Monthly Archives: December 2011

Interdisciplinary Team Meeting (ITM).

First thing that gets discussed at an ITM is concerns. The resident and then guardian give both their sides and their concerns. This particular resident (a 37 year old woman) was concerned with her job, she wanted a different one to coincide with her boyfriend’s work hours. The guardian (in this case, the woman’s mother) wanted to make her daughter happy and discussed with one of the faculty how work could be arranged. The faculty member said she’d look into kitchen jobs, since that’s where the resident’s boyfriend worked, but also warned her that if she made more money, The Center would take more from her paychecks.

The nurse present in the room then updated everyone on clinical exams, mammograms, well woman, dental, nutrition, and diet. All exams were up to date. The nutritionist wanted the resident to be more careful with her diet and so did the mother. A suggestion of not eating pizza past 9 pm was given and to eat less ramen as well. This then brought up the topic of not being in her room at curfew. The resident would often be on the 6th floor with her boyfriend until after curfew and would refuse to go to her room. The mother was concerned that she was spending too many hours at night on the 6th floor. It was decided that rules should be enforced for the curfew. The resident was told she had 3 months to change her habits on her own, or a plan would be implemented. The resident could only spend hours past curfew with her boyfriend in the lobby and on Sunday-Thursday the resident had to be in bed by 9 pm so that she would not be late to work. The nurse also stated there would be a change in her blood pressure medication.

Next, Kari discussed the behavioral program, target goals, reinforcers. Mom stated she wanted Seraquil dose reduced. The medication hadn’t been reduced since 2008 and was currently at 200 mg. At PMR reduction of Seraquil will be evaluated.

Finally, the lack of the resident doing her laundry was discussed as this was an issue with several faculty members and the one the mother was most concerned with. Laundry was discussed with the resident and was advised to do her laundry with her boyfriend or while he was at work so that they could spend more time together.

Completing laundry was added to positive target behavior list along with completing programs and returning to room by curfew.

Reinforcer Menu And Medical Records.

Today I watched Kari create a reinforcer menu for a resident based on a prior preference assessment. Kari uses a token system to get residents to modify their behavior. Afterwards, I reviewed medical records in the infirmary wit fellow interns. We looked at doctors notes and exams like EKG’s. We also looked at medications and to see if one particular resident was on a certain medication prior to a dental appointment.

Research.

Today we met a graduate student who attends Walden University. He introduced us to his research and showed us how to use his research equipment (scanner, computer, and software). Basically his research consists of evaluating quality of life assessments to show how ineffective subjective questionnaires are.

Classroom Visitation

Today I visited a classroom. Friday’s are normally movie days and as such the residents gather in a different classroom to watch a movie. The teacher, another intern, and I had to go to the residence hall to pick up two students who had not shown up to class. I escorted one resident to the class room after we found her struggling with her belongings. She then told me all about her cousin and her best friend (whom she carried pictures of). It was really touching and I enjoyed conversing with her.

After that I colored and did simple math with another resident. She was really good at math, which to be honest came as a surprise to me. She barely needed assistance and I mostly guided her. This particular resident had been taught math and had become to reliant on a calculator so the teacher was now teaching her to do math on her own. The resident had not yet reached the level of counting in her head or even on her fingers. Instead, she counted, added, and subtracted using popsicle sticks. We also read a newspaper together and she circled toys she wanted from various advertisements.