THE TRIALS AT ST TIMMY'S 45A ================================================================= THE TRIALS AT ST TIMMY'S -- The Continued Saga of Paul Ess's Rehabilitation ================================================================= Welcome to episode 45A of the Trials. As I am now able to make a little more clear, the name of the game in these places is bill bill bill. I have a copy of a multipage form called the Minimum Data Set which the state requires be completed for each resident upon admission and periodically thereafter. They are particularly interested in what sort of place the patient came from. This can be as innocuous a place as his own home or as loaded with connotations as a psychiatric hospital. They record lifetime occupations and primary language spoken. Any history of mental difficulties is documented as is any form of retardation manifest before the age of 22. I've added some symbols: - Doing this or having this characteristic in the negative will get you undue and possibly uncomfortable attention or treatment * Bound to gain you the attention of a psychiatrist or invasive physical treatment *** Any of this series of characteristics down to the next change in indentation will gain you the attention of a psychiatrist or invasive physical treatment $ A service or procedure from which the facility will gain additional revenue, bigtime P I think this applies to me... P! I think this applies to me negatively Personal Habits Stays up after 9 pm P! - Naps 1 hr or more afternoons - Goes out one or more days/wk Stays busy with hobbies or reading Spends most of time alone or with TV P! - Moves independently indoors w/w/o wheelchair Uses tobacco daily - Has distinct food preferences P! - Eats between meals P [I do better eat less more often.] Uses alcohol at least once weekly - In bedclothes much of day - Wakens to toilet at night P [ versus peeing or shitting the bed ] [The ole bod unloads water at night; I pee freely two to four pot's worth from ten to six. "Mouth" get a real workout.] Irregular bowel pattern - [They would really like for you to go when it suits Their covenience.] Bathes or showers Bathes in pm - Daily contact with relatives/close friends Attends church or synagogue Finds strength in faith Daily animal company/presence Involved in group activities [I was never all that social on the Outside; why should I act differently in here? -- to keep a shrink off my case?] Marital status [I'm the world's first completely out and militant fag in the history of rest homes.] Who do we bill-- State medicaid P MediCare (P) VA per diem Private insurance (P) $ Self/family (P) $ Responsibility Self P Guardian Power of Attorney P Family member Advance Directives Living will Do not resuscitate P Do not hospitalize Organ donor Autopsy requested Feeding restriction P Med restrictions P Other restrictions P [There is some question about my kidneys. I will not have dialysis.] Cognitive Patterns Vegetative state Short term memory deficient * Long term memory deficient * Recall Ability Current season Room number Staff names/faces [I'm not that good with names under the best of circumstances, so they can just fuck off.] Location Today's date [It bothers these people that I look at my C:\prompt...] Decision Making Consistent and reasonable Some difficulty in new situations Poor decisions/Some cueing required Rarely or never makes decisions Delirium/Disordered Thinking Easily distracted * Altered perceptions or awareness * Disorganized speech * Restlessness/Fidgeting/Repetitiveness * Lethargy/Inactivity/Staring into Space * Mental function varies * Level of hearing and speech * Ability to make self understood * Clarity of speech [This is not a big issue because I don't think they want to hear what you have to say, anyway, so just sut yer fuckin hole!] Ability to understand others * Visual ability/Use of lenses * Indicators of Depression *** Negative Statements - Nothing matters; would rather be dead; what's the use; let me die Repetitive Questions - Where do I go; what do I do Repetitive Verbalizations - Oh God - Help Persistent Anger with Self or Others - easily annoyed; outrage at placement in a home; displeasure with care P! Self-Depreciation - I'm no good; I'm not useful for anything P! [Oops. Sorry. I _am_ useful; I entertain the alt.tasteless community!] Unrealistic Fears - Abandonment; Fear of others Recurrent Statements - About to die/have heart attack Repetitive Health Complaints - preoccupation with bodily functions; persistently seeks medical attention P! [Ming the Merciful must be deaf because he doesn't "hear" me, and blind because he doesn't "see" me.] Repetitive Anxious Complaints - Seeks attention/reassurance on schedules, meals, laundry, relationships Sleep Cycle - Unpleasant mood in the morning; insomnia P! [Yeah. Every morning I wake up in this place it just pisses the hell out of me.] Sad, Pained, Worried Expressions Crying and Tearfulness (P!) [They don't know about it. Yet. Thank Glub. I can put on certain pieces of organ music and have a good cry. Silently. Think of it as a mental enema.] Handwringing, Fidgeting, Restlessness Loss of Interest in Activities Reduced Social Interaction P! Behaviorial Symptoms *** Wandering without purpose Verbally abusive P! [I express my almost continuous displeasure with the way things are done around here.] Physically abusive Inappropriate/Disruptive behavior Noisiness Screaming Self-abusive acts [Dunno if this includes wanking.] Public disrobing Throwing/Smearing food/feces Hoarding Rummaging others's property Resists treatment or care P! [Don't come at me with pills I haven't seen before and tell me they're "your multivitamin". Bring me the label.] Psychosocial Wellbeing At ease with others At ease in structured activities P! [Bored at structured activities!] At ease in personal activites Involves self in the group and their activites P! Accepts most invitations to group activites P! Covert or open conflict or criticism of staff P! * [I do not suffer stupidity and carelessness. I will call it on them even if they are doing it not to me but to somebody else.] Unhappy with roommate * Unhappy with other residents * Open conflict or anger with friends or family * Absence of contact with friends or family Recent loss of friend or family member Does not adjust well to changes in routine P! [This is especially true when it comes to Their convenience.] Strong identification with past roles and status P! [DAMN RIGHT! I want my life back, you twats!] Expresses sadness over loss of former life P! [Why not. Think I'm glad I got a fucking leg whacked?] Feels present routine is vastly different from past P! [No shit, Sherlock.] Physical Functioning No oversight or help required Supervision only Limited assistance/non-weight bearing help P Extensive assistance/weight bearing help Completely dependent No activity Bed Mobility P * Moving to/from Bed/Chair P * Walking inside the room * Walking in the corridor * Locomotion on the same floor P * Locomotion off the floor unit P * Dressing skill P * Eating skill P * Toilet use * [It will come. Car riding did.] Personal upkeep P * Bathing skill * [When there is a bench shower.] Balance tests P * Range of motion/movement Modes of locomotion: Cane/walker/chair [Chair] Modes of transfer: Slideboard/walker/trapeze [Slide, trapeze] Rehabilitation potential $ Bowel and Bladder Continence/Patterns *** Appliances and Programs $ including catheterization/enema/ diapering/ostomy/toilet use/bedpan [Bedpan] This chart will be continued in the next episode. It gets better... =================================================================