeeShare. I’m a little late this week, as yesterday my husband and I spent most of the day at my in-laws and I didn’t have my computer or external keyboard for my phone with me, so I could barely type. So grab a cup of your favorite drink and sit with me as I write about this week. I’ll have a cup of green tea instead of coffee even though it isn’t terribly late here yet.

On Saturday last week, I finally went onto the scale again. I hadn’t weighed myself in a few weeks. As I feared, I had gained weight, but even more than I expected. I’d gained 2kg. I was so angry with myself. I mean, yes, we’d eaten pizza three evenings that week, but that couldn’t possibly explain such a huge weight gain. My husband tried to reassure me, saying I was probably constipated. This may be so, as the next day I’d gained another 800 grams. Tomorrow marks one year since the start of my weight loss journey and I’m afraid I will not reach my goal of having a BMI under 30. Then again, last January, I did reach this goal already and stayed at that weight all through early May.

On Sunday evening, the Center for Consultation and Expertise (CCE) coordinator E-mailed me and my support coordinator. As we’d had the meeting with her on the 15th of May, she’d planned on discussing my case on the following Monday but hadn’t realized this was a bank holiday. She had eventually discussed me with her colleague and had decided to ask a consultant to focus assessment on my needs and wishes rather than on a diagnosis. On Tuesday, she E-mailed us again to let us know she’d found a suitable consultant and we’d be contacted again to set an appointment for a first meeting.

My support coordinator had also inquired about getting long-term care funding for me. Whether this is possible, depends on whether my blindness is the primary reason for my care or my mental health or autism. If it’s blindness, I may get long-term care funding, whereas if it’s autism or mental illness, I definitely won’t. Long-term care funding would enable me to move to supported housing for the disabled or get more support while living with my husband.

On Thursday, I had my first session of dialectical behavior therapy (DBT) with my new nurse practitioner. DBT was originally developed for treating people with borderline personality disorder (BPD). It’s usually group therapy. Though I do have BPD traits, I’m also autistic, which means that group therapy would be hard for me. I therefore do the DBT individually. I had already started DBT with my community psychiatric nurse, who left recently. My nurse practitioner, who took over from her, proposed to start at the beginning of the therapy manual again. We only managed to work through the first page, which details the goals of DBT. There are four skills domains on which I’ll work: mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.

I also realized as I was talking to my nurse practtitioner how angry I still am at the psychologist from the institution who kicked me out almost with no after care last year. My nurse practitioner did the intake interview for this team with me last year and mentioned how he and the psychiatrist got a totally different impression of me than said psychologist had painted. The psychologist had diagnosed me with dependent personality disorder for claiming care I supposedly didn’t need. She removed my autism diagnosis. The nurse practitioner and psychiatrist saw pretty soon that I’m not dependent at all. Yes, I need a lot of support, but that’s due to my disabilities (including autism), not low self-esteem. In fact, I just realized how this psychologist had in fact broken my self-determination. I don’t feel safe to ask for help much now and am a lot more passive than I was when I had this dependency diagnosis. My nurse practitioner validated my feelings, in fact saying that the reason for the CCE involvement is in part the poor after care this psychologist had arranged for.

On Friday, I went adaptive horseback riding again. Angie, my horse, was scared of a car passing by and attempted to go on the run while I sat on her back. This was terrifying. Thankfully, I managed to keep seated on her back. She was quickly calmed down again, but I was shocked for a bit aftwards. So was the girl who held the horse. Thanfkully, the instructor always walks beside my horse because of my blindness, so the girl wasn’t on her own. I still had fun horseback riding.

I’ve yet to think of what I want for my birthday at the end of the month. I will have to look at sensory toy shops for inspiration. I’m also thinking of starting up the soap making craft again, so maybe I’ll ask for supplies for that.

What have you all been up to this past week?

#WeekendCoffeeShare for May 26, 2018

Today, I’m linking up with Ali’s #WeekendCoffeeShare. The idea behind #WeekendCoffeeShare is to catch up on how your week has been. It’s a good way to share how you’ve been doing without having to devote a separate blog post to everything you’re up to. So sit back and grab a cup of your favorite drink (it’s rather late for coffee here).

