Thursday, January 29, 2015

When One Door Closes ...

I'll bet she closed the door behind her.

I got the email this morning. A woman I worked with many years ago, a woman who taught me one of the most important lessons of my working life, has died. I hadn't seen her for many years, I occasionally heard of her from staff who I'd run into at conferences or lectures. She is one of the many people who's name always brought a smile to my face. I'm not doing that 'the dead are suddenly saintly' thing that people do - her name, her memory, always lifted me and gifted me.

She had been referred by a frustrated group of staff. She was 'aggressive' and 'destructive' and 'impulsive'. I was fairly new to being a behaviour consultant and reading these descriptors had me on edge. I was surprised at how small she was in real life because believe me she was writ large in the minds of her staff and care providers.

Sitting to meet about her I listened about her obsession with the door of the how, with any door, any where. If someone was leaving the house, she'd leap up and run as fast as she could to the door and grab the handle and open it wide. If someone knocked at the door she'd run as fast as she could, pushing staff out of the way, to get to the door - she's open it and hold the door open with one hand and swing the other open in a wide gesture of welcome.

This was 'reinforced' by people who came in by saying, 'Wow, you are a real welcoming committee aren't you.' or 'What a great way to be greeted at the door.'

They lived in a smallish town and she'd do the same when out, when seeing someone approach a door, she'd rush to open it for them. Give them a grin and wait for them to go in. She never ran across the road, she wasn't so impulsive that she forgot the rules of the road, nor was she so impulsive that she knocked people over as she rushed to the door. The 'aggression' seemed to happen at home, if staff were in the way when she wanted to get to the door, or if staff tried, as they had, to stop her from her 'inappropriate behaviour.'

I went on a trip with them to the nearest city and had the delightful experience of watching her discover automatic door openers for the first time. She laughed so delightedly, as if she'd discovered the most wondrous of things and couldn't contain her joy! So, learning how they worked, made trips to the city such that she'd need to push those buttons for people.

After my observations had been done and I sat down to write the 'behaviour programme' I realized how nice it was to be working on a behaviour that wasn't about 'hitting' or 'spitting' or 'kicking' or any of the other kinds of aggressive behaviour that I was used to working with. Midway through the programme it struck me that this behaviour was a 'gifting' behaviour. It wasn't aggressive, it didn't have the goal of intentional hurt.

I threw out what I wrote and set about writing a teaching program for staff to accept the behaviour as an expression of her wish to welcome, her wish to assist and her wish to be helpful. Those are all wonderful qualities. We should be encouraging not eliminating these behaviours.


That's what I wrote.

And that's what I got yelled at about when I presented it to the staff.

But, that's also part of the job - dealing with staff aggression.

Once they got it, really got what I was saying, they learned to see the behaviour in a new way. We noted that she wasn't taking away anything from others in the home, none expressed any interest in answering the door or opening ti for others who left. She only pushed in rushing, she never pushed in anger. Staff needed to get out of the way, invite her to get the door, and let her give what she had to give.

Simple, easy.

I came away from that with the vow to remember that sometimes what we see and what we think we see are different things.

I am convinced, convinced, that as she left us for heaven she closed the door on one world and raced to open the gates of the next.


ABEhrhardt said...

How sad that you have to deal with 'staff aggression' in 'caregivers.'

I'm sorry you are missing your friend - and what a wonderful thing you were able to do for her to enjoy her life.


clairesmum said...

thanks for seeing her beauty and sharing it with all of us.

Anonymous said...

Thank you, Dave for making us stop and think. The question that should be asked when a behavior program or a medication is recommended is 'who is it for?'. Is the program/medication for the convenience of staff or is it something that will enhance quality of life?
Sorry for the loss of your friend, I can see how the memory of her delight in opening doors would bring a smile.

Donna Kirk said...

Great story. You pointed out something that doesn't happen often enough - blind staff. Just because they would never rush to the door, why shouldn't someone else? You taught them flexibility in thinking. I hope it stuck with them.
I loved your comment about the saintly dead. My mother used to say: "There's none so perfect as the dead."
Donna Kirk