Monthly Archives: March 2012

Training.

Over the past few days, the other interns have begun implementing training for Kari’s “Walking Program”. Earlier we had taught the ladies what an aerobic step was and how to do aerobic steps (walking fast for ten minutes) and where this could be done (on the track or if it’s raining in their hall). This week and last we began taking each participant to the track and walking with them. At first we walked with one individual for the entire ten minutes. The next time, we walked with the one individual for 8 minutes, and had them walk the last two alone. Next we walked 6 with and let them walk the remaning 4 on their own. We were present during the minutes they had to walk alone. Eventually, we will fade us out completely, to where we just watch them walk for ten minutes. After that, we will take them to the track and leave them there to walk alone.

So far, the training has dramatically increased aerobic walking. One participant walked for 102 minutes and did over 12,000 aerobic steps! All of the ladies accomplished aerobic steps, even the two that were not present for training last week.

I also tracked down medical information for a few residents. I wrote down what type of medication and the dosage they were given for sedation prior to dental treatment.

I also found out the diagnosis of our resident from the post, a visit by the EMT’s. As I mentioned in the previous post, she had been sent to the hospital. On Monday, they released her back to The Center, however her oxygen level decreased again and she was sent back. Her diagnosis is pleural effusion and hypoxia.

Com-qol I-5

Today at the Center, I and another intern performed two com-qol’s. The residents who participated were some of the ladies from the “Walking Program”.

Kari also updated me on the resident from my previous post. She ended up vomitting uncontrollably in the middle of the night, so they rushed her to the hospital. I was a little sad as I had brought my camera for her to play with since she had previously made her interests in it known.

I also discussed the not for profit school, The Chicago School of Psychology with Kari. She gave me a few pointers such as googling cv’s of former students.

After internship hours I emailed her about another school, Utah State University.

A Visit By The EMT’s.

Today the other interns and I were given three tasks to complete (Kari was not there). The first was to check on the resident with down syndrome and dementia in her room and to get her weight. This one I did. The second was to gather the “Walking Program” data and the third was to help with Henry’s doctoral thesis in the record room. I also helped with the third. I was the first intern to arrive at The Center and I assumed the other interns wouldn’t be in until later. I decided to go the the resident hall and collect the “Walking Program” data as I thought it was still early enough to catch the ladies before they went to work and I figured I could kill two birds with one stone by getting their data and getting the weight of the aforementioned resident. Unfortunately, the ladies had already left by the time I got there, so I said hello to the nurses and asked Maria (one of the nurses) if the resident had made it down to get weighed. She had not. So I borrowed the key and went and knocked on her door. Of course, she was laying in bed like always. I asked if she had eaten breakfast, no response. I told her that she needed to get weighed for the day and told her I wasn’t leaving until that happened. Eventually, Maria came down the hall and tried to coax her out of bed, but that didn’t work. I told Maria that the resident seemed to be breathing heavy. So Maria went and got her blood pressure monitor, oxygen monitor, and the resident’s medication. The resident immediately propped up in bed to take her meds and to be monitored. Maria noted that her pulse was low and then discovered that her oxygen level was below 90 percent. Maria tested her several times to see if she could get a different reading, the machine either did not read or read low. Maria then went to get another nurse. I told the resident that if she went down to the end of the hallway and got weighed that I would brush her hair, but only if she walked down to the end. She could not be weighed in the room and then get her hair brushed. Both nurses then returned and together we all three coaxed the resident out of bed and down the hall way to get weighed. We discovered she had gained a pound since the previous week. Maria then measured her oxygen again and it was still reporting low. As protocol, no one can remain at the Center who’s oxygen is less than 90. Maria called the residents brother and then informed the staff down stairs. I returned with the resident to her room to wait for the ambulance. The resident sat down on the edge of her bed and did not cover back up. I talked to her for a bit before remembering that I had promised I would brush her hair. I then asked if I could brush her hair, no response. I grabbed the comb from her nightstand and she did not stop me. I then brushed her hair. I had also promised her that I would put barrettes in. I asked if she knew where they were, no response. So I searched myself but could not find them. Eventually the nurses, the EMT’s and two other staff members returned to the room. They measured the residents blood pressure and oxygen levels, everything appeared normal and at 100 percent. The brother was then called and asked if we should take her. He decided against it. The EMT’s asked the resident if she wanted to go, but she gave no response. To my surprise though, the resident willingly allowed the EMT to measure her vitals without any resistance, which goes against her typical stubborn self! One of the staff members suggested that the resident thought the EMT was cute and she began to smile. After that she returned to her normal self and became very talkative. She even had a staff member pull out a photo from her drawer so we could all look at it. It appears that the resident responds to cute males, photos/cameras, and hair brushing. All good things to know!

Although the experience was scary, I definitely learned a lot from it.

After all of that I then went downstairs to work on the thesis in the record room. We’re almost done with it now!

Life Survey’s And Chatting.

