It’s Just Us, Or Is It?: Power Dynamics in Care

Posted on by Astrid

I am currently reading a book called The Dark Side of the Mind by Kerry Daynes, a memoir by a female forensic psychologist in the UK. In her first chapter, Daynes writes about how her college date tells her there’s no justice, it’s just us. Then she goes on to talk about her first job, which is really an unpaid position, at a correctional facility called Wakefield. There, the philosophy is “us vs. them”, “us” being the “good” guys (or girls), ie. the staff, and “them” the inmates, who often committed horrific crimes, such as rape, murder or both. This “us vs. them” mentality was often used to reinforce a rather exaggerated power dynamic, to say the least. As it turns out, it’s not that black-or-white, in that, several years later, a staff member Daynes worked with was given a long sentence for similar horrific crimes.

I want to use this example to talk about power dynamics. Not in the prison system, as I have no experience with that, but in the care system. In a sense, in care, at least as much so as in prison, there should not be “us” and “them”, since we’re all people first. The mere fact that I am disabled and my staff are currently non-disabled, shouldn’t make a difference. Neither should it when it comes to my fellow residents who are deemed unable to make their own decisions.

I just had a discussion with one of my staff about this. This person maintains that she’s in fact at my service, almost like I’m her employer. When I pointed out that she gets to decide when it’s necessary to physically drag me to my room (not that she personally ever has), she said this is because I live with nine other people. Yes, but if I lived with nine other people without staff, such as in student accommodation, no-one would be dragging me to my room for yelling and, if the situation did escalate too much, the police (who everyone except for maybe the police themself admits have a position of power) would be called.

I also mentioned some situations from the intensive support home. For example, staff grabbing a large cookie while giving us a tiny biscuit. “Who’s boss here?” one of the staff once actually asked one of my similarly opinionated but unfortunately less eloquent fellow residents. She named the names of the support coordinators. “And when they’re not here?”, he continued, clearly wanting to hear that the available staff are. I pointed out later that no-one is boss here, only to be told that this was a simplified way of explaining this to my fellow client.

When I told my current staff about this and other examples, I was told this is the way the intensive support home works and that she doesn’t agree with it. At the same time, she told me that, if I want a large cookie, I can get it because I’m capable of making my own decisions, while my fellow residents can’t. While I understand this, on a large scale, may be so, it isn’t necessarily true: I don’t technically follow my agreed-upon food plan either and that’s considered my responsibility, while if a fellow client points to a single extra cookie, that’s denied because their family (or the staff) agreed on a food plan. However, if I have an extra cookie, it will do the same for me as it will for another person (unless said cookie has allergens in it for the other person or whatever). I wanted to raise awareness of how, on a micro level, staff, including the staff who believe they’re at our service, are exercising their power more than they should be.

Power dynamics, for clarity’s sake, cannot easily be eradicated. Nor am I absolutely sure they should be. However, those in positions of power should be extra conscious of their position. And especially when it comes to situations in which they believe they have every rhight to make decisions for another person, such as when I got dragged to my room and when the staff decide another resident cannot have a large cookie (but said staff and I can).

What, When, Where, With Whom and What After That?

Posted on by Astrid

I have been struggling with staff randomly switching up who will support me, my day schedule being changed for various reasons, etc., a lot lately. This causes me a lot of stress. Like regular readers of this blog may know, I have about eight hours of one-on-one support a day, divided into blocks between 8:15AM and 9:30PM. Between my support moments, I have unsupported time slots that range in length between 30 and 45 minutes.

I often struggle with my unsupported time, looking at my watch every few minutes to see whether my support staff will be coming yet. I also look at my watch a lot during my supported times, because I dread the moment my staff unexpectedly say they’re leaving.

Last night, I thought up a way to possibly solve this issue: to organize my day schedule more by activity. We need to watch out this doesn’t become the stupidly vague day schedule my former support coordinator at the intensive support home gave me. After all, when the day schedule says that we’re going for a walk and doesn’t specify how long that walk will be and there are absolutely no timeframes related to the activity, some staff will take me for a three-minute walk around the home while others will take me for an hour-long walk. Then, if after the walk I’m supposed to have unsupported time until lunchtime, the length of my unsupported time could range anywhere from like 30 minutes to nearly an hour and a half. This was actually what my day schedule back at th e intensive support home was like.

