Tag Archives: Hygiene

H – #AtoZChallenge on Mental Health

Welcome to the letter H post in the #AtoZChallenge on mental health. I’m very tired but still managing to schedule my posts in advance. I hope the week-end brings some relaxation. Anyway, here goes.

Handover

The nurses’ discussion of patients at the end of one shift and the beginning of another. At least, they’re supposed to discuss patients but may discuss whatever’s on their minds. Handover, like evening and afternoon breaks for nurses, tends to last much longer than it’s supposed to.

Homelessness

A significant number of patients on long-term inpatient units don’t have a home outside of the institution. Some have actually been homeless before they were admitted to the hospital, while others, like myself, gave up their housing. I didn’t have a home for over 2 1/2 years between giving up my student accommodation in 2010 and getting the small town apartment with my husband in 2012. Unfortunately, if your official residence is the institution and you want to rent a home later on, the housing corporations may make a problem out of it. It wasn’t too bad when I got the apartment – they just needed my psychologist’s approval to move -, but I’ve heard of people being kicked off the housing list for being institutionalized.

Hormones

Hormones are often thought to play a role in mental health, especialy if the problems start in puberty, during or after pregnancy or during menopause. Postnatal depression or anxiety is fairly common, although skeptics believe it’s a fictional disease. Unfortunately, when people get ill and hormones are being blamed, they may miss out on potentially sanity-saving treatments. The reverse is, of course, also true: people getting treated with psychotropic medications when really their hormones are acting up.

Hygiene

Hygiene is often a big issue for mentally ill people. Of those in long-term inpatient units, most, including myself, need reminders or even bribing to get showered, use deodorant or brush their teeth. With some people, staff leave this responsibility with the patient, but with others, they’re very asseritve in their attempts to get the patient to take proper care of themself.

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I Am Astrid’s Functioning Label

Back in 2008, Bev over at Square 8 wrote a post entitled I Am Joe’s Functioning Label. The post struck a chord with me right the first time I read it, and, over the years, it has become more relevant. For those who don’t want to hop over to read the post, it’s about what the label “high-functioning” is perceived to say about an autistic person, and how this impacts the way autistics are treated.

For clartiy’s sake: I am not saying that people with an intellectual disability have it easy. The cuts to care and the accompanying independence doctrine affect them too. What I do mean is that it is often easier to understand why a person with an intellectual disability needs care than if you have a high IQ.

It is often presumed that a person who can do a cognitively challenging task like operate a computer, can also do more basic tasks like brush their teeth. In reality, these skills have nothing to do with each other. Another assumption is that people who know how to perform a task and/or why it’s necessary, can also perform that task. I remember even years before Bev’s post reading on Autistics.org about a woman who was getting ulcers beecause social services presumed that if she knew about hygiene, she must be albe to wash herself.

There are many more assumptions about people labeled high-functioning. Here are a few that are affecting my life.


  1. Because of my functioning label, I am presumed to be safe in traffic. Since starting to learn a tiny route around the building, I am not only allowed to leave the ward alone without any purpose, but am expected to leave the ward if I’m angry.

  2. Because of my functioning label, I am presumed to be able to take care of my personal hygiene without reminders or help. This is in a way somehting I don’t want to change, because the reason I’m not able to perform some skills of personal care is because of sensory issues.

  3. Because of my functioning label, I am presumed to know how to solve problems myself even when anxious or overloaded (my fuctioning label dictates that overload is just an excuse to avoid demands). I am presumed to be able to make my needs known in very specific terms.

  4. Because of my functioning label, I am thought to be able to perform practical skills like making a bed or pouring coffee myself. Ironically, the motor deficits which cause me to be unable to perform these tass, were originally thought to be especially common in Asperger’s Syndrome.

  5. Because of my functioning label, I apparently don’t need a lot of structure. This means I am presumed to be able ot schedule activities without help.

  6. If I get overloaded, my functioning label dictates that it was my own choice and I’m depriving other people of the right to make noise.

  7. If I have a meltdown because my routine is interrupted, again, my functioning label dictates that I’m just spoiled and trying to always get my way.

  8. Because of my functioning label, I am presumed not to engage in aggressive or self-injurious behavior. If I do, it’s obviously because of BPD-related attention-seeking.


Yes, I see that a lot of these assumptions are not just based on my functioning label, but also on my co-occurring diagnosis of BPD. Before I had this diagnosis, not only was I not presumed to be unwilling to act normally, but my autism was presumed not to be as mild as it is now. Hence, an additional diagnosis makes it seem as though I’m less severely affected. Isn’t that ironic? By the way, if instead of Asperger’s and BPD, my diagnosis had been multiple complex developmental disorder (McDD), which is characterized by practically the same symptoms, I would likely have been seen as quite severely autistic.

Teaching Your Autistic Teen About Hygiene

Many autistic people have trouble with self-help skills, like clothing and personal hygiene. I hear on many autism parent blogs that their child cannot bruth their teeth independnently, is incontinent at an age where accidents are no longer normal, etc. These are obvious self-help difficulties, but there are many more subtle problems with hygiene that even many more capable adult swith autism deal with.

First, many autistics are unaware of the social rules of hygiene. I remember my sister gave me deodorant for my fourteenth birthday and I still didn’t get the hint. I didn’t have an aversion to grooming as much as I was unaware of the changing rules that came with puberty. Similarly, I remember going to the school doctor at age fifteen and, when being asked to undress, realizing I’d forgotten to put on a bra. It is important, when teaching autistic children and teens about hygiene, to explicitly talk them through the changing norms that come as your child ages. Just because your teen boy knows how to work a shaving tool, doesn’t mean he knows or remembers when to use it.

Another problem in self-care may be an autistic person’s sensory aversion to certain tastes or textures, such as that of certain clothing, shampoo or toothpaste. With regard to clothing, comfort goes before style. It’s okay to tell your child that children aged twelve don’t usually wear sweat pants, but don’t ridicule them or try to force them to wear jeans if they’re uncofmortable. If your child is bullied, that’s not their fault even if you as the parent too see them as an easy target. Don’t make it worse by blaming yoru child.

Whn it comes to hygiene, sometimes comfort has to go. I for one refused to use toothpaste until I was eighteen, because even the kids’ toothpaste had too sharp a taste for me to cope with. I started usign toothpaste only because having the dentist need to fill seven cavities was worse. A few years ago, I again developed a problem with toothbrushing that I still haven’t gotten over.

Lastly, this may seem a bit TMI, but please do teach your autistic preteen girl about menstruation. It can be a very scary experience having your body change in general, and menstruation is overwhelmign to many NT women. Therefore, it’s logical that it causes great distress to many autistic teens. Preparing your teen for what will come can be done using simulation, such as with red wine on a pad. That’s what some kids in my sister’s class did when doing a presentation on puberty. Again, remind your daughter to take pads with her at all times. If menstruation is too overwhelming, your teen girl may consider birth control. Most birth control pills cause lighter, shorter, more regular and less painful periods, while some birth control methods eliminate periods completely.