DAY 128 - 13th December, Friday
Keri finally met Dr. Harland today. On first impressions she seems nice but we've learned that first impressions are normally wrong. Me and Keri are both in agreement that in time we will find out she's completely clueless and has no idea on how to treat Keri while she's on the ward. Keri brought up the subject about leave as she was desperate to go to her foster parents' house for a few hours, even if it was just lying on the sofa watching TV. Dr. Harland rightly pointed out that banning her leave had been pointless as Sally had gone and left the ward on Tuesday anyway. So Keri now has her two half an hours a day to go to tesco, into Brislington or around Bristol (not very far in half an hour!) and in the hospital grounds. She's also able to take herself to occupational activities such as the yoga group and she's also wanting to attend the Hearing Voices group too (this is basically a social group where anyone who suffers with hallucinations, particularly auditory, can sit together and discuss things. People who don't suffer with this, or are carers etc cannot attend so it's purely for patients with these experiences plus the couple of members of staff that run it). Keri's allowed to go down to Woodside to do the therapies on the condition that the ward phone the OT (occupational therapy) department to say Keri's on her way, and for the OT department to phone the ward when Keri's on her way back. This is to keep Keri safe, otherwise she could have left to go to a two hour group, not attended and no one would realise until afterwards. Two hours is a long time! Her unescorted leave is only to be taken in daylight hours and she can't go if she's got a headache as this is normally a warning sign that Sally wants to come out. Finally, she's been granted three hours a week to go home with her foster family. Hopefully this can be changed for Christmas Day and Keri can spend the day there.
Liz came to pick her up early afternoon, after she'd been interrogated by the staff about Keri. I bet she had a lot of fun with that. Her leave was pretty normal. A normal family environment, not confined within the fences of a psych ward. Keri chatted a lot to her foster parents and also sat and watched some TV. She felt a bit odd being out of hospital but that house still feels like home to her. I don't think her foster parents realise how grateful Keri was that they took her home for a while. Keri told Dr. Harland that if she wasn't granted home leave then she'd go apeshit for the day. Liz also said this to them when she came to pick Keri up. Keri didn't even get into ward round until after midday so she was already thinking of ways of being completely rebellious (she was going to deliberately cause trouble due to the fact the cabin fever was really wearing her down, I think that's partly what's been causing all the crying episodes). Luckily that didn't happen!
Keri even got to see her kid foster brother, although technically they aren't supposed to see each other. Who cares? I don't see the issue with it, neither do Keri or her foster parents. Unfortunately Keri's key worker wrote out a risk assessment for her leave for when she goes home for a few hours. Obviously there are 'Risk to Self' factors: "...currently at high risk of self harm and suicide when dissociating mainly as Sally...". However they've also put her into the 'Risk to Others' category by stating: "...have grabbed knives with intent to use them while at your foster parents needing to be restrained by them". This was a one time incident when Sally came out last year the night before she was first admitted to an adult psychiatric hospital. I don't think this even needs to be written down on her risk assessment! But a nurse turned around to her this morning and said, "Keri, the best predictor of future behaviour is past behaviour". Really? Is that really true in this case? Either way it's written down officially in Keri's notes and there's nothing she can do about it. To tell you the truth, if that wasn't written down and Sally came out while Keri was on leave at her foster parents and went for the knives then a lot of people would be in deep trouble!
This evening something has triggered Keri off but I really don't know what it is. She was fine when she got back to the ward from going home, she was fine for a couple of hours after that, but then for some reason she found herself curled up on the floor and not being able to stop crying. Trust me, she tried to stop. She wanted a cigarette and doesn't like people to know she's been crying. It took her nearly half an hour before she could wipe away the last of her tears and even then it was obvious she'd been crying. Her eyes were all red and puffy. Luckily when she went to smoke the staff were busy in the office and she used a door to go out to the garden that most of the other patients rarely use. It's bugging me though. I'm trying to find a trigger so I can write it down for Keri in the future but I can't find one anywhere!
But let's focus on the positives. Keri had a good time with her foster parents and has never appreciated a cup of tea more from Liz! Let's hope it's a regular thing, although they are very busy people so sometimes things do get in the way and Keri isn't able to see them. It's been three years pretty much now though so she's past the 'feeling rejected' stage. She doesn't take it personally, it just makes her appreciate the next visit even more.
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