Wednesday, June 08, 2011

When the impossible seems impossible; difficult case fellow

Here's a question I received from a friend:

What are your thoughts on working with a 40 year old man who's been felled by a reaction to a bee sting 5 or 6 years ago. He is in a long term care facility. His eyes are open but he does not see. I think he hears well and understands some/most of what is said around him, but he does not respond in any meaningful way. He can vocalize and uses a few word (I'd say in an automatic way - pat phrases). He can swallow food, but not liquids. He can move his arms and legs and head, and roll to his side(foetal position) but cannot sit or stand. He has to be moved with a winch-like hammock system from bed to chair. He loves music.

I've seen him a few times, but am at a loss of how to go beyond making him feel more relaxed and more comfortable.

My thoughts are that a lesson
is a lesson is a lesson.

comfort and a feeling a reassurance go a long
way to opening a person to being alive

but certainly can't really move
the person forward
(unless they can learn to make themselves more
and then less comfortable as
a volitional thing0

So what's a lesson to be
for this poor fellow

same old same old:

Can he understand yes and no?

Can he follow someone with his eyes?

Can he open and close eyes on command/

open and close mouth

turn head this way and that

Can he distinguish which music he likes more

Can he tell when the music stops

can he tap this hand, that hand,
this finger, that finger in time to the music

can he watch a hand move up
and down in time to the music

can he tap on his body
or feel taps in time to the music

can he distinguish fast and slow tapping

can he feel the difference between more foetal position and less
can he turn head eyes tongue ? while in fetal position

can pressure through feet or sit bones in fetal position
give information about sitting and standing

and so on

what do we have to lose
trying anything
and everything

that's a start anyway

in a way,
this is like autism:
what can the brain latch onto
and learn from?

anything is
a step in the moving back
into life


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