What I’d like instead, is to know what, when, where, with whom and what after that. To put it more concretely, I’d like to discuss during my morning routine who will be supporting me for the rest of the morning shift (and after handover for the evening shift), what we’ll do, including what I’ll do during my unsupported times, and to put those activities on a tactile “picture” board (with Braille instead of pictures). I think knowing what I’ll do during my unsupported times will lessen the number of times I look at my watch too. It also will mean I know who’ll support me for my activities, so that I know whether I feel comfortable with them doing certain activities with me or not.

I’m pretty sure this is all wishful thinking. One of the staff, who happens to be one of my “favorites”, didn’t think it was a bad idea. Then again, my assigned staff said I was lucky that I heard 25 minutes in advance that he was going to be there for my early afternoon activity, because his shift doesn’t start till fifteen minutes before that activity starts and if it was up to him his morning shift colleague would’ve conferred with him prior to telling me that he was coming. That would mean I’d get at best ten minutes notice. According to my assigned staff, no-one specified how much preparation time I need, so technically speaking five minutes should be enough. I think that’s rather, well, literal-minded at best and purposefully twisting the truth at worst.

This post was a rather long contribution to this week’s Stream of Consciousness Saturday, for which the prompt today is “watch”. I usually don’t write pieces that are this lengthy and in fact struggled to maintain stream-of-consciousness style.

January 2024 Reflections #WBOYC

Posted on by Astrid

Hi everyone. It’s the last day of January, so I’m reflecting back on the past month. This month was rather eventful but slow-going at the same time. Christmas sounds like centuries ago. As usual, for my monthly reflections, I’m linking up with What’s Been on Your Calendar? (#WBOYC).

The month started out rather positively with me being full of energy, new hope and inspiration. Indeed, I did create some cool new polymer clay things over the past month, including a Valentine’s frog. That one now stands on a Valentine’s Day-themed (well, kind of) table in the living room of the other side of the home.

Polymer Clay Valentines Day Frog

I also crafted the cat I showed you all earlier, a penguin, a rabbit and a few things that I might be turning into earrings at some point.

Last week, I also cooked rice and chicken for myself and my fellow residents. This was great.

Early in the month, I didn’t have many visitors due to various circumstances, but thankfully I was able to see my spouse twice this month anyway. I also saw my mother-in-law twice, on the 16th because it was every-other-Tuesday (we’d skipped the 2nd because I was sick) and last Monday because I had my care plan review.

This care plan review probably warrants its own post, since it was a lot to process. Midway through the month some issues that I’ve been having with my assigned staff, that I can’t go into here, came to a point where I was greatly struggling too. This and some other things, including the fact that I frankly don’t do as well with male staff as I do with female staff, have led me to request another assigned staff. Whether this can happen, I’m not yet sure of, but I hope so. Thankfully, I do have my support coordinator, with whom I do get along.

A week and a half ago, she and I finally finished my new crisis signaling plan. This has yet to be brought under the attention of all staff and even then, staff have to be willing to follow it.

Last week, a staff not being willing to follow this plan, led to me having a massive meltdown. More specifically, I spiraled out of control because the staff assigned me a temp worker for the late shift, while that entire day there were no staff I sort of trust except for one and she, contrary to what’s in my plan, refused to come over for just five minutes. I was a horrible person to her and the other staff and there’s no justifying that, but it’s sad to realize that her coming over for just five minutes might’ve prevented an evening-long meltdown.