The week started off rather relaxed with Monday being a holiday because of it being the day after Pentecost. That being said, I don’t really like days off, as I tend to sleep away the day anyway and feel bored when I’m awake. I’d have rather gone to day activities.

When I came to day activities again on Tuesday, I was a little anxious. There’s a family day at the center next week. Originally, my mother-in-law would be attending, but given the fact that I’m being kicked out of this center anyway, I feel it’d be useless. Besides, I have an appointment with my psychiatric nurse practitioner for dialectical behavior therapy that afternoon. I just told a white lie by omission and said my appointment was the reason I and my mother-in-law won’t be there.

On Wednesday, I had an okay day. My home support coordinator came by. She’d visit me on Thursday too, as my regular home support worker couldn’t come. I may get another support worker in her place, as she has a rather heavy workload. My mother-in-law also took me on some errands.

I found out on Thursday that things might not be as hopeless on the day activities front as I thought them to be. My support coordinator had contacted a day activities farm about 25km from my house. Farming isn’t my ideal sort of day activities, but I’m willing to go take a look there. The coordinator for that place had referred her to another person for placement inquiries. This placement person said they have three other day activities places in that area, all roughly 20-25km from my home. This is quite a bit farther off than the 15km to my current day activities (which is already relatively far), so transportation may be an issue. However, I’m sure my support coordinator will find a solution to this. I’ll be going to visit all four places on June 11. There is the farm, which was said to be good for those seeking experience-based activities too, so you’re not necessarily required to work hard. Then there’s an industrial place (but the placement person said not to worry about pressure), an artsy place with a shop and a day center similar to the one I attend now.

I am feeling slightly optimistic about one of these places possibly being a good fit for me. I actually am thinking of mentioning my experience with soap and skin care product making in hopes that I can get the support to pick up that hobby again, either at the artsy place or the day center.

Yesterday I went to the adaptive riding school for horseback riding. Everyone in my class was more noisy than usual and I experienced a bit of overload. Nonetheless, I enjoyed riding my current horse, Angie.

Today, my husband and I went to my in-laws to spend the afternoon and part of the evening. My in-laws have a pretty large house in the countryside. They have horses there. I helped brush one of my mother-in-law’s horses, Remco. We also ate homemade pizza. One half of each of our pizzas had a cauliflower crust. I actually liked it better than the regular crust.

What have you been up to this past week?

An Eventful Week

And again I didn’t write for an entire week. The past week was rather eventful and stressful. I have been distracting mmyself by going on Tumblr and attempting to start something up there. I’ve had one Tumblr account or another ever since 2008 but never quite understood how it works and still I really don’t. However, I’m enjoying the community of mental health users there.

The reason the week was stressful was because of a lot of emotion-evoking events. First, my grandma died Saturday night. This caused a lot of emotions in me, because my grandma was the only family member I had a good relationship with. Her funeral was yesterday and it was good to see a lot of aunts, uncles and cousins I rarely see at all. The funeral service was good. My sister spoke on behalf of the grandchildren. I couldn’t help but laugh at some of the stories she told.

Another emotional event was the orientation meeting with the coordinator from the Center for Consultation and Expertise (CCE) on my situation re day activities. In attendance were the CCE coordinator, my day activities and home support staff, my mother-in-law (who acts as my informal representative), the local authority social consultant, my psychiatric nurse practitioner and me. The coordinator does the first meeting. If she decides it’s necessary, she’ll involve one or more consultants who will help find solutions to the situation at hand.

As it turns out, my day activities staff were hardly open to any suggestions from the CCE coordinator that would allow me to stay at this center. They kept making excuses about my meltdonws (which I haven’t had in a while) causing seizures and aggressive outbursts in other clients. This never really happened. Besides, these other clients get seizures/outbursts from a lot of behavior that other fellow clients exhibit too. I myself witnessed this on Monday.

We discussed the reasons for my meltdowns. Sensory ovelroad, demands and stress often set me off. The CCE coordinator asked whether I’d ever had a sensory integration assessment. I haven’t. It was at one point suggested by another consultant but my then psychologist (the one who kicked me out of the institution last year) dismissed this. Same for the trauma therapy recommended by the CCE consultant when we had a consultation in 2010.

