Shay Jacobson, RN, MA, NMG, LNCC, CNLCP
Martha Kern

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Sandy had a tendency to read too much into random life occurrences.

The boys who lived behind her house played quite a lot of baseball and, occasionally, one of their fly balls would come over the fence and land in her yard.

Sandy, thinking it might send a message if she followed suit, threw a variety of garbage – coffee grounds, banana peels, empty carryout containers — back over the fence into the boys’ yard.

Not surprisingly, the neighbors were both confused and upset. Sandy had never talked to them about the baseballs in her yard so the sudden appearance of garbage was simply inexplicable.

The Role of the Coach
Sandy, though fully capable of managing some facets of her own life, struggles with interpersonal communications. She is in her 50’s and developmentally disabled. She learned a great deal from her parents and siblings as she grew up, but their gentle promptings and assistance in solving problems are no longer available to her; her parents have passed away, and her siblings have children and jobs and very little time to resolve the many issues that arise in Sandy’s life.

This is where the “coach” or “personal assistant” becomes indispensable. Our clinical team offers guidance, advice and problem-solving assistance to many of our clients who contend with mental illness, traumatic brain injury and developmental disabilities. Several of them can drive and hold jobs, but they find other aspects of life absolutely confounding:

  • John was diagnosed with Asperger’s Syndrome as a teenager. He is bright and engaging and eager to please. He lives with his elderly father and helps out with the household chores. John, however, cannot manage the tasks of shopping and budgeting – when air fresheners went on sale at the store, John bought 45 of them, a supply he would be unlikely to deplete for years. His sister, hoping to equip him for an eventual life without his father, asked us to work with him on life skills. John needs someone other than his father and sister to rely upon in sorting out what does and does not constitute a reasonable purchase. He also needs help with writing checks and adhering to a budget.
  • Mike had a job at a grocery store. He worked there for many years but one day walked out, without a word, due to his belief that a shopper had said something rude to him. In truth, Mike’s schizophrenia caused him to hear voices, and he believed one such voice in his mind came from a shopper. Mike’s mother hired us to help him apply for, interview and then hold a new job, where he sometimes continues to misinterpret sounds and ideas and gestures. Rather than walking out, Mike has learned to call his Lifecare Manager on his break or at the end of his shift to talk through whatever happened that day and how he should respond. He has successfully held this new job now for three years.
  • Max has a day program that he absolutely loves. The bus comes each morning, picks him up at home, and delivers him safely to the program for the day. Similarly, he is brought back to his front door each evening. He thrives on the structure and routine of it all. But once he arrives home, he struggles a little. It is lonesome and he doesn’t eat well. Sometimes he oversleeps in the morning. His parents, too elderly to offer the hands-on care they once provided, asked us to help solve this set of issues. We set up caregiver services for the morning and evening to help Max prepare meals, pack a lunch, get on and off the bus, and get ready for the next day. This simple bit of assistance makes all the difference for Max, who looks forward to telling his caregiver about all the goings-on at his day program.
  • Jan is perplexed and confused by the mail. She keeps her home in immaculate condition and loves to take long walks in the neighborhood, but finds it difficult to deal with paperwork and process/pay bills. She has a tendency to believe that every piece of mail is actionable and urgent. Understandably, the mail’s arrival causes Jan, who is developmentally disabled, to panic a little. Her “personal assistant”, as she calls her, visits at least once each week to go through the mail, identify and act on the important pieces, and throw away the “non-urgent” mail. Jan’s Lifecare Manager also helps her secure home repairs, make physician appointments and perform other tasks with which she is easily overwhelmed.

Maximizing Independence
Tailoring services to support an individual with disabilities in precisely the manner they need enables continued independence in life spheres they find more manageable and generates confidence in areas where they struggle. Life-skills coaching is often an ideal approach when an adult with disabilities first separates from his/her parents. There are many new things to learn and new situations to unravel and understand. We do find that many adults in these circumstances strive hard to show us just how much they’ve learned about the world. They stretch in new directions, and feel a tremendous sense of pride.

Sandy no longer throws garbage over the fence into her neighbor’s yard. She still spends too much of her paycheck buying stuffed animals at the store where she works, and she may never be a tidy housekeeper, but she has come to understand that human relationships can be a little bit tricky and that running the story by her life coach/Lifecare Manager before she makes a decision to “respond” with banana peels may point her in a social direction she had not previously contemplated.

The neighbors are delighted.

© Lifecare Innovations