Over the past week, I’ve generally been struggling with all the staff changes, changes to my one-on-one for various reasons and general chaos. I feel, truthfully, like I’m swimming in the North Sea again, as I explained it at my care plan review. The way I explained it then, when I was in Raalte in late 2021, it was like swimming at the shallow end of the pool as far as support went. And, while, like every toddler that needs to learn to swim having their days when they resist the water, I had my bad days, they weren’t due to poor support. Then, the first male staff and, later, some temp workers were introduced to me and I had to endure the odd day when I didn’t get my allocated one-on-one. I struggled massively with this challenge and this was the main reason I decided to move. Then, at the intensive support home, I was thrown right into the Pacific Ocean: a day schedule that was rather stupid, constant staff changes, me always being assigned the new temp worker, etc. Now, on good days, I feel like I’m swimming in a calm lake and, on bad days, I feel like I’m swimming in the North Sea. And then there are those really good days when I feel like I’m back in the pool. Those are the days I’m supported by my “favorites”, as my assigned staff calls them. And just so you know, just because I survived my previous home, doesn’t mean I coped or can cope with the current chaos of my home. Yes, it’s better than it was, but that doesn’t mean it’s good. I try to be understanding of the fact that everyone faces staff shortages, temp workers, etc., but honestly, listening to all the “everyone has to give a little” wears me down.

December 2023 Reflections #WBOYC

Posted on by Astrid

Hi everyone. I’m early sharing my end-of-the-month reflections, because I’ll share a review of the entire year tomorrow or on Sunday and I just now felt inspired to write. As usual, I’m linking up with #WBOYC.

The month started out pretty good with my new, pretty much ideal day schedule having taken effect. I did worry slightly that it’d be taken away if I didn’t spend my every two-hour activity time slot in the afternoon actually working with polymer clay or doing some other long activity. Thankfully, so far, it’s not been changed.

Also early in the month, I started acting out a bit because I got assigned a temp worker due to a staffing rearrangement. I started constantly comparing myself to a client who doesn’t need to deal with temp workers. Finally though, I calmed down and asked my assigned staff to write in my signaling plan that staff focus on validating my feelings and needs rather than feeding my comparison trap.

In mid-December, I went on the lights tour (I called it “Christmas lights tour”, but it wasn’t actually specifically Christmassy) around town. I loved it but had to agree with the staff that going without my one-on-one wouldn’t have been an option.

Christmas itself was okay but overwhelming. My spouse and I spent Christmas day at my parents’, where my sister and her family were too. Dinner was a lot better than I expected. However, both my spouse and I were overwhelmed by my nieces and my spouse might’ve contracted whatever illness my sister was carrying (COVID, possibly).

We spent the afternoon after Christmas at my in-laws having a Christmassy lunch. I went for an hour-long walk with my mother-in-law that day.

Like I mentioned last week, the storm last week caused one of my institution staff to be hit by a falling tree. She unfortunately died. This was quite a scary experience to many people here, so I for one at least hardly went for walks all week. I finally found out how to check for weather warnings today, so was able to go on a walk (two, in fact) again. Thankfully, the areas with lots of trees now cannot be entered anyway.

I have been slightly more creative than I used to be over the past month. Stilll not as creative as I’d like to be, but I’m getting better. Projects included another polymer clay unicorn, a butterfly and a pineapple charm. Also a dolphin which hardly anyone sees as a dolphin. The worst insult it’s gotten is that it’s a mouse.

Polymer Clay Dolphin

In the health department, I did okay. I did gain 2kg over this past month, all within the last two weeks. However, I am still within the weight range I agreed upon with my dietitian and on the upper end of a healthy BMI. I did resolve to lose those 2kg eventually though, but it doesn’t have to be in two weeks.

I do have some pain in my lower abdomen. No UTI and a bladder scan was normal too. I guess that’s a positive thing.

Another positive thing, which I almost forgot to mention, is the fact that my one-on-one got renewed. Not just that, but the hours the agency had asked for, were granted. This means my care for now will definitely not be decreased, like I had feared. After all, until the renewal, the agency was paying for some hours itself and that couldn’t have lasted. Thankfully, the Care Office granted the full number of hours requested.

Never a Perfect Day: Is It a Bad Attitude?

