201 Comments Posted by dme

Most children don't like showers (at least not until about the age of seven). It's also easier to assist a person with a bath than with a shower--showers tend to get the assistant wet as well as the bather--and tub baths lessen the danger of a fall. As for more sinks than tubs, while only one person could bathe at a time, two could easily brush teeth or wash hands at the same time.

What is the difference between a generator and a turbine? In the summer of 2001, I went to the community open house held by a local power plant. We watched an informational film and took a tour, then went to a picnic lunch in the parking lot, all free. The computerized control room (not the actual room, but a replica they use for training and demonstration). To a non-engineering/electrical person like me, it looked so intimidating! Then we put on hard hats and toured the plant, looking at the turbines, cooling towers, rail siding, coal storage area (they have a device that pick up the entire railroad car hauling coal and dumps it onto the storage pile), dock for barges on the river, a huge crane (I think they said there were only a handful that size in the world), etc. They discussed all the scrubbers, etc. used to reduce air pollution. But with all that, I don't remember what the difference is between a generator and a turbine. The tour I was part of turned out to be the last one held, because after 9/11 a few months later, letting the general public have that kind of access was deemed a national security risk.

I am very interested in history, and also hate to see beautiful buildings fall into disrepair. But let's say a government has one million dollars to spend on mental health. Should it be spent to renovate an abandoned psychiatric hospital, or on treatment for today's patients? It's the basic economic dilemma of limited resources and unlimited needs.

I hope that if a patient were beaten to death or died in restraints, any staff who knew about these incidents would report them to the state protective service agency, the hospital licensing agency, the police, the Justice Department (as a violation of civil rights), the local newspapers and television stations, the prosecuting attorney, governor's office, etc.

These boards are sometimes confusing for staff--you come in to work, pretty sure it's Thursday (although you hope that it might turn out to be Friday) and the board says "Wednesday." Now, you ask yourself, *is* it Wednesday...or did someone just forget to update the board?

Someone ran off with the Christmas turkeys! Now what will we serve?

Don't most physical therapy departments have pools?

I remember back in the 60s when you could rent a bathing suit from the pool for a quarter if you wanted to swim but had forgotten your own suit. Nothing seemed unusual about that then, but now...let's not even go there!

There are usually ways around the "age appropriate" dogma. For example, puzzles and coloring books for adults can be purchased from companies that focus on products for patients with Alzheimer's (reminiscence therapy) and hobby stores usually have beautiful coloring books intended for adults. Then you just use colored pencils instead of crayons (markers work too but most of our people would end up wearing more color than the paper). For people who have trouble gripping the thin pencils, buy the soft foam adaptive grips (my kids came home from grade school once to tell me they needed "rubbers"--I was only familiar with one kind of "rubbers" and they were NOT something I wanted my seven-year-old to have! It turned out that that was the name the kids had given the adaptive grips) or make your own out of sponges. One thing we usually become pretty good at, because so much of what our people need "is not in the budget this year," is finding ways to transform everyday items into therapy tools. Case managers should not be coming in and taking things away from staff or residents unless they are also providing better alternatives and training.

consider yourself fortunate if this is really the "grossest thing you have ever seen in your life!" You've had a very sheltered life!

It looks like a standard 13-step flight of stairs to me. Probably an emergency exit, not the primary stairway.

I agree with Lynne that it looks like a basement storage area, with a door that locks--could have been for potentially hazardous cleaning supplies or old records. The wall closest to us doesn't look solid enough for anything other than a storage space. The more I look at it, the harder it is to decide whether we are inside the room looking out, or we are in the hall looking into the room.

Some guesses at what the safe might have stored: original documents related to the construction and opening of the institution (deeds to the property, surveys, blueprints, licenses, etc.) the fund from which petty cash was distributed to the various departments, once or twice a month the institution's payroll funds (in the days before paychecks and direct deposit, when employees were paid in cash), perhaps life insurance policies of patients who had them, legal record of bequests made to the hospital, the hospital's own insurance policies, perhaps especially valuable jewelry or other items held for patients (although I doubt if many patients had anything of that nature)...but I doubt if any clinical records or drugs were there.

People with mental illness do not live "short and pointless lives" any more than any other category of people does. Nor are psychiatric care facilities "prisons for the damned." Statements like this seem to be a back-handed jab at mental health workers as "jailers of the innocent," but really they project the very attitudes they appear to be condemning in others--that people with mental illness are less valuable, that mental illness is somehow the person's own fault. I hope I have misunderstood the earlier comment and read into it something that was not intended.

keywords...no particularly good ones here, but a funny story about mental health work. Back in "ancient times" when the Internet was only a few years old, a co-worker and I (both totally new to the Internet) tried to look up information regarding treatment for a new resident who had mental health issues, as well as developmental disabilities, and also had been charged with a sexual crime. We entered "sex offenders" in the search box,j and up came a site called "(state name) House of Porn." It shocked us so much that for a long time we stared at the screen. Later we learned that we should have started with a keyword like "mental illness" and from there narrowed the search to "forensic" and our person's specific issues.

I would be grossly inaccurate if I described any of the people with mental illness that I have known as "lifeless shells." Very rarely, heavy sedation was needed for a few hours after an especially severe psychotic episode, but this was never the person's "normal" (baseline) state. Like everyone else, they were people with opinions, dreams, fears, memories, imaginations, pet peeves, skills, jokes, etc.--all the components that make up a personality. Some of what are called the "negative symptoms" of schizophrenia--lack of interest, flat affect, unresponsiveness--are not due to psychotropic drugs but to the illness itself. Yes, some psychiatric medications do have side effects that are found intolerable for some patients and those patients choose to not take medications because of that. Most patients find the side effects an acceptable price to pay for the relief of symptoms of mental illness. One of the most difficult medication-related experiences I remember was when Clozaril was first introduced. For many long-term patients for whom other neuroleptics had already failed, it really was a miracle drug. It gave them back what mental illness had taken from them. What was so sad was when one of the patients who had exhibited such a dramatic improvement with the drug developed a blood condition called agranulocytosis (a dangerously low, life-threatening, level of blood white cells). When that happened, the drug's protocol required that it be stopped immediately.