We also discussed my living situation. This had not been the direct reason for contacting the CCE, but now that we had them involved anyway, my home support coordinator suggested we discuss this too. It is really hard. I mean, I experience a lot of stress now that I live independently with my husband. I was open about the worsening of my depression, including suicidal thoughts. I don’t want to die though, so the CCE coordinator asked what I do want. I honestly don’t know. At one point, the CCE coordinator also asked me directly whether I’d have wanted to live independently had the psychologist not kicked me out of the institution. I said “No”. My home support coordinator talked about the possibility of me and my husband moving closer to supported housing. This may be very difficult bureaucratically, as psychiatric diagnoses (including autism) don’t qualify you for long-term care, but maybe the CCE can help us figure this out.

I have mixed feelings about the meeting. I am somewhat hopeful but also a little pessimistic. Since the day activities staff aren’t open to solutions that will allow me to stay there, we’re at the mercy of a possible other day activities center. I hope we can find one.

What I’ve Been Up To Lately

I’ve been meaning to write a lot lately, but I didn’t. All that I started on were random ramblings that I didn’t finish. Today, I’m writing down these random ramblings in a kind of list, in hopes of finally finishing this post.

First, I had movement therpay on Tuesday. It was good in some ways but not good in a sense too. I dissociated a lot. Like the last time I had movement therapy, a part of me came out. This is good, in that it allowed me to express myself in a way I otherwise can’t. However, since my parts are not fully accepted by my mental health team, I’m not sure whether I’ll be taken out of movement therapy for it “not helping”.

Second, on Tuesday evening, my mother sent me and my sister a text message that she and my father were at my paternal grandma’s. She is being kept asleep for pain control and will soon die. This is terribly sad. I mean, yes, she’s 94 and in a lot of pain in addition to having long suffered significant cognitive decline. However, I cherish my grandma greatly. She was an official witness at my wedding in 2011. This was in th eearly stages of her cognitive decline, when she was still just able enough to fulfill this role. I am so glad I had her for this role, as I didn’t have the greatest relationship with my parents or sister at the time, so didn’t want to ask them.

Third, I started at yet another increased dose of citalopram last Monday. I told my psychiatrist on Friday what I’d written down here and she concluded that the medication is helping some but not enough, so she increased it to 40mg a day.

Fourth, yesterday I reached the recomended daily step goal of 10,000 steps despite the hot weather. This is only the second time since I bought my Fitbit activity tracker last February.

Fifth, I’ve been reading some good books lately. I finally finshed Angels with Dirty Faces by Casey Watson, a collection of five previously published mini eBooks. I may post a review soon. On Tuesday, I bought my first Kindle eBook. I wasn’t 100% sure whether it’d work with my screen reader, since it wasn’t mentioned explicitly that it would, but it did. It’s What Every Autistic Girl Wishes Her Parents Knew by the Autism Women’s Network. So far, I’m really enjoying this book.

Changes

This week has been rather eventful and yet, nothing really did happen. A lot of changes are on the horizon for me, yet nothing has really changed yet.

First, I found out a few weeks ago that next week, my primary day activities staff will be leaving the day center. It is great for her, as she’ll embark on a new and challenging path in her career. For me though, it’s quite hard. Some of my other staff and family have been askign whether I mind at all, since I’ve been struggling at day activities and she was the one who filed the incident report that led to my day activities hours being cut. Yes, I do mind, since despite this, I like this staff a lot.

Then on Thursday, I found out that my CPN is leaving too. It’s also to embark on a new and challenging path in her career, but it’s sad nonetheless. My CPN and I have had quite a few misunderstandings over the ten months so far that we’ve worked together. However, I’ve noticed that I did make progress. It seems odd, since both my husband and my psychiatrist have been commenting on how I didn’t get far on the DBT course yet and it’s apparently my CPN’s fautl. Apparently, she should be limiting my bringing up only indirectly related topics.