Posted on by Astrid

Yesterday, as I was paging through some collections of journaling prompts I own, I came across a prompt that said: “Today was a perfect day because…”. Now I would counter that not a single day in my life was perfect. That in turn reminded me of something my assigned staff at the intensive support home used to complain about. She’d say I never said I’d had a great day and rarely said I had a good day. Most days though, I said my day was “okay”. I’d regularly say a shift had gone “pretty well”. To that, she often asked me to clarify what didn’t go well, since I didn’t say it went well, but said “pretty well” instead. According to her, even if I’d had a perfect day care-wise – my day schedule was followed precisely and I’d gotten all familiar staff -, I’d still find something to complain about.

There are several things I could add to this. For one thing, I wasn’t the one complaining. I think “pretty well” or even “okay” isn’t negative. For another, I never had an entire day where my day schedule was followed precisely and I was only supported by familiar staff. I do have those days now.

Another thing is, I am in near-constant physical discomfort. This may be relatively mild, but it is present nonetheless. I am also perpetually in a state of overload. For this reason, merely going through the day takes me more effort than it would a non-disabled person. I realize neurotypical, non-disabled people cannot grasp what it is like to feel what I feel, but to label my lack of overt positivity as somehow being a bad attitude, is quite something different.

Sunny Sunday (December 17, 2023): A Good Day!

Posted on by Astrid

Hi everyone. Today I was writing another post, which I’ve since scheduled for tomorrow, but instead of sharing that decided to join in on Sunny Sunday. Today was a good day. Let me share what made today good.

First off, the weather. As I opened my phone this morning, I saw a weather report, which I didn’t read, but the headline said it was “ideal walking weather”. It was a little cold in the morning, but that’s only to be expected in December (I guess there’s a reason I was born in the summer, ha). However, later in the day, the sun peeked through the clouds and the daytime temperature rose to 10°C.

I decided to follow the headline’s advice and go for an hour-long walk. In the morning, I was supported by the most familiar to me staff member, which was awesome. I am so grateful she supported me rather than leaving me to be supported by the temp worker or very young and inexperienced new male staff.

In the afternoon, my spouse came by for a visit. I said that I was thinking of buying another case for my phone, since the one I’d gotten was too rigid. I am grateful to share my spouse showed me how to properly fold the back of the case.

In the evening, I had lots of fun crafting with clay. I created a butterfly pendant.

Overall, today was a pretty joy-filled day. It was also a productive day. After all, I had a shower in the morning and washed my hair, rearranged my Day One journals’ content, and have been spending the evening online reading and writing blog posts.

I of course could think of reasons why today wasn’t perfect, but no-one needs a perfect day. All we need is a little joy and sunshine in our life.

#WeekendCoffeeShare (December 16, 2023)

Posted on by Astrid

Hi everyone. It’s been a while since I last joined in with Natalie’s #WeekendCoffeeShare, so here goes. I already had my last coffee for the day and had my weekend soft drink (yay, we still got Dubbelfrisss!) too. I bet you could still get a cup of tea though. That is, I’ve had some later in the evening here. Let’s have a drink and let’s catch up.

If we were having coffee, I’d share that I bought a new iPhone last week. I bought the SE 3rd gen. I had originally intended on buying the 15, but that costs like €1000 and I would probably get annoyed with the lack of touchID and a home button. Besides, it’d be a greater risk of being stolen. Still, to be honest, I am slightly disappointed with the battery life of the one I got and had wanted the 15 for its great camera features. Of course, I myself can’t take good pictures at all, but I would’ve loved to have a device that can make them. All that being said, I’m pretty sure the pros of the one I got outweigh the cons.

My spouse bought me a lilac case for it. It’s a little on the thick and rigid side, honestly, so I might want to replace it eventually. I still have my old phone’s case, which the new one fits into too, but I don’t feel like I could in my right mind switch them up. That would be unfair to my spouse.

If we were having coffee, I’d ttell you that I joined the Christmas lights tour in my town yesterday. Originally, the staff hadn’t thought of inviting me and, since it wouldn’t end till 8PM and my one-on-one leaves at 7:30, they were saying I could walk an alternative route with my one-on-one. I was disappointed and tried to say I could walk independently alongside the others just fine and didn’t need my one-on-one. The way I had imagined it the staff would be pushing a wheelchair that I’d hold onto too. As it turned out, the wheelchair users were pushed by volunteers and one staff would need to watch the entire group of ambulatory clients, including me, if I didn’t get my one-on-one. Thankfully though, my assigned staff, who did my one-on-one till 7:30, offered to stay half an hour longer to be able to allow me to participate too. Normally, I’d have to pay like €30 for those 30 minutes of extra one-on-one – not that staff actually earn €60/hour, so don’t ask me why -, but he said he’d find another way.

