Sara and Miriam

SARA

Long time ago

Valentina, a former senior counselor, loved Sarah and cared a lot about her. Maybe because she put so much energy and efforts in her, but maybe she loved that special aura Sara carried. At that time many counselors loved Sara including me. It was an  adorable very naive "child" 30 yo. Sara had pretty good thinking/logical abilities, but had very limited experience in a real life. Both of her parents had serious mental illness. Still they managed to give birth to 5 daughters. 4 daughters were adapted by nice families and became regular productive women with families and children. Sara as the youngest was left with her biological parents. For some periods she was living in some legal organizations and/or foster families, but then parents wanted to have her back. Eventually she got into OHEL. When I started to work there Sara didn't like her life. Almost every evening she literary used to "talk to the wall" standing near the office facing the wall and cursing OHEL and her life there. The favorite memory of her life was the time with a family where she was living as a queen, where everything was done for her . She loved it so much, that seems she adapted that image of herself. I jokingly called her "your highness" when asking her to do something, but maybe "blue blood" was running in their family. Her mother a very attractive woman used to hold herself the same way-with some dignity even if she was just took a walk in a mental hospital hall. You could feel "a good breeding"

Valentina told me that she taught Sara the most basic self-care skills and personal hygiene starting with the very beginning. When I started to work in FH we carefully carried that on improving learned skills and helping Sara to learn new ones. It was not easy considered that Sara wanted things done to her and had a tendency to treat staff as her servants. She loved not only being called "your highness", but she would love to be the One. When Valentina happened to go outside with her, Sara tried to make Valentina carry her bag
So, Valentina and me worked with Sara using elements of game with very consistent approach of Sara doing things independently for herself no matter what her resistance was. It  worked good and Sara learned a lot of skills......till Valentina was not there any more and other staff started to apply another approach.

SARAH GOT a MAID!

One of the residents was assigned a help, a Spanish woman Maria. Sometimes kind and caring Maria helped Sara as well on a volunteer basis.
Somehow Sarah got attached to Maria till obsession. She would sit by the window waiting for Maria to come refusing supper and/or medication. When Maria finally was there Sara glued to her following her around. Maria did some favors to her helping in the shower, etc. The resident Maria was assigned to didn't like it, so conflicts started..
Eventually it was decided that Maria's help would be paid off and Maria started to help Sara on a legal basis.   Sara finally fulfilled her dream-she got her own maid. A few time Sarah shared with me her wish of getting married and  have a baby. I warned Sara that a  husband and children are required a lot of care which Sara was not able to provide at that moment. Sara solved that issue very quickly "I'd have a maid"

LOOSING INDEPENDENCE

Slowly Sara stopped doing things for herself relying completely on Maria. She guarded Maria aggressively and during the hours Maria was with her (doing her laundry, cleaning her room, giving her a shower) it was impossible to approach Sara-she was rude and aggressive. When Maria was not around she did everything to find a substitution. One Shabbos she asked me to help her with laundry. I was a wrong person to ask as I carefully talked over with Sara all the steps of doing laundry and it came out that Sara could not do independently only one of the steps. I promised to help her with that particular one. I did asked my coworker who was more agreeable than me not to do Sara's laundry. In a while I saw them talking . A little later Sara came to the office where my coworker and me were sitting and when she saw me her face expression became very angry. She didn’t expect me there
I spoiled "the deal" for her.
 Simultaneously with independence Sara became very rude to the staff and new staff were upset with her...finding her impossible to handle. I continued playing with her and responded to her rudeness with humor and jokes. It usually stopped her rudeness turning it into something funny to deal with.

