Sunday, 14 April 2013

Adult clients, real collaborators

How group members care for each other, including me

It is strange how time flies past when my work with adults begins.

A three-week block with children appears to me to last at least twice as long as a three-week block with adults. I enjoy both but I wish that the work with adults would last just a little bit longer. No sooner has the camaraderie picked up again and it the time is over again for a while

I love to work with my colleague with the little children who attend our sessions for three weeks at a time, to meet the older children who attend sessions each afternoon after school, and to help them with their lives in mainstream schools, but my favourite work of all is with the adults. I especially enjoy the work with the stroke group, although I now have another favourite string to my bow, with the new group called Fit and Active at an Older-Age.



I wonder whether it is because we do not see each other regularly each week that this special camaraderie has developed. I expect that all group members, all in their own special way and for very personal reasons, look forward as much as I do to our intermittent blocks working together.

Taking responsibility

The stroke group has been established since 2002 and has a hard core of members, with one of them still with us from the very beginning. They are all active and it is their active work that often attracts new members who they then encourage and help integrate into the group. They all feel responsible for each other’s full participation and the development of everybody’s skills, including social skills.

A new group member, a new colleague...
...well sort of

I am really lucky to have a former colleague working with me once again after a five year break in the adults’ groups. I just love having him there; he brings a relaxed atmosphere in the group with him. We had worked together for years previously and developed a wonderful working relationship. We do not really have to discuss much as we work, we just know what the other one is doing, and we both know what all the clients are doing and need. We swap ideas and help each other, and the clients, carry them through in action.

Our clients love this atmosphere too as they know that things will run smoothly throughout the sessions.

Personality traits

Of course there are always clients who prefer to be with one conductor or another. We will all have experienced that in our lives, and not only with children. Adults often show preferences too. It could be a personality thing. It could be how we help, how we touch people, how we speak to them or our actual physical strength.

The big chap in the group feels safer when walking through the ladder in the middle of the room with my male colleague beside him. I always put the ladder beside the parallel bars when I work with him alone so he feels just as safe, he walks in the direction so he can grab the bars if necessary. 

Now that I have a colleague again who is stronger than me we all prefer it that he walks alongside the ladder with the clients.

One lady may prefer the fine-tuned finger-tip help of a quiet experienced conductor, while other clients might prefer the smiley personality of another, but perhaps less experienced, conductor.

We switch and swap so that no one gets too attached and everyone gains lots of experience, conductors and clients alike.

I like working with all these people, the conductors and the clients, and I love to observe how we all learn and progress, and how it all comes together like cogs in a well oiled piece of machinery.

Oiling cogs

Oiling the cogs takes place at the hands of all members of the team and last week it was one of the old-time clients who got on with some very necessary and quite tricky oiling.

There is a newish member in the group. He lives in a sheltered community, in a care home, whereas the rest of the group live at home with their families. He has lived in the care home for over ten years, since suffering a stroke when he was in his late thirties.  Two other group members are in their sixties, one has children and lots of grand-children and has an active social life, and the other enjoys travelling with her retired husband and participating in musical and carnival events with him. A younger member of the group has a young family, one of the children born since he suffered the stroke. All these factors are important in the changes and transformations that take place in these clients’ lives, in their personalities and relationships with others, both before they took part in conductive living and since.

Their ability to communicate and the expectations put upon them from others to participate in life differ, and of course change as their various social and physical skills develop.

It was in this context that last week I experienced something that made me smile inside.

One of the group who ten years ago could not string more than two words together in her native tongue (in English, a foreign language, it was a little bit easier) mentioned to the newest group member, the one who lives in the care community, that he did not smile very much in fact hardly at all. I remember her telling me the story years ago about when the smile came back into her life, when she realised that it had been missing and decided to live each day as it came, and to the full. She put a smile back in her soul with help from her husband.

She asked this man why he did not smile. He was forthright, explaining that he had consciously given it up years before, directly after he had suffered a stroke, at the time when the smile seemed to disappear from his life. The lady explained how important it had been for her to be influenced by her husband’s philosophy in life of finding a way to do their best, to put on a cheery smile as often as possible, and to make the most of their new lifestyle. The rest of the group, those with families at home, added their nods of agreement.

In the event, during that day’s session they all received smiles on more than one occasion from the younger man.  He is the one member of the group who does not live with his family and therefore does not have people rooting for him in quite the same loving way as the others do. He has no wife or children or grandchildren beside him, motivating and encouraging him constantly to reach new goals or to smile. This conductive group are his motivating force and it is they who got him to smile again.

During the three hours twice weekly that this group is together they often interact with each other like a family unit, each with their own jobs to do, their own supporting roles to play, their own acts of encouragement, their own highs and lows, just as it is within a family. And it usually all goes on without words, without spoken agreements, in much the same way actually as the work with my new-but-old colleague.

Finding the words in a difficult situation

As the session progressed on the day in question the older lady, who can now string together long sentences and hold interesting conversations, explained her more complicated thoughts about what she thought was happening in the group, and she soon became much bolder in her observations. I was amazed at her ever developing ability to express herself. She was able to translate her thoughts into words and directed them towards the newer group member, with the rest of the group spontaneously offering in turn their support to both of them. I was actually quite shocked by what I heard – but at the same time very moved.

More than a client

It was such a strange situation for me to be in. I was receiving the kind of support from a client that I would normally expect from a fellow conductor.

‘Why do you only complain about your aches and pains and your fears when Susie is standing beside you, and not when a male conductor is there?’ asked the lady.

For myself, I did not at first know what to say, but I soon pulled myself together and thanked the lady for thinking about this and being brave enough to ask. I had actually been struggling to find a balance between encouraging this client to be active and try new things and actually moving away from him and giving him a break when he became quite tetchy. The man who had been asked the question took a bit longer to react, he too I think was shocked and needed time to reflect on what was going on. 

The other group members had time to pass their own remarks before he eventually said that it is because I am small and he is more fearful when I am there with him. The lady replied that there was also a very tall and strong young man (not a conductor) who was helping him and that she suspected it was nothing to do with that at all. We all agreed that she was probably right and the atmosphere improved enormously.

Time to question the word “client”

I have happily used the word client for a long time, I do not like the word participate. As my clients and their groups develop so do our relationships with each other and the word client no longer seems enough.

The members of the group are there alongside me not as fellow conductors but as fellow human beings engaged upon common tasks.

I am no spring chicken but I am younger and less worldly than some of my adult “clients”.

As they begin to master their motor disorders and the social disruptions that these cause then these mature people emerge again in their own right and we really begin to work as a “team” developing alongside each other, every one of us with a contribution to make.

Acknowledgements

One of the clients who attends this group, one of its founding members, has long since come to the conclusion that it is time to question the words that we use to describe the people we work with.

She addressed this in the book that she wrote, “It came like a bolt from the blue”, a book in which she describes the establishment of her conductive lifestyle.

Having thanked several people for the roles that they play in her life she wrote –

“I also wish to say thank you to conductor Susie Mallett. With her I have learnt how to be happy again and how to do things. In the conductive group I have become an active person again (not seen as an object). Susie has become a very close friend to me.”

Notes

It came like a bolt from the blue, A post-stroke story in words and pictures by Waltraud Heußinger – edited and published by Susie Mallett, Conductor, Nürnberg


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