Along the tour, there were various points where people had decorated their houses or front yards with Christmas lights and some had left Christmas lights along the pavement. We also came by my former support coordinator’s house. You know, the one from the intensive support home, the woman one who was my original support coordinator there. She no longer works for my care agency. Anyway, we were actually instructed to come into her garden, where she was toasting marshmallows and handing out hot cocoa. I initially didn’t recognize her even though I knew she lives in this town and the instructions mentioned her first name. She said, “think [intensive support home],” and then I realized who she was. She asked me how I was doing at my current home (she knew where I’d moved). I said very cheerily that I was doing well and liked it here. I also told her that I found out about the move through my current assigned staff E-mailing my mother-in-law wanting to know my preference for the paint on my wall. “Oh, that wasn’t fun,” she said. “In fact, that was fun,” I replied.

At the end of the tour, we got fries. That was so cool!

If we were having coffee, lastly I’d report that I finally disclosed about my possible dissociative symptoms to one of my staff yesterday. She said she’d seen some of my alters, contrary to what my assigned staff says. Maybe what he’s looking for is me calling myself by different names, which I don’t do unless I really trust someone. I’m trying to maintain the status quo as to whether I/we actually have DID or not, in the sense that it’d be much easier for treatment purposes if we didn’t but then again the parts, whatever you’d call them, are there whether I want it or not.

Crafting Lately: Polymer Clay Santa

Posted on by Astrid

Hi everyone. I have been quite crafty lately, but haven’t finished anything yet. The reason is the fact that my latest polymer clay unicorn broke because the oven was set to too cold a temperature. As a result, my latest craft project is still the Santa I created for a staff’s granddaughter two weeks ago. Today, I want to show it to you all and tell you how I made it.

Polymer Clay Santa

First, I created the body. I used Fimo in the primary color red for this. I usually use this color only for mixing other colors but I figured I had enough of it to be using some for the Santa’s body. I also sculpted the hat and arms while I had the red Fimo in my hands anyway, since I usually have one color clay on my work surface at a time. The reason is the fact that I am blind and would mix up the colors otherwise.

Then I sculpted the head out of light flesh-colored Fimo. I also sculpted ears, a nose and hands. The ears are barely visible under the hat.

I used white Premo for the beard, the rim of the hat and the ball on the hat.

Black was the hardest color to work with. I needed it for the belt, the buttons on the body and the eyes, as well as the shoes, but it can easily leave streaks on other colors of clay. I used Fimo’s black, as I don’t have Premo’s. I had my staff wrap the belt around the body and trim off the ends, as I was too scared I’d leave streaks the way I would need to feel to work with it.

Shortly after I’d finished this project, there was a topic in the Dutch polymer clay Facebook group asking us to snap a picture of our latest project or work in progress. I decided to take on the challenge and snap a picture of this Santa all by myself. I was going to show the picture here too, but unfortunately I deleted it.

A few days ago, the staff I had started this project with showed up in my room with her granddaughter. The granddaughter wanted to personally thank me for the handmade birthday gift I’d created for her. I was so touched!

It’s Not About Them #SoCS

Posted on by Astrid

Lately, I’ve fallen back into the habit of comparing the care I get or don’t get to that which another client gets. I did it with the full-time one-on-one client at my previous home too and it got so far that I ended up calling her derogatory names for getting what I felt I needed. Which, for clarity’s sake, wasn’t full-time one-on-one, but to have staff not leave me during my assigned one-on-one hours for every little thing. And more importantly, I felt it was unfair that she was assigned familiar staff 100% of the time while I got stuck with the temp workers most of the time.

