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Tuesday, January 18, 2011

When not to care

Doing individual sessions at home let’s you see some aspects of human life that you usual don’t see working in a CE centre. You might sense their existence but usually it’s hidden under the mask of privacy and happy faces. Last week I’ve witnessed a relationship breakdown and re-birth that I am sure what have been presented in softer version would I see this client in a group session. But there it was, the sudden rather inspected outpour of my clients wife at the end at the session, that she will not help him anymore unless he really wants to do it. That she was done caring if he didn’t. That what she is doing now, constantly motivating him is too much for her.

Unexpected in a sense, that there wasn’t a major incident during that session that would have provoked this kind of reaction, or was there? However, the way this was said (there were more brutal words then this though) that lets assume this has been building up for a while and just had to unload. A lot of emotions where in this on both side (mine excluded).

My client had a stroke over a year and a half ago. He not only lost his ability to move and control his left side but also part of his short-term memory, planning activity, self-awareness, confidence, hand writing (as he used to write with his left hand) and worst of all his independence. His wife has been thrown in the position of being his caregiver, advocate, memory, motivator and instigator. As a couple they have lost their identities they had before the stroke happened.

About a month ago, I tried to suggest for the wife to try to step back out of some of the activities as his husband realized on her a lot to cue him to do certain things, even though he could do some without needing the cueing. She used to be a primary teacher and seemed to have slipped right back into this one when she lost her usual role as the wife. But then it didn’t seemed to find any resonance and I noted down to try to a later point.

That morning during the session my client brought up, how he used missed his handwriting. I used this as a opportunity to tell him about Suzies awesome blog and how helping her clients to develop hand writing after a stroke has really helped them to organize themselves. I was planning to try to introduce this to him at one point but was not sure he was ready for it. But seizing opportunities is possible one of the most important skills of a conductor. I asked him if he had tried to write with his right hand. And he didn’t. So I asked him if he would like to try it and he was willing to. I explained that writing down what he did, might help him to remember better and make it more real. He has a hard time believing that he did something when other people tell him that (we discussed that the week before). I also explained that he can take over some more of his care to write down what he wants to do that day, so it doesn’t seemed to always come from his wife. It turned out that handwriting was very difficult for him. Not only didn’t it feel right, there were also problems with other body in space judging issues (I also observed similar difficulties during gross movements). He didn’t space out his letters or took breaks in between words, which made it very illegible. He felt embarrassed trying to learn to write again, like a child. I assure him that there is nothing to be embarrassed again and made him aware of some things he did. By the end of the page his writing improved drastically and you could see some improvements with his confidence.

At the point of the outburst, I felt rather awkward because the emotions involved seemed to be so private. But at the same life is sometimes just like that: messy, complicated and a bit awkward. I think the hardest part was, to feel the hurt on both side without being able to make it better. I tried to help to discuss this a bit more - carefully- but the best thing for me to do was listening. On my way out I assure the wife that bowing out of the responsibility for improving his skills is a good idea as well as being important for her health and for his recovery.

On the way home, I felt very down after a otherwise good and productive session. I cannot imagine how my client and his wife felt, but possible it wasn’t as positive as I want everyone to leave any of my sessions. I thought the words were pretty harsh and it could have been sat differently. But then at the same time, who am I to judge. It’s their relationship and it’s there emotions and how they communicate them to each other is their private choice.

When I returned this week how it has been going with the wife backing out of things more quickly, the wife reported that she left him more by himself and said she feels a lot happier. My client reported that he didn’t notice the change. So after all it wasn’t a big issue anymore and one of them are like Norman quoted on her way to take care of herself physically and emotionally.


PS. Sorry Susie, I cannot find the post I was referring to in your blog.Tried to find it for a while but got stacked reading all those other wonderful posts. I have to go and do something else but I know it there somewhere. Reviewed: Thanks to Susie I have the right link now and im looking forward to hear more!!

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