Many of our residents are being significantly affected by the pandemic known as COVID-19 or coronavirus. The disease causes respiratory illness through contact from another person. Prevention can be reduced by strategies of hygiene and social distancing.
However, with the temporary closure of day habilitation programs, postponement of socials, restructuring medical appointments and most importantly limiting home visits can have a substantial psychological impact on the people that we serve. Furthermore, the concept of social distancing is a challenge due to my observation of our residents.
Last week I worked at one of our residential sites and couldn’t help but notice all residents pacing around the house, a minor action which if persistent could turn into a major hindrance. Pacing can be inconsequential initially but if the action becomes repetitive, it can create an extreme boredom and idleness within any person. When I asked one of the residents, “What do you plan to do today?”, he replied, “I’m not sure, probably the same thing I did yesterday.” This simple exchange is a microcosm of the boredom that residents have experienced for the last two weeks. The psychological consequence of extreme boredom can escalate to a term called “cabin fever” which is defined as distressing irritability when confined to one location for an extended period.
Now for many of us, being secluded to your home, working remotely and limiting social interactions would be very difficult to deal with, but imagine if you already had to make these adjustments in your life already in addition to being diagnosed with a developmental disability and psychiatric diagnosis? The ideas of normalcy and independence are luxuries many people take for granted. However, what if the further disruption of your routine caused mental distress and agitation? What if your only movements were relegated to your bedroom, kitchen, living room and basement, how would you manage? Things would be very tough to say the least both emotionally and behaviorally. In another example, I observed a family member and manager working collaboratively to reduce the anxiety of one of our residents not being to attend his psychiatry appointment due to travel restrictions. Instead of attending the appointment at the clinic, the family member was able to connect with us remotely to complete the appointment resolving the behavior issue.
As a Psychologist, one of my responsibilities is to develop behavior treatment programs as a guide for our direct support staff to manage varied behaviors in the environment. With these behaviors, the presence of specific triggers or antecedents precede the action which can be either positive or negative. Often, these actions are de-escalated by staff however in these present circumstances, we as “essential staff” work hard to remain present and patient to create a comfortable environment. Patience can be considered a “subjective” term because people have different ways of demonstrating the act nonetheless, we also add empathy. The clinical team and I created active treatments that include constant engagement, strategies to discourage unwanted target behaviors and positive approaches to behavior support as creative ways in making this transition less than a hardship.
We are taking the residents outside in the area for fresh air more often and are using technology to discover new remote interactive learning opportunities that will help result in a stress-free atmosphere for everyone.
The psychology department has also been checking in throughout the day with our staff. With each conversation and interaction, I continue to be impressed by each one and I would like to commend them for working closely with the residents while maintaining safeguards.
During this pandemic, we will only endure by the commitment to our work, the people that we serve and to each other.
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