I know the nurse practitioner who will be replacing her already from my intake interview last year. It is a slight disadvantage that he’s male, but other than that, I think I could get along with him just fine. However, it’s still a bit stressful that so many people are leaving at the same time. After all, my nurse will also be taken off my case. We’re not yet 100% sure who will be replacing her.

On Friday, I had a meeting with my psychiatrist. We discussed my progress on the DBT course, my medication and I mentioned I’ve been rather depressed lately. I did say it’s been going on for half a year already, so if I can hold it together for that long, it must not be that bad. She ignored this comment and proposed to increase the dose of my citalopram from 20 to 30mg. It’s a bit scary, since I’ve been on 20mg ever since 2010 with no med review whatsoever and I didn’t even know why I’d been prescribed it. IN this sense, I like it that my psychiatrist did ask to see me in a month’s time for an evaluation. I really do hope the med increase will help with mood improvement.

Update on Day Activities

I have not written a diary-style entry in a while, even though I hoped it’d help me write more often. The past few weeks have been rather eventful with things needing to be worked out for my day activities. Not that anything concrete has come out of it yet, but today, I am hopeful that something will.

In early February, we had a “big meeting” to discuss how to proceed now that my day activities hours were cut and I would maybe have to leave this day center. It was decided that we’d involve the Center for Consultation and Expertise (CCE) to help us detail my support needs. In the meantime, my home support hours were doubled as to give my support coordinator some time to help me find a new place.

My CPN took it upon herself to call the CCE. I don’t know how the conversation between her and the CCE person went, but they concluded eventually that my problem was mainly my blindness. I didn’t understand why, since I’d been almost kicked out of day activities for self-injurious behaviors and meltdowns – not your average blind person’s everyday behavior. The whole thing frustrated me to no end, as blindness agencies have consistently said that my main problem is definitely not my blindness and now the CCE was referring me back to them.

When I read my CPN’s notes on the meeting in which she told me about her conversation with the CCE, I got an idea where the misunderstanding had come from. She wrote about my anxiey regarding demands in light of my having to learn new skills. I figured she’d told the CCE person about the recommendation that I get independent living skills training, which is not the CCE’s department. They offer consultations in situations where the client falls through the cracks because of severe problem behavior, after all. Resistance to demands does not necessarily present with severe problem behavior, I suppose.

When I asked my CPN for clarification though last week, I found out that she doesn’t even believe I have severe problem behaviors. I’m not 100% sure either that my behaviors are severe enough for the CCE, but my CPN’s reasoning for dismissing my problem behaviors altogether was rather strange: I wouldn’t be able to be married if I had problem behaviors. She also mentioned that I wouldn’t be able to live independently in that case either, which I understand. Then again, with today’s budget cuts to mental health and long-term care, once living in the community, you’d need to be virtually dead to be admitted back to an institution. Maybe a virtually dead person is the kind of case the CCE usually works on too, and in all fairness, I’m not dead.

I was badly triggered by my CPN’s comments. What mostly triggered me was her saying that I had “escaped” an institution. I hadn’t. I had been kicked out.

Later last week, my support coordinator talked to my CPN about her feeling that we should at least try to get the CCE involved based on my full story. We worked on the application this afternoon, but didn’t finish it yet, as I was getting overwhelmed.

As for finding me a new place for day activities, we currently have two organizations we’re still in contact with. Both are organizations serving primarily intellectually disabled people. Neither has offered me an orientation meeting yet, but at least neither has rejected me yet. Two other organizations did reject me and several others, we are still thinking on contacting but are most likely unsuitable.

Considering Getting a Psychiatrist’s Appointment on My Depressed Mood

Tomorrow, I have an appointment with my community psychiatric nurse (CPN). Part of our appointment will likely be about where to go from here regarding day activities. My CPN already E-mailed me that she’d contacted the Center for Consultation and Expertise. They will hopefully take on my case and help me and my staff assess my needs. That will hopefully help us find a new place or get me the right support at my current place.

I also intend to ask her to get me an appointment with my psychiatrist. I feel too embarrassed to schedule one through the secretary. It’s been 3 1/2 months since my last appointment, so in that sense I could request one just for a catch-up. However, I want to discuss something specific with the psychiatrist and I feel incredibly ashamed of it. I’m finally coming to the conclusion that my depression symptoms are getting worse and to a point where I don’t know how to handle them anymore.