VOLUNTEERING WITH KIDS

Sara had many friends in Boropark. She was loved by people . She was a part of community. Friends came for visit to the residence often bringing kids and husbands and they invited Sara over. I visited with her many of her friends. Sara was good in keeping a conversation and she was very nice talking to  kids. Sara often expressed a desire to work with kids and I advocated for her in front of management as I saw how good she was with kids during our visits to her friends. One day I was offered to supervise Sarah in day care doing volunteer work with kids. Of course I agreed. It came out that work would be once a week for one or two hours in the middle of a day ( so I couldn’t take a shift that day in my other workplace) and it was paid from Sara's personal money. Still I couldn't refuse.
When I first brought Sara in it was her second time and she obviously did not like it there. It was a huge room fill with 30 or 40 screaming/crying little kids, a few adults and a lot of different stuff around. Nobody paid to us any attention. In 10 minutes Sarah tried to grab her coat and leave. I begged her to stay a little longer. Then "o, joy" we were given job to do-some preparation for an art project. We could not leave any more, so we started to work. Later some kids joined us "What are you doing?" I involved them as well. I watched Sara carefully, attending her any whip, so she'd have no any negative experience. She was very uncomfortable and anxious. But I needed her to stay till the end of volunteering. And she did. And we finished a task ..

......In a couple of months Sara enjoyed her volunteering enormously and was completely independent there. I was just present there playing with kids, while Sara helped the teacher with projects on her own
What approached I applied?
Appreciation and feeling wanted and needed (something Sara did not have much in her life). Sara became motivated
I inspired day care staff to tell Sara how much they appreciated her work and how helpful she was and how much they liked Thursday, because it was the day of Sara was coming. I believe they were sincere asking her "Do you come next week?" and thanked her for work done "You helped so much today, thanks a lot". On Purim they gave her a great card and $25 present.
First Sara could not believe it was true constantly asking "Do they really wait for us to come?" I did everything in order she would feel needed and appreciated......and it worked....
In the beginning when I used to come to residence to take Sara she usually was in a bad mood , it was difficult to make her going and all the way to day care she complained about OHEL. I made a rule " Forget OHEL completely for 3 hours" On the way to day care we discussed kids, on the way back we discussed what happened during our time there (we started to work for 2 hours), In the end we went to bakery and Sara used to buy a treat for herself to celebrate a good and productive time.

…..IN THE RESIDENCE

I started to think about ways to improve Sara's behavior in the residence using her positive experience with day care.......but then I realized it was already used although not in productive way and rather destructive one.
Sara asked me “Please, tell them (OHEL staff) not to talk to me about day care” So, I tried to find out what was going on.
Nobody was interested in details of Sara's volunteering, but it was used in services a lot.
"If you are so rude in residence you'll be rude in order places as well. How you could do volunteer work if, etc, etc...." Sara reacted with more rudeness
Conclusion was made: " Although Sara's life dream as working with kids was fulfilled however she did not appreciate it and it did not affect her behavior in the residence in a positive way.....Sara is hopeless"
I tried to tell staff,  that Sara is not able to make such a connection, that those 2 environments are completely separate for Sara. We have to use Sara's volunteering experience as an positive example of "another Sara" which could be spread for residence instead of using it as a "manipulative tool"
 
Nobody listened. I asked management to give me the afternoon shift that day which was free from permanent worker. Then I could do day care hours for free on volunteer basis, but being paid for the shift. I could do related services with Sara myself and try to use day care positive experience to affect Sara's residence life in a positive way......I did not succeed….management was not interested in Sara’s progress. Probably because….
At that time they needed to get some residents out of residence and Sara was one of candidates. She was defined as a person who was not progressing, had terrible behavior and could not perform her daily living duties independently .....so her place was in an adult home....
When I’ve learned it I couldn’t continue that anymore. It was not make sense any more, it become upsetting instead of inspiring and motivating and I needed to earn my living. So, I gave up
I begged those counselors who that shift was given to take Sara to day care instead of me. One worker agreed, but in a couple of times she started to complain that Sara did not want to go and refusing to do work there and eventually it stopped all together.

I felt bad that I abandoned Sara's volunteer job, but even if I would not it'd not change anything in FH management attitude to Sara and so it’s not change much for Sara as her progress or abilities was against management plan.

