Professional Participation Activity at the Birchwood Living Center

This is a paper I wrote on my experience last April of spending eight hours interviewing and learning about different ways of working to educate adult students with disabilities. It has been heavily edited for privacy concerns. I absolutely fell in love with this facility and I am grateful for the time I spent there. Without further ado, here it is. :)


Throughout this class we have discussed the many ways that education happens and how diverse challenges can be addressed to promote social parity and learning advancement in students. Our classwork has focused on school age individuals, public education, and uses and access to literature as many of us hope to work in the public education system. I was interested in how nursing or primarily medical facilities dealt with trying to stimulate and educate older individuals. After some research and discussion, I chose to observe and participate with teaching at the Birchwood Living Center located in Ellsworth, Maine. It is a program under the management of Yesterday’s Children, Inc. and is an inpatient nursing facility for individuals with intellectual disabilities and unique medical needs. The residential program can accept up to 15 clients at a time and the facility caters to all their medical, dietary, and educational needs. The clients that I observed in this facility were varied in diagnoses and medical needs, however, many were non-verbal and limited in many aspects of physical expression/ movement due to their specific disabilities.

I visited this facility on two separate occasions and participated in a few different activities- I will focus on day treatment and on understanding how this facility addressed the educational needs of its clients as well as the individuals specific medical needs that impact educational success (occupational therapy, sensory integration), as well as physical health.
All inpatients attend the Day Treatment program in a nearby building and this is where most of the group activities happen. A ratio of four staff members to eleven clients is maintained and it is this that makes this particular facility very different from other facilities who might care only for immediate medical needs. Clients are removed at different times from the group to complete some forms of therapy. I watched as a large group of clients was seated around a table making some get well cards for missing staff members. Some members were in regular chairs and some in specialized chairs while one slouched forward nearby wearing a helmet for their protection from potential falls. The majority of the physical work- picking up stickers and sticking onto card paper, bending, folding etc.- was completed by support staff. I observed questions and choices of stickers and designs asked by staff to different members of the group and eventual choices were made based on feedback received from group members. I am not knowledgeable enough to recognize how each member’s level of attention was focused. What I did observe was that I could start a conversation with someone, give them a marker or a pen, and suggest drawing, and I would get appropriate physical responses to my requests- a name written, a picture scribbled together. I rarely got verbal responses; if I did they were not usually words, but laughs, shrieks, and other noises. It was very apparent that the staff members could interpret correctly what was being said even if it was not clear to me; I still feel a bit of awe and wonder from watching that. I saw no behavioral difficulties that were out of the norm for each person- for some clients, aggression or self-abuse are common to their diagnoses and it is watched and redirected when appropriate.

Each individual who was removed from the group for therapy was removed for only a short time to a side room with a worker. Therapy available includes occupational and physical therapy to help promote functionality, mobility, and fitness for these individuals- many of whom are confined to specialized chairs due to poor physical independence. I watched therapy given to promote relaxation and encourage muscle use and development as well as sensory processing. Sometimes it was obvious that the person didn’t have any interest in participating in their therapy that day and they would make that abundantly clear in both physical and verbal ways. Redirection was kind and thoughtful and modifications in materials were sometimes made to achieve compliance without complaint. It is not required that all individuals must be in the group the whole time and I observed some patients removing themselves from the group for periods of time for their own comfort or privacy. Even with these wanderings (which were quietly supervised), it seemed that full inclusion was achieved to the best of each individual’s ability to participate.

As a potential future educator, I found this facility to be well- organized and primed to do the very best they can to help their clients progress in all aspects of their lives. Aspects of successful classroom activities were easily discernible in most parts of the facility: student pictures, artwork, and statements of patient rights were hanging on all public walls; teaching and therapy aids were easily seen and accessed; the day treatment facility has lots of natural light and appropriate ambient temperatures. There are areas for individual and group meetings, instruction, or medical or physical needs that are easily accessible. I also appreciated the other modifications that I saw all over the facility – such as color and areas for personal belongings- to attempt to soften the harshness and institutional flavor of what is an inpatient, residential facility- a difficult feat to achieve and not one that the center fully accomplished as evidenced by the obvious signs of institutional care and not home living. I look forward to learning more about this facility and its role in my community through future interactions.

Self Care.... Filled with Hormones

I have been struggling this semester. I think there are a few reasons including feeling a lot less motivation with the loss of my grandpa, work health problems... the usual suspects. I tried to work on some homework but I seem to be unable to concentrate on either history nor interdisciplinary studies so I found myself roaming my shelves for something to read. I have agreed to try and take some time for self care- I'm quite terrible at it and I am working to do a little better- and I have decided that some of my self care should include stretching and fun reading. My eyes slid down the rows of books and then stopped on my nutrition textbook. I have never been willing to get rid of it because I sometimes find myself using it as a resource for trying to understand comments from my doctor better or even as a resource for a history paper. So, amusingly enough I hauled it to the couch (We can't say I picked it up because it's huge) for a bit of 'light, restful reading. I found myself quite frustrated by the reading so please take that in mind when I discuss my thoughts below... I guess it wasn't very restful reading.