I was more or less by chance diagnosed with major depression last year. This came to light when I had my autism-related independent assessment. I had to fill out a screening tool for depression as part of the intake procedure. I scored as severe on that one. I was then evaluated further and was diagnosed with recurrent moderate depression. Because this was an independent assessment, my psychiatrist isn’t affiliated with this hospital and doesn’t need to take over the diagnosis. I don’t know whether she has.

I do take an antidepressant and have since 2010. Same medication, same dose all these years with no med review whatsoever. I don’t even know for sure why I was put on this medication, except that my Abilify (an antipsychotic) had been increased twice in a few months and I was still irritable.

This is the main reason I feel embarrassed about asking my psychiatrist to evaluate my mood. I mean, irritability bothers other people and ttat’s always been the main reason I was in care. Like, in 2007, when I was admitted to the mental hospital, it was really because of suicidal ideation but my staff always said it was because I’d been having public meltdowns.

I don’t know whether I truly believe that psychiatry’s job is to keep people, or me specifically, from being a pain in other people’s asses. I don’t think it should be. However, I’m rather afraid that my psychiatrist thinks so at least in my case. I’m not exactly sure why, as so far she’s been pretty understanding. I guess they may be left over feelings from all these years being treated like a cumbersome waste of resources.

Keep Calm and Carry On Linking Sunday

Cuts to My Day Activities Hours

And again I really didn’t get to write as much as I’d like to have done. The past week was quite busy. I had my first session of movement therapy on Tuesday and a meeting with my nurse on Thursday. Actually, I would’ve had a session with my CPN, but she’s off sick. I was so grateful that my nurse asked whether I wanted an appointment with her instead, as I really needed to talk.

I’ve not been doing well lately. I’m very irritable and easily overloaded. I switch a lot between being completely in my “rational mind” and feeling terribly emotional. I try to use my DBT skills, of course. Not that I’ve come far on the formal DBT course I do with my CPN, but I’ve been doing it by myself. I do an okay job when I’m not overwhelmed, but once overwhelmed, all my skills go out the window.

I mostly find that I can’t handle this huge, gaping split between my (verbal) IQ and my emotional, practical and behavioral functioning. At day activities, this is becoming more and more problematic. The staff are telling me that my irritability upsets the other clients, who are “like a baby” and can’t understand. I tell them that I don’t understand stuff myself, either, but because I’m not intellectually disabled, I should somehow be able to be more capable.

Because I’m too much of a handful, my day activities are being reduced. I won’t get additional home support in exchange. This upsets me greatly. It feels as though, when I need more help the most, I’m punished for it by getting less. Again, the main reason is my IQ, because other people with significant behavioral challenges at my day activities, get more care.

“We don’t do psychiatry.” That’s my day activities staff’s reasoning for cutting my hours when I’m too irritable. The other staff even mentioned finding me another place to go. I don’t know where. I mean, day activities for mentally ill people cater mostly to those with psychotic disorders. I have experience with that and I run into the same crap I get here there. After all, people with schizophrenia can’t help reacting to their voices either.

For clarity’s sake, I’m not saying that people with severe intellectual disabilities or those with actively psychotic schizophrenia should just be able to hold it togehter. I know they can’t, but I can’t always hold it together either.

I know my staff try their best. The staff who decided to cut my day activities hours, got angry when I told her they’re expecting too much out of me. I know she’s never worked with a person of at least average intelligence who still has signiificant sensory issues and challenging behavior. I know the manager probably told her to prioritize her main focus group, ie. those with severe intellectual disabilities. It’s interesting that she refers to the other clients as “the clients”, not “the other clients”, when she talks to me.

However, I can’t keep from being reminded of all the great lengths to which the staff go to accommodate their other clients with challenging behavior. For one person, a staff goes to his group home to provide him day activities one-on-one. Two at my group get several hours of one-on-one too. I don’t ask for that, but I don’t ask for the other extreme, ie. being cut off my hours, either.