Today I helped Henry with his dissertation. We scanned several residents life survey’s. The other interns and I got an entire drawer completed! Henry and I discussed some flaws with the survey (why the existed, potential explanations, and how to correct them when I’m a grad student). We also talked about my new minor in Quantitate Social Sciences. Afterwards, I visited with several residents seeing how their day was. I reminded a few of the ladies from the “walking program” to do aerobic steps and reminded them of how to accomplish that. I also talked with one of the residents I frequently visit. She was very talkative today, she even asked me what my name was, something she hasn’t had the opportunity to do before. It appears as if her lower dose of medication is working so far.

Alphabetized Data Sheets and Aerobic Steps.

Today I collected data again for the “Walking Program”. Kari recently began having the interns collect aerobic steps as well as we will be measuring that in addition to the physical steps each person takes a day (as counted by the pedometer). Today I collected the aerobic steps and “normal” steps from all four ladies who are participating.

During this time, I reminded one particular resident (from Wednesday the 7th) what an aerobic step meant and how to accomplish this. I had her repeat back the task and defintion as she had not remembered what it was upon first inquiry. Later on I saw her again and reminded her.

After this I paid a quick visit to a particular resident that I’ve mentioned several times (an older female with down syndrome and dementia). I visited her after her room-mate informed me that she hadn’t bathed in several days, fighting with staff, and still not leaving the room. Today she had a doctor’s appointment so it was pertinent that she got up and got dressed and ready for the day. I stopped by the room for approximately five minutes and tried to coax her out of bed by stating that she had to follow the rules and see the doctor. I also tried coaxing her by saying that I knew her mother would not be happy if she did not get up and go to the doctor. When I left her hair was combed and she was supposed to be getting dressed for the day.

After that I went downstairs to the office and filed alphabetically data sheets from December 2011-Feburary 2012.

Aerobic Steps and Backwards Chaining.

First thing I did today was help the doctoral graduate student, Henry, out with his thesis. We scanned three different residents quality of life survey’s from 2006-2009. This took approximately an hour to complete.

Afterwards, I went upstairs and assisted Kari with making a video for her presentation at the University of Houston-Clear Lake. We performed a backwards chaining task of making coffee. The steps included in this were take the cup out of the cupboard, get the carafe, pour the coffee, put the carafe back. My reward was drinking the coffee.

What is backward chaining? Backward chaining is a chaning procedure that begins with the last element in the chain and proceeds to the first element. What does this mean exactly? Well, first, the person teaching the task completes all but the last task and then uses what ever level prompting the person learning can succeed at to complete the last task by him/herself (as defined by BBB Autism Support Network) . When this is completed a number of times successfully, the person teaching then goes through all but the last two steps and again prompts for the next step in the chain. This is done until the person has successfully completed the entire task on their own.

After this I then went an taught one of the residents who is in the “Walking Program” what an aerobic step is. The first thing we did was go up to her room where I handed her tokens that Kari owed her. I then showed her a new goal sign that stated “1,000 Aerobic Steps”. This individual is to walk 1,000 aerobic steps in a day. I had her pick a spot where she would see the sign and then explained aerobic steps to her. I stated that 1,000 may sound like a lot but that it’s easy to reach, all she has to do is walk as fast as she can for ten minutes. I told her this could be done in the hallway at night or on her way to the workshop. I then had her practice walking as fast as she could in the hall way once down and then once back up and then returning to her door. After that I had her repeat back to me what an aerobic step was. I also explained to her that her pedometer would read 0 for the time being until she had accomplished her goal. I told her to not feel sad about the number but just to work on walking as fast as she could. We then returned to the workshop. While on the way there I had her repeat the definition one more time and asked her about the number 0 (if she is supposed to feel sad about it). She successfully repeated the definition back and that she was not supposed to feel bad about the number.

Data Sheets, CIRCLES, and Alzheimer’s.

As today is the second day of a new month I collected data sheets! I also put two new data sheets in for one resident who was missing data sheets for March, and one resident who just started a BIP.

Kari introduced me to CIRCLES, a “program [that] teaches social distance and levels of intimacy through the use of six colour coded concentric circles”. Although the curriculum is a little childish for our adults, it still gives some good points and a good leaping off point. A few of the residents are still a little hazy on how to act appropriately, especially with a new person, like myself. Kari gave me a few pointers on one particular resident who likes to hug me and tell me she loves me almost every time she sees me.

I also gathered data from pedometers. I got the four participants full step count from the day before, and their calories, distance, and aerobic steps from the past seven days. Aerobic steps was very interesting as they all had zeros for almost every day, only two participants had something other than a zero.

Kari also gave me an article to read (listed under the page Articles [coming soon!]).

I visited two residents that I check on every day. One had made it to the classroom while the other had not left her room. The latter later informed Rosemary that I had placed the visual prompt (reminder to go to the classroom) in her room and she did not like me. She would not take the paper from the classroom (the slip she needed to go to the workshop, a preferred place).

After Kari left, Dr. Grossett let me make copies of a book and pamphlet on Alzheimer’s (these are listed under the page Articles [coming soon!]).

I also made copies of math sheets for the teachers so that when the two aforementioned residents made it to the classroom they wouldn’t be bored.