#WeekendCoffeeShare (November 18, 2023)

Posted on by Astrid

Hi everyone. I have barely touched the blog lately, but it’s not because I’ve been uninspired. Rather, I’ve mostly been doing other things online. Before I abandon it altogether, I thought I’d write a post though. I’m joining in with #WeekendCoffeeShare. I’ve had my last cup of coffee for the day, but thankfully my assigned staff ordered my favorite soft drink, apple and peach-flavored Dubbelfrisss, so I’ll have that in a bit. If you’d like one too, join me. Let’s have a drink and let’s catch up.

If we were having coffee, first I’d talk about the weather. It’s been raining all day today and, though we were supposed to have a daytime high of 12°C, I don’t know when that was supposed to have been the case as it’s been around 7°C each time I looked at the weather on my Apple Watch. I haven’t been outside at all. I mean, I can bear the cold, but rain, yuck! I can tolerate it when it starts raining midway through a walk, but when it rains as I leave the house, I usually turn right around. Consequently, I didn’t meet my movement goal on my Apple Watch today at all. In fact, I’m pretty sure I hit an all-time low, but frankly, I don’t care.

The rest of the week, though we had some rain, it wasn’t constantly pouring. Though some days I needed to get out my winter coat, most days the daytime temperature wasn’t too cold either.

If we were having coffee, I’d cheat a little and tell you all about the meeting I had last week with my assigned staff, support coordinator, behavior specialist and my mother-in-law. Okay, who said you can only talk about the past week during a weekend coffee share? Maybe I did. Anyway, the meeting started out with my assigned staff complimenting me on how I do accept men and unfamiliar staff now. This rubbed me the wrong way, as the day prior he’d pretty much given me no choice, so what was I to do? I’ll see tomorrow whether they’ll go the full length and assign me a male staff for my ADLs (which is a big no for me), as then the female staff who normally always assigns me temp workers is working the morning shift with a male temp worker. Said temp worker is familiar with everyone here, but I am honestly quite sure she’s going to assign him to me for my morning routine anyway. Let me just say I’m going to throw a big hissy fit if this happens.

Other than that, the meeting went okay. We talked about my day schedule, which is okay in terms of how many hours of support I get but far from ideal in terms of how it’s cut up into small blocks. Since my ExtraCare (one-on-one) funding hasn’t been approved yet for next year, we’re waiting to see what happens to that to change anything. I’m pretty fearful the Care Office doesn’t consider every single moment the staff spend with me as ExtraCare, as, well, it isn’t, but the manager does. Oh well, we’ll see.

We also talked about my wish to start therapy again for my trauma-related symptoms. Upon further thought, I realized I need to work on stabilizing first before I start EMDR or whatnot. The behavior specialist is going to write an application. I am also going to work with my assigned staff on my signaling plan, which details how I can best be supported during each phase of emotional (dys)regulation.

If we were having coffee, lastly I’d share about my dietitian’s appt on Wednesday. It went pretty well. I am currently at a healthy weight and within the weight range I agreed upon with her. She did finally admit she doesn’t know why I’m not gaining weight when I’m having quite a lot of food in excess of my food plan. I honestly currently have far too many other things on my mind to care about this too. I mean, yes, I’m scared, but I’m scared for a lot of other reasons too.

How have you been?

Signaling: Using Crisis Prevention Plans #AtoZChallenge

Posted on by Astrid

Welcome to my letter S post in the #AtoZChallenge. There are really many S words that are fitting in a self-care routine. After all, “self” starts with an S and self-care is about YOU. I will be writing about creating a crisis prevention plan.

A crisis prevention plan, which is also called a signaling plan in Dutch (hence the letter S), details the signs and symptoms you experience leading up to a crisis. In most mental hospitals, it consists of three phases:


  • Phase 1 or green: I’m doing well.

  • Phase 2 or orange: I’m not doing well.

  • Phase 3 or red: I’m in crisis.

Here in the intellectual disability care facility, a signaling plan is more extensive and can also be used to signal lowalertness. It consists of six phases:


  • Phase -2: sleeping (when not appropriate).

  • Phase -1: low alertness.

  • Phase 0: adequate and alert.

  • Phase 1: low stress, highly alert.

  • Phase 2: high stress, too highly alert.

  • Phase 3: emotional outburst or loss of control (crisis).


I find it pretty hard to translate these into English, so sorry for my quirky word choice.

In each phase, the signaling plan lists signs patients or their staff will notice when the patient is in that phase. For example, one of my phase two behaviors is loud talking. Abilities are also explained. For example, in phase 0 in my case, I am able to make decisions adequately. In phase 1, I can make choices between a few (usually two) different options. In phase 2 and 3, it’s up to the staff to make decisions for me.

Mental hospitals and mental health agencies in general are strongly focused on patient self-reliance, so they include lots of stuff about what you can do yourself in the different phases. In most cases, in fact, the patient is held fully responsible for their self-care unless they enter phase 3. I mean, patients are allowed to ask for help in phase 2, but staff will not reach out and patients are usually required to come up with direct requests for help. IN my opinion, this is rather odd.

I find it extremely comforting yet a bit surprising to see that my current signaling plan, which was created by my care staff and the behavior specialist, details staff responsibilities for each phase.

Like I said yesterday, my signaling plan also includes a recovery phase, which lists signs I’m coming out of a crisis and ways staff can help me then. This is really helpful.