SYSTEM RULES

I was very surprised and upset with a fact that another resident I also knew very well was moving to Baiz Esra, but Sara to adult home. I got the explanation, that Sara showed higher IQ on the test and so didn’t belong to OMPDD System
Why nobody taught Sara not to do good on test? Although Sara’s math and logical ability were higher than it was by another resident, but if to compare their maturity in life Sara was a child …..but seems nothing could be done

I was very upset and tried to find another solution for Sara, different than adult home. I asked our Social worker if adult homes are really improved as she told residents during the meeting. Privately, she told me “almost the same”. Adult Home is a lowest place in the System for people with mental problems . I have an adult home near my place and so I was terrified. Social Worker gave me an idea of foster parents. I went to my religious friends who had huge number of connections in Jewish religious community and asked her for help. She tried , but then she said that nobody was interested as Sara had very little amount of money from government to provide for her needs. One day when I came to my overnight job I asked my coworker Adina if maybe she knew somebody who could take care of Sara.

ADINA

She said that right now there is a good chance. Her relatives’ family is looking to marry their beloved disable child. They have money and will do everything so he’d be OK. If they would like the girl they would do everything for her as well. How could I miss such opportunity. I asked FH management opinion. Overall the management attitude to my  efforts to save Sara from adult home was not positive. This time I just was said “It’s a family business. Talk to Sarah uncle” So, we talked to Sara’s uncle
Adina scheduled to have meeting for both sides to see each other in some cafe.  Sarah and the guy would just have some coffee and cake and relatives would just look at each other or maybe talk, whatever. But suddenly management got involved and accused me in doing things behind their back. They said it’d be hurtful to Sara. All my objections that it’d be only coffee for Sara in my company and her uncle were ignored.
Meeting was cancelled. The “groom” with his parents were returned back to Queens from half way to the Brooklyn (father half paralyzed) . Sarah’s uncle was under fear that he could hurt Sarah. They explained him-only OHEL (as a father figure) and  residence management (as a mother figure) could take right care for Sara.
So, Sara was saved and was sent straight to an adult home. During that ordeal with Sara I recommended Adina to FH residence , she quickly got employed and became close to management in result of that I eventually had to leave FH residence

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MIRIAM

Miriam spent her childhood  in a foster care system. She changed 9 families. Her childhood was not happy, she went through a lot of negativity, however her personality remained peaceful and warm. I knew her for many years I never saw her angry. However very often I saw her being very upset. When I first met her Miriam was trapped in a very frustrated divorced situation. Miriam's husband was not healthy as well. She told me about  a lot of abuse she got from him during their marriage. Their 2 kids were adopted by childless family who later got their own kids, but continued treating Miriam's kids equally well. Once Miriam and me had a meeting with them. Great kids. But Miriam's husband didn't want to give Miriam religious divorce and that was the source of constant frustration for her. He kept calling her and upsetting her. Miriam was very affectionate woman , she attracted men by her wonderful personality, however according to Jewish law she was not allowed even touch man's hand. I used to work overnight that time and she always shared her frustration with me. Her sleep was affected a lot by that situation. Rabies were involved to help Miriam with divorce, but it didn't work. I usually distracted her from upsetting topic asking her to sing for me. Miriam had a very pleasant melodic voice . She used to sing in women's choir and knew many songs. Miriam used to work in some places with kids as well. Somehow slowly Miriam started to regressing. It's easy to start regressing when a person is not oriented on progress.
Finally Miriam got her divorce and wanted to remarry, but it did not work. Women's choir got closed and we could not find a new place for her. Then a counselor who was concern with keeping clients busy left the residence. Slowly Miriam became "a couch potato". Everybody got used to her sleeping on the couch in front of TV. Slowly she stopped talking care of herself, etc, etc and was sent to adult home. Once I worked substitute shift and forced Miriam to do everything herself and properly. She did everything OK and was proud of herself. I informed management about that, but got no reaction. Probably solution about adult home was already final and regress was needed.


ADULT HOME

Recently I visited women  there. Sara recognized me and my daughter who worked in FH residence for awhile. She was very glad to see us. Went around the building introducing us to staff- black and Spanish women. It was obvious they liked her. They were hugging, etc. Sara is very affectionate person. Seems Sara was OK.  There was no order in the room or in hall.
But Miriam was not good. She didn't recognized me and looked very bad physically as well as mentally. It seemed she just got out of the hospital.
FH staff knew that I was visited women. Nobody expressed any interest…….