This same issue is what’s at stake again now, since there’s another one-on-one (not sure it’s full-time) client here who doesn’t need to deal with temp workers. I didn’t mind this at all until one day earlier this week, the staff schedule got turned upside down to accommodate him and as a result I got stuck with a temp worker who was here for the first time.

This illustrates my point: I don’t care what others get. It’s not about them, it’s about me.

To solve my unfairly comparing myself to others and falling into an endless trap of what others have or do to “deserve” the care I feel I need, I am going to ask my assigned staff to write up a note saying that staff not engage in arguments about other clients’ care. For clarity’s sake, this is not the same as saying “No arguing, I’m leaving”, like the staff were originally told to do at the slightest opposition from me regardless of topic. Rather, I’d like the staff to listen to me and validate my feelings regarding my unmet needs. After all, to me, it doesn’t matter what someone else gets or doesn’t get, but when my care is compromised, I feel bad.

This post was written for today’s Stream of Consciousness Saturday, for which the prompt is “to me”. I realize I didn’t make the phrase central to my piece, but this was what popped into my mind.

November 2023 Reflections #WBOYC

Posted on by Astrid

Hi everyone. It’s the end of November, so I am joining #WBOYC and reflecting on the past month. Can you believe we’re almost in 2024? Ten more years and everything will be okay, as I always say (or WWIII will be started, as the book I used for inspiration for that claim says). Anyway, let’s wrap up November.

It started with the meeting on how I’ve been adjusting to my current care home on November 6. This meeting went okay. At first, I was a bit disappointed in my assigned staff’s attitude. I honestly still am to an extent. However, I’m trying to believe the staff are doing their best to help me.

The new application for one-on-one support was sent out the following week. I only heard some superficial bits and pieces of what went onto it, so I’m still very much stressed out about the possible outcome. It doesn’t help that my now old day schedule was used as a reference to base my necessary hours upon, which I’m pretty sure the Care Office are going to be very critical of, as was I.

Thankfully, at least for another 31 days, I’ll now have my revised day schedule. It started on Monday and I’m thrilled about it. Please, all pray or send out positive vibes or whatever you do for the necessary one-on-one to be approved for next year too.

I also worked on my crisis signaling plan with my assigned staff. This led to a major surprise, and not a good one: it turned out my original support coordinator from the intensive support home had significantly changed my plan without my knowledge or consent. I knew right as my assigned staff read me what staff are supposed to do when I’m asleep (the first phase talked about in the plan) during the day, ie. let me sleep and wait for me to leave my room rather than check on me periodically. Since my former support coordinator hadn’t altered the date and names of the people writing the plan, it still looked as though my staff from the care home in Raalte had written it though. I however was adamant that this was not the plan I’d agreed upon.

My assigned staff initially tried to dissuade me from focusing on this and seemed to disbelieve me, until I went and fetched the manila folder I had with my old day schedule and, yep, my old plan from Raalte. He tried to tell me they looked similar, but this was only when referring to the signs of the different phases, not the staff’s expected actions.

Unfortunately, my old support coordinator no longer works for this care agency, or I’d have filed a complaint against her. Oh well, my current assigned staff erased the evidence by editing the name and date to his and November 2023 and saving the document, after we’d indeed worked some on it. I am honestly extremely mistrusting of everyone here now that I know of this. I mean, all staff say that this home isn’t the intensive support home, but how do I know it’s different?

In the creative department, I haven’t really been as active as I’d have liked, but I did okay. I crafted a gnome out of polymer clay and most recently a Santa, both without the use of a tutorial. I also wrote some creative pieces, which I intend to do more of in December and in the new year.

Health-wise, I wasn’t as good to myself as I could’ve been. I really snacked far too much. The thing is, I still didn’t gain any weight, and am currently at the lowest point I agreed upon with my dietitian, weighing 56kg. It wasn’t that I over-exercised either, as I didn’t meet my movement goal on my Apple Watch several times this past month (and my movement goal is only 300 active calories, so you know).

I finally did get my support coordinator’s attention re the possibility that I might be experiencing cognitive decline. She’s going to ask the behavior specialist for some screening instruments for self-help skills or whatever. Sadly, these haven’t been administered to me before, so this is going to be my baseline really.