Friday, February 6, 2015

Addendum to Endgame

To those who read my post Endgame, you will have noted that I have four children left.
Last year and this year I have felt that I am singing the song "10 Green Bottles."  I began last year with 10 children, and the number has steadily decreased. Yes 4 children left, and I won't take anymore, that is clear, but at the risk of being repetitious, here are some more of the reasons why.
When I returned from South Africa I had 5 children I returned to. One of them began a different program, so that was 4. When I went to visit a little girl I had been seeing every week at the same time for a year and a half, her grandmother informed me, when I arrived at the home, that she was not there. The entire family (other than the grandparents) had moved to another county, Santa Clara County, to be exact. They left without so much as a by- your -leave, or a goodbye, or a gracias!  I informed the case manager who said she would look into the matter, but of course that was the last I ever heard of it.
A few weeks later the case manager asked whether I would take another child and I agreed to this one so that I would still have 4 children. I began to see a one-year old girl who lived with her extended family in Richmond. I never met the dad, which is typical. Mom seemed sweet, rather young. She only speaks spanish and on the first visit she told me her 1 year old daughter does not do anything other than sit, if she is placed in sitting, or else she lies on her back.
I told her I like to work with kids on the floor, so she did put a blanket down for me when I got there. The living room was tiny and dominated by a large couch and TV, and within a couple of weeks, a large Xmas tree .The area I had to work in was tiny, but I was used to that.The girl does not like being handled, or placed in different positions. She screams and screams, in fact she screams blue murder, and it is tough to understand whether something really hurts her, or she is used to being picked up as soon as she screams. Mom would sit there and say, 'that is what she is like,'  she screams with everyone.
On my request she gave me the number of the Public Health Nurse seeing the family, and also that of another therapist who was seeing her. I called them and left my numbers, e-mail etc. but needless to say, never heard from anyone - of course not, so much for the village. The child had an appointment with her doctor and I told the mother what questions to ask the doctor and also gave the mom my card for the doctor. On my next visit I asked mom what the doctor  said. Mom never made it to the doctor, or rather, she arrived too late for the appointment which then had to be changed to another day. Another couple of weeks passed by. I knew the mother was not putting the child on the floor, or trying any of the suggestions I had made. She either did not understand, or did not want to be bothered - it was much easier to leave her sitting or lying, and mom kept on saying 'that is what she is like.' She did eventually make it to the doctor and told me that the doctor told her she would receive a call from Childrens' Hospital Neurology Dept. to make an appt. I was relieved to hear that, some progress was being made.
At the end of my session mom said to me "I am going to Mexico"
"When, and are you going with your daughter."
"In a day's time - yes with her."
"When will you be back?"
"I don't know yet, I will call you."
That was a month ago, and I haven't heard back, and probably won't. So much for the neurology appointment. If the parents are not overly concerned, there is really nothing I can do.
I did tell the Case Manager when I saw her at a family meeting a week ago. She had no recollection of the child or her family, none at all.
Then she told me that as of January 2015 eligibility requirements for the babies are easing up,  and they will be taking babies at risk again, that is, those born prematurely,  low birth weight, etc. In other words there should be way more referrals, but they have such a backlog that they are nowhere ready to begin with new evaluations!
A home therapist called me as her case load is perilously low again. The other therapist had called me with the same concern towards the end of last year.There is nothing I can do. They have to make ongoing work related decisions themselves, because we are on our own!

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