THE TRIALS AT ST TIMMY'S 45A
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THE TRIALS AT ST TIMMY'S --
The Continued Saga of Paul Ess's Rehabilitation
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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...
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