Tuesday, January 25, 2011

IMPULSIVITY and ANXIETY

Danny was unable to stay seated on the transport van n so they couldn take him 2 his appt. He was so full of anxiety n a mess. Dont know when they will reschedule. He needs 2 b able 2 sit still 4 a swallow study 2 n not sure he can. Hang tough hun. This too shall pass! 
On my way to the rehab. Care manager meeting 2day when she has a few moments. Time 2 start getting solid plans in place. 
Red tape when it comes to the state n its programs. We are looking@abt 2wks til discharge n danny will need constant supervision 4 sum time. Therapies will be 3x/wk for 4hrs here@good shepherd, plus follow ups here n there. My main worry? How will i take him anywhere w/o him stepping out of the car? Im praying he overcomes the impulsivity hes having n improves his safety awareness. 


Danny was improved with his ability to stay still much of the time, but being seatbelted into a wheelchair for transport to the bone doctor proved to be a disaster. Wendy, one of the aides was to accompany us on the van. She was a very calm, soothing and patient person. Danny did fine being wheeled out of the facility. Sometimes it was hard to remember that he was so very confused, and I was sorta expecting a happy comment about getting outside when we left the unit. Out front the van awaited, the wheelchair was lifted in, and the driver secured several chain-like straps to various parts of the chair. Then it started. Danny undid his seatbelt and stood up in tears. "Please, I just have to stand for a moment" We allowed him to, since this was common behavior for him all the time...frequent breaks to stand. But each time we redid the belt, off it came again. Danny's anxiousness escalated to the point where he was crying and shaking...begging to be allowed to stand. Then he would apologize profusely and promise to stay seated, only to repeat the process all over again in 30 seconds. Wendy took him off the bus for a break, then brought him on again. Same thing. The driver was telling us he could not move the van or take Danny to the appointment because he was unsafe. We finally took him off and back to the unit. It was very disappointing as we were hoping the bone doctor would remove the brace that day so we could stop battling with Danny all the time about leaving it on.
The need to keep standing was interfering with speech therapy clearing him for drinks and food as well, because they needed to do a swallow study, and Danny would have to sit very still and for a good 15-20 minutes. They had attempted it twice so far and it just wasn't working out. Danny was still begging for drinks and it was so difficult to deal with that.
The care manager met with me to start setting solid plans in place for a discharge to take place in two weeks. She set me up with the therapies that would take place three times a week, and also all initial follow-up doctor appointments were made.
My main worry was Danny's impulsivity and lack of safety awareness. I began to worry about how I would be able to transport him anywhere in a vehicle by myself.