I entered this chapter with little knowledge about hormones and how they affect the average person’s body, and by extension, my own. I have listened to doctors chatting about my hormones to my parents from about the age of 14 onward. In almost every doctor’s appointment that I attend as well as incidental evidence in my own life, my hormones are in control of me… and not me of them. I see menstruation and the whole process of hormones in a very negative light. As early as 18 years old I wanted to get a hysterectomy to try and end at least part of the process. The only thing that has stopped me from a hysterectomy is money... and if I was offered the opportunity to have it done tomorrow and have it paid for...I would not hesitate at all. As mentioned in the text, some of the societal and cultural ideas around menstruation are definitely alive in my mind for I too believe that I am filthier and more disgusting during the time of my menstruation and I want to avoid people and try to do anything I can to hide it. I don't talk about it much and I used to go to great lengths to hide any evidence including sanitary supplies from any one in my home- I even used to hide it from my husband when I was married... which was challenging and sure looks foolish from where I stand now. The way I think sure has changed... as evidenced that I am try to talk about it here. I found myself a bit bemused to read the words on the pages in front of me such as “One Indian phrase for menstruation is the flower growing in the house of the god of love” and “when researchers looked for positive changes in the premenstrual phase, they can find those as well." I haven't found those yet I guess.

The chapter listed a lot of research on women's health as well as hormones and sexuality. I suspect that the reason there appears to be so much research focused towards these topics is that hormonal changes are seen as an overall negative in quality of life for the majority of women. As Americans live in a fairly patriarchal society and women are not seen or treated in many cases as equal to men, focusing on the differences- and perceived negative differences- makes perfect sense. In general, if we look for the bad over the good that is what we will find. As a history buff, the discussion of women, women’s health, and sexuality have been seen in a negative light throughout many cultures and ages in time. The text also mentions that religion can also play a role in how hormonal changes, menstruation and reproductive activities are viewed and treated. It seems clear to me that many cultures and religions view the unique actions of women's bodies as problematic and use social pressure to control these actions, using members of both genders to create and reinforce this pressure. Another thing that most people who practice medicine have noticed that wasn’t mentioned in the text is that there is gender bias when it comes to many serious problems such as pain, heart attack, etc. How a person is treated when experiencing these disorders can vary widely based on the gender of the person experiencing them and that bias tends to create more negative outcomes for women than for men. What these facts and ideas say about our culture are not great. If the perspectives and biases in our culture and society tend to be more negative towards women, their health and potential in our society, it shouldn’t come as a shock that more studies are focused on the negative aspects of women and their health when research is being discussed, funded, and developed. If society sees men unconsciously as physically better and less hormonal as the male gender has no outward appearance of hormonal changes as stated in the text, then it also makes sense that research is much less likely to turn its focus toward men. Research in general tends to start with the spark of an idea on how something works, an idea of how to change something, or even how to fix a problem or perceived difficulty. If a culture in general is unable to recognize that men’s hormonal cycles exist or that they are important, no funding or time is going to be focused on that as it will be seen as waste of time and resources. I think that creates difficulty for both genders as men’s health and experience is ignored or undervalued so that problems are not recognized and potentially helped and women find that that their health and the study of their health is focused more on the negative aspects of it – or perceived negative aspects- and less on the positive traits and aspects of the health differences.

If more research was focused towards men and their health as well as hormonal cycles, I believe that we could gain knowledge that could be quite beneficial for men and the health problems that occur for them. However, it must be acknowledged that the majority of all medical research is focused on men- just not hormonal research- and it is vital to start including women in these processes. Excuses for leaving women out of health studies include the perceived 'variability' of their hormone cycle and the 'uniqueness' of the female body's functions... which feels a bit like a cope out. After all, the majority of all of our bodies- male and female- work and respond the same in similar circumstances.

I am not sure that reading this was really good self care or if I found myself distracted and worked up about something that really isn't super relevant to my life right now. But I found a few things that I was interested in researching at some point. I wonder how much of my health problems is based on some of the external influences the text mentioned. Do I feel more pain because of hormonal changes or because I feel like I ‘should’? Do I feel dirty and awful because of my sensory disorders which cause challenges with the physical sensations… or do I feel that way because I have been taught/ influenced to feel that way? Are the mental symptoms of confusion and personality ‘changes’ really a part of the hormonal changes, part of what I expect to happen, or pieces of both intertwined in the perspective and package of me? Certainly interesting questions to ponder this evening. Although the ponder must end soon as the guys are headed over. :D

What are your thoughts?