We Walk With Brian

Friday 30 November 2001
FROM MY NOTES:
There were no early morning calls today, but Brian DID wake up at 5 am.
I arrived about 8:15 and Brian was finished eating. He had gotten his breakfast first, and was nearly done with his cocoa. He and I worked on remembering what he ate, for his Journal (one of the things ST Julie wants us to work on).
Brian had a shower at 8:30, walking there and back again with CNA Megan (Certified Nursing Assistant; CNA's work directly with the patients, while the nurses administer meds and run the floor). He was dressed in hospital pj's when he returned, because he was going to get dressed during OT. He got to sit in a regular chair in the room with me when he returned!
During OT with Erin, Brian picked out his own clothes, got dressed, and brushed his teeth and hair. His hair is very curly!
Brian had PT with Susan at 10 am. She was amazed at his improvement since she last worked with him, earlier in the week. They walked to and from the gym; Brian worked on balance exercises on the mat and standing. Between 10:30 and noon, Brian worked on his ST homework, and finished it perfectly. I found that leaving him alone worked best for keeping him on task. I went to the Dining Room and did my own "homework", letting Brian know where I was.
All day long, Brian wanted to WALK! I helped him stand up to pee and shit. (rolled to the toilet, I closed the curtain, he did everything on his own, I stood nearby, ready to help) (I remember when we first visited the Unit and I saw the toilet set-up, I wondered how long it would be before Brian would be able to use it.) Brian is wearing only his boxers now - no more diapers! This happened a couple days ago.
Brian and I ate lunch together. Dave couldn't make it because he was at our home, shoveling 2+ feet of snow off the trailer roof. He had gone home Thursday evening, to check on things, and more snow fell. He arrived after 1 pm.
After lunch, Brian and I worked on remembering what he ate again, for the Journal. "Why are we doing this?" he wanted to know. I explained that it was practice to get his short-term memory working right again.
At 1 pm, Brian had his combination PT/OT session with Amy and Erin. he worked on soccer ball kicking; played volleyball with the beachball; and started a game of checkers with Erin, which he was winning. 
Dave and I gave him some time alone, while we talked.
During his next OT session, he played checkers with Erin again.
At the 3:30 PT session with Amy, Dave And I learned how to walk with Brian, by staying behind/beside him, hand near his back, keeping him focused, not conversing because it's distracting. We also learned how to walk up and down stairs, and how to catch him if he starts to fall. All these activities are done with Brian wearing a wide, white canvas "gate belt", which is used to help him if he loses his balance and/or starts to fall. Amy also taught Brian how to get up. The Rules were discussed, and written out by me, to be put up on the wall next to Brian's bed, and in his Journal. He can only stand with an adult, must be wearing shoes and the gate belt, and can only walk with a parent or a staff member (after training). Now, we have to impress upon Brian that the Rules must be followed, for his own safety! He needs to be watched and reminded constantly. From four to five, we worked on using the Journal for Remembering, looked at pictures, and talked about his friends and their passions (Dave's idea). Marc was the only described as having a passion: playing piano. Brian's passion is drawing: "I love to draw!" Describing his friend Chris: " He's really smart and he's a dork." (Chris has a reputation for this; he is also a sweetheart).
Vanessa Dudley and Ahsa arrived about 4:50. I walked with Brian to show them, and they joined Dave, Brian and I for dinner (they had already eaten). Dave got Chinese food for he and I and brought it in. We had a laughing good meal. Ahsa is very calm and intuitive with Brian, careful about not talking to him when someone else is, and directing him to use the Remembering Journal. After dinner, we all worked with the Journal and looked at Europe photos. The girls left at 6:15 pm.
Dave walked with Brian a bit, as did I. Brian and Dave visited June briefly.
We got Brian into bed around 7:30, because he was tired, disjointed, getting wobbly. We had spent some time looking at art books I brought in - Vermeer paintings, Van Gogh sketchbooks - and Brian asked, "Are you guys showing me these because you think I could be a professional artist?" We told him "Yes!" and he was thrilled, kept thanking us. He said he liked using colored pencils the most, and "can't paint". Dave suggested he not say he "can't", that there is time to practice. Brian continued on the theme of "Do you really think I can be a professional artist?" for the rest of the evening. He was especially amazed that we thought he could be one if he only did pencil drawings. Dave engaged him in describing the self-portrait with the skull, which Brian did not describe as a self-portrait, but as something that "came out of my head". He was able to describe the basic process of drawing the picture, but not any of the emotions. The self-portrait the cards were made from elicited a description of the look on his face that appeared accurate: " Angry and confused". He also commented that he doesn't have a "6-pack" like indicated in the drawing, then explained to us that "6-pack" refers to well-developed abdominal muscles. 
In the morning, I met with Janet Murphy, who reported that, as a result of their staffing Thursday morning, it has been determined that Brian MIGHT be released on December 11th! This necessitates a family meeting as soon as possible; Dave and I will meet with Marshall, Janet and Shelley on Wednesday afternoon at 1 pm. We will discuss discharge plans and try to work out arrangements with Marshall and Kellie (Kellie will not be available for the meeting). The re-hab team wants Dave and I to continue our work with Brian, and Janet told me there is a possibility Dave and I could be paid by Medicaid to be Brian's caregivers. Everyone thinks we are doing a great job.
Even though Brian was very tired, he was still awake when I had to quit reading at 8:30 pm. I left him peaceful.