she wants everything done for her

Hello there...I have a question for those of you with friends, family or who work with the developmentally disabled. One of the ladies I provide care for, constantly asks for help with everything, including many things she can easily do for herself. My boyfriend, who worked with MR patients for 10 years says that, often, MR clients get used to being taken care of and will try to get as much as then can done for them. After promting her to do all these things for herself, because I want her to feel as independent as possible, she will, but will test me again if I haven't worked for a few days or if she is feeling more in need of attention, etc. Any thoughts, other ideas, etc? It can be a bit exhausting at times.

thanks!

Hi, sorry for the late reply.

I guess that you will have to just be harder on her. Also, when you make a decision that she has to do something herself, never change your mind or she will view you as weak.

Kevin.

Okay, i'm glad I got a response, thank you!

I have never worked with the MR population before, so any advice is great. Any books you would recommend. I am a natural disciplinarian though and have sen what happens with the people who are too soft.

My question is, how faar do you go. If I raise my voice a bit, or threaten a time out it works..what is too harsh for raising the voice. I never make the pitch higher or scream, but I get stearner and a bit deeper voiced and louder, okay?

She speaks but it's all impulse driven, and has no physical diabilities. I try to think of it in terms of child development and proper behavioral mod. What age level is a kid when they try to push the envelope a lot. Positve and negative reinforcement work, praise and punishment, but not logic or reason wher you can sit them down and talk. Cognitive age level.....6?

The other thing is she has some form of Munchausen's..she feigns illness if she wants attention, their is another person in the room, or tries to monopolize their attention by giving them endless cough drops and juicy fruit gum. It's kinda endearing like she's being generous but I discovered it was a diversion for attention, cause it only happen when she feels the threat of losing the attention of the primary caregiver, aka me.

Some of the other aides say she won't leave them alone, but I know they have a harder time with discipline. She leaves me alone for the most part when we are alone and will do any chore I ask her.

ANy thoughts? What is your situation?

KC

What is my situation? Well, I have no experience of working with MR people - I am merely offering advice as best I can. I don't think you can quantify a level of sternness that you should take. You will just have to judge that for yourself but one thing is for sure: you cannot go easy on this person the entire time.

Life may be tough for her but it won't help if people do everything for her. The Munchausen's side of it should not come into it either. If you use that card, then you are bound to take pity on her and do stuff for her again.

Simply put - I have no experience from which to offer advice so take what i have said here with a pinch of salt!

Take care,
Kevin

I feel your pain! I am a step mom to a 30 year old 2 year old. She is also capable of doing more than she will. I did not know she could zip her own jacket for 2 years. She whines and begs for others to do everything for her. She will go so far as to wet herself or vomit if she is unhappy or just wanting a change of scenery. I have not found peace in this situation. Her father and I do well together, but many days having the child outweighs the marriage. He will not consider putting her in a home and I have had about enough of her care. Her mother died and her sisters left home when we married. They have very little to do with any of us and are no help with their sister. She is in a day program M-F 8-3, but with us the rest of the time. I have started making her dress herself and don't let her stick her fingers in the food of other people, and her family thinks I am mean because I have to be insistant and firm.
Help?

I agree with not doing for her when she can.

However, I notice that you'll go on a long way by using the carrot discipline.
What you describe is that she craves positive attention as she feign being sick in order to get positive attention.
It shows that she gets attention only when she has (being sick) or she does something wrong.
Giving her more attention when she does wrong will reinforce this behavior of attention seeking, even if this attention is negative.

So, you can use this way to discipline her and get what you want. You won't be too soft by using the carrot discipline.


1) When she does something for herself, praise her. Praise her as if she did the most important thing for you/of the world (you get the idea).
On the long run, she will understand that she will get attention when she does something for herself, and it will be a positive attention.

2) Ignoring means that you have no interaction with her. Pretend you didn't see her, you didn't hear her, didn't smell, didn't touch.
Be unemotional. Don't show that you are angry, or annoyed, because it equates attention (even negative).
In a sentence, the play stops when the audience is gone.

3) When she is non compliant, or when she replies back, ignore her.
In fact, ignore harmless annoying behavior. Replying back ? Ignore. Non compliant ? Ignore and wait until she complies like if you had all the time.
Intervene only when behavior is a matter of safety, and be as unemotional as possible.

4) When she is non compliant, wait her compliance like if you had all the time. It means being late ? Be it, let its natural consequences fall on her.
When she is compliant, then, you interact with her in a positive way, by praise.

5) Attention seeking often comes from a lack of interaction with the person. When the person understands that she will get attention with positive actions,she won't resort at manipulative behavior because she won't need them to get attention she craves (as she will have the attention she needs with positive actions).


Are you authoritative with her by using this leverage for attention seeking behavior ? ? You bet !
Because you will get what you want without being coercive.
You don't need to be coercive in order to be authoritative.

Do you need to yell or even raise your voice, threaten ? Not at all.
Ignorance for bad behavior is the most powerful and safest scorn for an attention seeker.
So, you can safely use this leverage to make yourself obey.

Authoritative people use the most adapted leverage to get what they want.
In such a situation, when you discipline her for bad behavior, you involuntarily reward her with attention, so you lose your authority in a certain way.
When you ignore her harmless annoying behavior, you show to her that you are aware of attention seeking and you don't give any attention she craves. OTOH, when you interacts with her when she shows a positive behavior, you reward her for the positive behavior she gets.

I don't know if my explanation is English. I hope it helps.

Hi there,
Before I got sick, I was a health professional working with adults with disabilities. My short answer to your concerns about your clients "attention seeking", is that, there is no problem. And yes, your work is exhausting.

I remember there were two categories of clients. There were those who did everything they could to get attention and maintain human interaction. Then there were those who had given up and mainly kept to themselves. It's far better that your lady is doing what she can to be part of the human race.

It's great that you are trying to understand her point of view using different behavioural models and so forth. Now I want you to understand her point of view as a human in a particular situation.
Think about the number of times you engage in your own 'attention seeking' behaviour with other people in your lives - family, friends, etc. You are much better at communicating appropriately than your client. Your client lacks appropriate communication skills so she does this 'attention seeking' thing.
I can bet that every single time she does it, it's for a legitimate need. Is she bored? worried? hungry? Maybe something is happening for her that she can't tell you. I had clients who got teased on the train home from work, through one who was being neglected at her day placement, and plenty of 'mystery' behaviours.

Now your job is tough, and you have competing demands on your time. If she is 'attention seeking' at the wrong time, try to work on her understanding the concept of 'later', or try to build it into your routine. I haven't done your job so I can't completely advise on how to do that.

It's also important that she is building her communication skills, just like she is her dressing and toileting skills. Does she have any alternative and augmentative communication you can use to work with her?

I really applaud the lengths you are going to in order to work effectively with your clients. It's really admirable the amount of thought and research you are doing. It's not an easy job at all.

Best of luck.