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Thursday, April 5, 2012


I tell you, I am so sick and tired of this word: FUNCTIONAL. I am so fed-up with FUNCTIONAL that I really just want to scream.

OK, allow me to scream for a moment. 

OK, I got it out of my system. Sort of.

The first time I heard that word used about/against Bob was in PT Outpatient Rehab at the time of his discharge, i.e. 'No Functional Improvement' and I said, huh? He is improving. But the therapist said, "It's not FUNCTIONAL improvement". So I say, but he came here unable to stand, and now he's standing. And he came here unable to walk, and now he's walking on the parallel bars.... The PT interrupts me and says, but that is not FUNCTIONAL. You don't have parallel bars all over the place to hang onto so therefore he cannot FUNCTION in normal life.....

OK, I get it.  I don't like it, but I get it. We'll work on that....

Yesterday, the Speech Therapist comes in and tells me that Bob's speech is FUNCTIONAL.

Meaning he can ask for what he wants, i.e. point to the ceiling fan, say turn it up or down. Point to the radio, say turn it off or on. Tell me if he needs to pee or poop. Tell me if he wants water. And that is FUNCTIONAL. 

So therefore, he is doing GOOD!!! And therefore he doesn't really need Speech Therapy, so she'll work on the swallowing instead.....

And I am thinking, what? So I say: But what about being able to have a conversation? What about being able to express his feelings or thoughts or talk about, I don't know, the weather? politics? the neighbors latest antics?  

Oh no, ST tells me. That's too complex. THAT'S TOO COMPLEX.  She says that's too complicated. She says I'm asking for TOO MUCH. 

And I should be grateful that Bob is, speech-wise, FUNCTIONAL.

OK, I guess I should be flattered, because I must be a darn good speech therapist. Because back at Outpatient Rehab that ST told me Bob would never be FUNCTIONAL in his speech and that his prognosis was poor. And he should learn to make gestures and point at pictures instead of speaking....

So now he's FUNCTIONAL. And that's it. I'm supposed to be happy about this?

OK, I did tell the ST a thing or two after this discussion. I showed her what Bob and I have been working on, asked her specifically for tools i.e. Level 2 guides in Increasing Length and Complexity of Sentences (I have Level 1) and some other stuff. And she did say she would look into it, but still she thought it was "too complex" for Bob.

And I told her I didn't care if it was "too complex".  I wanted to work on it with him, anyway.

And right before she left, she suggested if I wanted to continue working on Bob's speech, I should work on making it MORE FUNCTIONAL.

So I asked her what she meant. And she demonstrated it this way:

She said to Bob, "OK, pretend we are in the bank and you want to cash a check. So you go to the teller and what do you say?"

And Bob pointed his finger at her, like a gun, and said, "Robbery!" 

Well, that's FUNCTIONAL, I guess. ha!

I'm giving this ST one more chance and if she doesn't come in on Wednesday (Bob's next appt.) with something helpful, I'm calling the agency and requesting a different therapist. Because, this is just crazy.

At least, that's what I think.....


Anonymous said...

Stick to your convictions Diane, you know and understand Bob and his capabilities more than anyone else. I believe the PT's/ST's work to get the minimum proficiency from a patient before moving on, where we as caregivers expect and want the best possible. The therapists come and go, we are always there.

Bob is a very lucky man to have the love and dedication you provide him. Keep up the fantastic work you are doing.

Hugs, Dan

oc1dean said...

Your therapists are being lazy. They don't want to expend any brainpower outside of their booklearning. Almost all of the stuff I work on is non-functional because I have to work on the little pieces and eventually put them together into functional movement.

Anonymous said...

Hi Guys,
I laughed,when I read what Bob said. Just wanted to say you are doing a great job Diane.
Happy Easter to you both. Enjoy reading your blog.
Love you guys. Ed & Neta

Anonymous said...

OMG. Hey D. Bob knows how to answer these people. Love him and you, Patricia

Jenn said...

Bwahahaha! I dig Bob's response to the bank scenario! Wh-what can't the ST see? Or shall I say hear? Day-yam! Bob can make jokes....surely that qualifies for much more than functional! (I'm still giggling)
Yes. Please stand tall and firm. The therapists are supposed to be working for/with you and Bob. Demand no less than someone who will work with Bob sans the standard classifications in the ST field. You've both grown immensely.

Elizabeth, John and Jack said...

Oh...the old "functional". The excuse for I don't know what I'm doing so I'll use that excuse. Stand your ground, get someone better, they do exist. I went though a bunch of therapists because I was "functional" early on...but still not me. I worked hard, pushed through the morons and finally got an amazing ST that helped me be me...almost. :)You and Bob are amazing!

Mark A. Ittleman, M.S., CCC/SLP said...

Hi Diane,

Just wanted to stop by and say hi, and let you know that I am here to support you. Please study "Teaching of Talking" and immediately start applying it; whether you are ready or not.
Get ready for the ride of your life!

Best regards,

Mark A. Ittleman, M.S., CCC/SLP
The speech pathologist who can make a rock talk!

Anonymous said...

Hope you have a nice Easter and the lord bless you both. Thinking of you always, Aunt Rose and Uncle Arnie