Tim joined our adult day health program nearly four years ago. Diagnosed with schizophrenia in his 20s, he has had a difficult life. Due to the long-term use of a variety of anti-psychotics, he exhibits Tardive Dyskinesia, along with involuntary movements of his hands and arms.
On “good” days, Tim would speak in full sentences, and even joke a bit with staff. At his request, he would help clear the dishes from lunch, stating that doing this task would help decrease his “voices.” When Tim cycled downwards, he became catatonic. He stopped speaking altogether, had trouble walking, and could hardly even chew his food. He simply shut down. After a few times of sending him to the hospital and having him sent back home later in the day, we became doubtful that anyone could help him. With input from his nurse, I wrote several letters to his medical team asking them to take a closer look at his medication regime. I left messages for his primary therapist and his mental health nurse practitioner. The only feedback that I got was that Tim would never improve. He had tried all the medications that he could, and he was allergic to others. This was to be his life. One day, Tim had really spiraled downward. He had been asking to go to the hospital for a few days, and was now expressing suicidal ideations. Despite his community doctor stating there was no point in sending him out, we arranged for him to go to the hospital. Finally, he was transferred from the Emergency Department to a psychiatric inpatient unit. After he had been there about a week, I went to visit him. As they buzzed me into the locked unit, I could see him shuffling down the hall. I approached him slowly and called out his name. He looked me straight in the eyes and smiled. “Tim,” I said. “It’s good to see you. I came to visit. Do you know who I am?” He smiled and his shaking hands slowed for a moment. “Sara.” Tim is one of the many reasons that I am a social worker. Despite the voices working overtime in his head, he knew me. He knew that someone cared about him, and was not willing to give up. I realize that I am limited in what I can really do to help him. But I can care. I can offer to take his hand, look him in the eye, and let him know that I am on his side. Sara D. Moore, LMSW, is an Adult Day Health Care Social Worker in Upstate New York.
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