Day 207 – Grayson’s Journey

Dear family and friends

Grayson had a good day today. He did his therapeutic home program (THP) on the back patio of his apartment while his chicken was baking for dinner. After dinner and clean-up, he picked up the mail. Today he received a letter from a friend that included pictures. This always makes Grayson's day! He put them back in his apartment then went for a walk around the nearby park with his residential assistant (RA). After the walk he got ready for bed, then lay down and listened to The Hobbit, one of his audio books, before slowly drifting off to sleep.

Continuing my debrief on yesterday's patient conference, I'll talk about occupational therapy this evening. Grayson's grip and pinch strength is assumed to be about a 4 on a scale of 1 to 5. The "assumed" part is that it is difficult to measure due to a lack of compliance with the test. He continues to get stuck in the beginning of multi-step activities, even though he has the ability and the desire to complete them.

Grayson is spending a lot of time in the kitchen, as this is such a necessary part of living. He is very curious with the stove, and keeps everyone on their toes for fear that he will burn himself. His short term memory is so bad, that each day he has to relearn where the pots are stored, and after the dishes are done an hour later, he needs to learn it again to put them away.

Grayson has the entire staff laughing at some of the interesting things that he says when refusing to do tasks. Typically his responses have a historical base ("FDR wound have done it that way" or "I won't do that with my arm - it looks too much like a salute to Hitler!") Compared to many of the patients, Grayson is very well read. Actually, Grayson is very well read compared to most people (thanks, teachers)! The worst punishment we could give him and his brother when they were little was to take their reading time away before bed.

Grayson's sense of taste and smell are significantly altered, but not gone as feared earlier. Through smell, he is able to accurately identify pepper, lilac and cinnamon, but he is unable to smell smoke. His taste is pretty significantly impaired, as he is only able to identify salt.

To keep Grayson motivated, the staff has developed a reward system for him. His reward of choice is almost always a few minutes of computer time. He is not able to do much more than watch as the keyboard is too much for him, but this has been a breakthrough motivator for him. For the last 5 minutes of his hour-long session, he gets a reward if he focuses and completes the goals that he helps set at the beginning of the session. Good stuff!

Grayson's functional problem solving is ok, but not great. His initial responses are good, but the follow on actions are not. For example, when asked what he would do if the house was on fire, his initial response was, "Call 9-1-1". Good. Then what? "I don't know." Would he be able to understand the danger and get himself out of the house? We don't know for sure, but that is why Grayson is expected to require supervision during waking hours for quite a while – measured in years.

More tomorrow!

Pax!

Brant