Assignment Four

As previously outlined in my blog, the goal of my work with R.H. is to lessen his isolation in his inpatient facility. As part of this goal, I hope to draw R.H. out of his room, or at least out of his bed, using the meals that I bring him from McDonalds. R.H. often refuses the in-patient facility’s food and looks forward to the treats that I bring him. I planned on having him eat the food in the ward’s dining hall instead of in bed, as is his norm.

When I entered R.H.’s room, his roommate was also present. R.H. detests his roommate, and hates how the roommate intrudes on the privacy of our conversations. I pulled the curtain separating the two beds shut, in order to at least give R.H. the allusion of privacy in the shared room.

Per usual, R.H. was lying in bed listening to music. I said hello to R.H. and commented on how well he looked. I asked how he was doing. “Horrible,” he replied. I asked if anyone new had come onto the ward with whom he might connect. “No,” he told me. I asked if there was anything else that I could bring him to pass the time, books, magazines, or anything like that. R.H. told me the only thing he wanted was to “get out of here.”

I then showed R.H. the McDonalds that I had brought him. Rather than eating in bed, I suggested, why don’t we take the food into the dining hall so that you can eat at a table. R.H. flatly refused. I again suggested that we take a walk at least, get out of the room. At this suggestion, R.H. became greatly agitated. He became angry with me and walked out of the room. In this manner, I suppose that he was less isolated because his agitation and anger forced him to get up and leave. However, when I followed him he became increasingly angry and refused to speak with me.

I told him I was sorry that he did not want to talk, and that I always enjoy our visits. Rather than walking me to the elevator and saying goodbye, as R.H. normally does, he walked angrily back to his room, with no goodbye or parting greeting.

I am unsure of how to proceed with R.H. I do not know how to implement my intervention when he is so intractable in his refusal to socialize or be around the other residents. R.H. has been in his current facility for years, and for years has spent the vast majority of his time in bed. I do not know how to encourage him to leave his room without agitating him.

In addition, R.H. eats so little that I am cautious about making his McDonalds a stressful experience.

Therefore, I feel somewhat stuck in my evaluation study. I have yet to be able to make any inroads with R.H., or to use any intervention on him. As the vast majority of my clients have severe cognitive impairments, R.H. is my only possible subject. However, I am unsure if I can get him to even attempt an intervention.