Sunday, 11 January 2009

Learning during the bits in between

Is spring in the air? by Susie Mallett, 2003

At the beginning of the week I was discussing the affects that the festive break has on the mobility of the clients in my Tuesday evening adult cerebral palsy group. We did our utmost in this cold spell to keep mobile and motivated by fitting in four two hour sessions in the two weeks.

Taking a constructive break

Yesterday I visited one of my stroke clients in her home. It was our first session since before I went to Norway at the beginning of December, her first session of any kind for at least three weeks.

This was her own decision. The physio- and occupational therapist had taken only two weeks holiday and I had taken none, she could have carried on with as many sessions with me as she wished all through the Christmas period.

She didn’t wish, she made a conscious decision to have a well=earned break from formal sessions, but not a break from living, which for my client means practising.

Understanding

This is one to ask if you what to know about conductive upbringing/pedagogy, the one I always suggest could give an interview if the local paper turns up. She understands and has made whatever it is she does, physiotherapy, occupational therapy, speech therapy and every-day life, “conductive”. My client has always tried to incorporate, quite automatically, all that she learns into her daily life. From the start, from when I first met her over ten years ago, she has always seen her work with me as a way to improve her activity in her life and never as a series of exercises.

Pros and cons

I sometimes visit her at home and she also comes to my groups, enjoying both types of sessions, using one to complement the other. During home sessions she can ask more personal questions and work on problems more specific to her needs within her home. In the group she enjoys the motivating colleagues and the exchange of news and ideas. The pace of the group's work is slower than she experiences working alone at home, but because of the space and my colleagues I can offer a slightly different and more varied programme. In each situation, she says, she has time to think and correct her movements, but in different ways.

So what happened today to prompt this posting?

Feeling the movement and improvement

My stroke client and I spent most of our two hour session wondering in amazement at all the improvements that had taken place during her “holiday”. She had consciously chosen not to have any visits from "therapists" of any kind to her house for three weeks, she did this to give a bit of normality to the lives of both her and her family. This is not the first time that she has done this, she feels that she needs the time in order to use what she has learnt and get to know her body, its feeling and movements, more intensely. The interesting phenomena is that this client isn’t actually aware of the huge progress until we start work again after a break. During the more formal task series she tells me she is able to control her movements and she can feel what she can feel and do. Through this she begins to realise why she is finding certain situations in her life easier.

My stroke client is active. She spends every waking moment trying to be as active as possible in her family life, as independent as possible and enjoying as much of the world as she possibly can through whatever means suit her at the moment.

After we had marvelled at even the sometimes invisible improvements my client has made she began telling me of her plans for a holiday in two years time, on a cruise ship to the Norwegian Fjords. On this future occasion the break from all sessions will be filled with some extremely exciting “bits in between”.

Striving for greater independence

There is a difference between my stroke client, who took a break, and the adult cerebral palsy group, which was determined not to, but I am struggling to put into words what this difference is.

Just one of the adults with cerebral palsy lives with her family and is motivated similarly to my stroke client, by her family life and practising what she learns through living. The others live in a home and many of their daily needs are provided for them, they don’t need to cook and clean and do their washing, they are certainly less independent than they could be. For them the source of motivation to be active comes possibly more from the other members in the group than it does from their own need to be active in their daily lives.

It really is time to take a look into how the lives of such young people with cerebral palsy can become more autonomous, how they can increase their independence and become more active in running their own lives.

1 comment:

Judit Szathmáry said...

It is all about empowering isn’t it? Our work is done when we can empower people to take charge and feel empowered to move onto the next individually comfortable level. It is when they start seeing themselves as still capable ‘heroes’ and ‘heroines’ instead of victims. When they see the larger part of themselves, which is valuable, competent and well. The wellness and the bigger part of ourselves have the power and the never-ending ability solve anything we have to face with in our lives.