Taking Care 3 (ii)

       By eleven, I'd only managed to get through three folders.  It was a massive amount of information to take in.  I'd written down things like cerebral palsy, autism, Down's syndrome - none of which I knew much about at the time.  I'd looked at long and confusing lists of medications, browsed through risk assessment forms - most of which seemed to have phrases like 'possibility of death' in them.  I'd seriously begun to wonder what I'd let myself in for.

       I went to the kitchen to get myself a coffee.  Jill, the cook, was preparing lunch.  She was about fifty, quite quietly-spoken.  I'd heard her earlier speaking with a couple of the residents, and she sounded very kind and patient.  Not quite so loud and in-your-face as the others.

       She asked me if I'd done anything similar before, and I told her it was all completely new.  I think she could tell that I was a bit overwhelmed with it all.

       "It hits you on the first day.  I don't know why they stick everyone in with all the reading straight away.  It's all too much.  Once you get working with the guys, though, it gets easier.  You get to know them.  They're a lovely lot here.  We have a lot of fun.  And the staff are always helpful.  You'll be fine."

       Towards lunchtime, Andrea came through to use the toilet and to see how I was doing.

       "I wouldn't worry too much about making loads of notes," she said.  "It'll only confuse you.  Just try to get a general sense of who they are.  You'll learn the rest as you go along."

       It was the same refrain I kept hearing.  It was reassuring in a way.  But I felt a bit like I'd felt years earlier, when I took an admin job at the local hospital and had just two days' training from the previous post-holder before she left. In that time I had to learn two complex computer databases, including the management of appointments, case files and medication regimes.  At least, though, I'd had that person there to guide me.  So it did feel disconcerting to be starting a job like this, with so much responsibility involved - basically, having charge of people's lives and welfare - by just being presented with a pile of information and being told to get on with it.  At the back of my mind, though, I told myself that I was probably just as capable as any of the other staff I'd met.  I had a feeling it was going to come down to personal qualities in the end.  My instincts were telling me that I'd be good at the job, and that I wanted to do the job.  That was a good starting point.

       It was a long afternoon, but I managed to get through the rest of the files, making brief notes.  I looked at the photos of the residents and tried to attach a bit of knowledge to those faces - some old memory tricks that I'd learned.  There was Derek, Jake, Dilip, Shirley, Greg, Steven, Jamie, Phil, Ian, Lizzie, Richard and Tim.  Greg had Down's Syndrome, plus autism.  Steven and Jamie had cerebral palsy and learning disabilities, but while Steven could walk freely, Jamie needed support to walk.  From what I could see, the others all basically had general 'learning disabilities' on a spectrum from mild to severe.  Shirley, it seemed, was the most able and could even go out on her own to do her own shopping.  All except Jamie and Phil could communicate verbally.  Jamie made noises - 'bleating' it said in the notes - and Phil used a form of sign language called Makaton.  There was a sheet in his notes showing some of the common signs he used - for words like 'Hello', 'Please', 'Thanks', 'Toilet' and so on.  They seemed straightforward enough. Phil, Tim, Jake and Dilip were the ones who mainly did college courses, but would also occasionally swap with one of the Centre regulars during the college breaks. 

     Tim seemed to be the most capable, with the mildest learning disabilities.  He was doing college courses in gardening and woodwork.  He also had good verbal skills and understanding.  It did state, though, that he was prone to mood swings and could become physically aggressive - hitting others or breaking things - and these were most often triggered by changes in routine, or by other people becoming agitated.  Because of this, it said he was better doing activities alone, or in smaller, quieter groups of people.  Phil - another one I hadn't met yet - was described as a quiet and happy young man, non-verbal, able to write simple words and sentences and who preferred lone activities.  He could also be triggered by certain others - especially, it seemed, Jamie because of the 'bleating'.  So they were best kept apart if possible.  Richard was an older man, in his fifties, who was capable of many things - though he could only walk slowly because of having one deformed leg.  He was verbal and liked to talk - though he had a tendency to repeat things.  It said he was impatient and liable to become upset and cry if he couldn't get his own way, or if someone else was upsetting him.  Apart from Shirley, none of them had any concept of money and had to have all of their money allocations and expenditure handled by staff.

       At three, a new staff shift started and I sat in on the handover, with John (who'd been the shift leader) running through how things had gone.  The afternoon staff seemed a mixture, as before, of younger and older people.  They all seemed confident, relaxed, friendly.  I spoke to a few afterwards and got those same positive 'it soon falls into place' words.  Then, at four-fifteen, I heard the doorbell ring, followed by a commotion of scuffling feet and loud voices in the hall.  Jill popped her head into the room.

       "They've just got back from the Day Centre if you want to come and see them."

       The afternoon staff were out there directing operations - helping people off with coats, assisting them to their rooms, giving orders about washing hands, etc.  Jake and Shirley recognised me and said 'Hi'.  Thandie was there, too.  She was a big and energetic Nigerian woman - her hair braided with coloured beads.  She introduced herself and I warmed to her immediately with her generous smile and easy manner.

       "So, you're the Will I've been hearing all about," she said, giving my hand a firm shake.  "Welcome to the house of fun!"

       "Thanks.  It seems like it, anyway."

       After she'd helped with a few of the residents - putting bags away, getting Shirley a cigarette from the office and directing her to the garden - she joined me in the small office.  She could see what I'd been doing.  She said the same as everyone else.

       "It's a lot to take in.  But you soon get it.  Once you start the hands-on work."

       "How was your day?" I asked.

       "Good," she said.  "No problems with anyone."

       She took an A4 diary from her bag and put it on the desk to show me.

       "This is the usual end-of-day thing.  You just need to write in the day's activities for each resident you had with you.  What they did, what they ate and drank, any personal care, any medication they had, etc."

       She wrote the first entry down to show me.  It was just brief details - about six lines.

       "There's only really Ian who has meds at lunchtime, and he doesn't always go to the Centre, anyway.  If he does, you'll have to get one of the staff down there to administer it until you're trained.  You'd also write in what their moods were like, any incidents.  Then you hand it over to the late staff. If there were any incidents, like an accident, someone kicking off, something broken, you'll also need to do an incident form.  They're kept in the office.  You need to do those on the same day."

       I nodded.  "Okay.  Do you get many incidents?"

       "Not really," she said.  "Alan, if he goes, likes to wind people up and can cause trouble.  Sometimes Steven can be triggered by something and you'll have a bit of shouting and swearing.  That kind of thing."  Then she added, reassuringly, "In three years, I've not had anything serious.  A lot of it depends on knowing the guys, their likes and dislikes, being vigilant and aware, and just doing the job properly.  That way, it should all run smoothly."

       She went back to the diary.

       "I'll just fill in the rest of these now and hand it over."  She gave one of her big smiles again.  "Then it's grab my bag and home I go."

       At five, I walked out with Thandie as she went to her car.

       "First day's the worst," she said, cheerily.

       "I know," I said.  "I've had a lot of them.  First time in a job like this, though."

       She smiled.  "I'm sure you'll be fine."

(continued)  https://www.abctales.com/story/harryc/taking-care-4-i-day-centre