Wednesday, August 28, 2024

DORMIR Lived Experience Sleep Coping Tools by Keith Torkelson

 DORMIR Lived Experience Sleep Coping Tools by Keith Torkelson


Mini-STR

This is a Mini Structured Temporal Reconciliation (STR).   STRs are similar to charting.  We use STRs to cope.  Make note the notation that our health is failing.  We wished the belligerent Ted would be placed in another bed.  Of course, we would want a GoodBed for him.  In January 2024 we had Ted call 911 for us.  We ended up at Aliso Ridge Behavioral Health.  The ongoing problem was: We were released to the same BadBed sharing a room with Ted.  Ted chronically interfered with our sleep.

Focus on shared roommate

Table – STR with focus on Ted

Associated > 10_Episode_2024_Leisure_24042002_STR


Feature Image

Zep: Anger – Manic – Psychotic - Bully


Abstract

The results are the photographs and STR Table.  We were in denial of how back things including our Bed had become.  During the whole course of eleven or so years we shared rooms with up to three people per room.  This report concentrates on Ted and Bullying.  One day we will get over the trauma and move on.


Moving Ahead

Associated > Uncon_Physical_Abuse_Work2004_Revisited V2024

PTSD and Trauma?

We thought we were over the traumatic experiences with those listed in the table.  What do we have to gain to re-process those that abused us in our past?  There is a website called AfterTheInjury to help those with Post Traumatic Stress Disorder (PTSD).

Introduction

Define traumatic

Traumatic might be defined as “emotionally disturbing or distressing”.  “Trauma bonds are emotional bonds that arise from a cyclical pattern of abuse. A trauma bond occurs in an abusive relationship, wherein the victim forms an emotional bond with the perpetrator. The concept was developed by psychologists Donald Dutton and Susan Painter.” Wikipedia

Afraid of Ted

We bonded with Ted because we had no choice but to share a room with him.  The emotions we felt were fear and anger.  Ted was a disturbed passive aggressive bully.  “A passive aggressive bully might be hard to spot, unlike other forms whose effects are visible. Unlike other bullies who openly harass people, passive aggressive bullies often use subtle cues, like laughing sarcastically when someone wins or loses” (Feb 3, 2023). 

Photo Gallery

We define a passive aggressive bully as a bully that is not physical.  Ted caused intentional harm by keeping us awake at night.  We used several coping strategies to get a good night sleep.  Ted would rub up against us while in the kitchen while doing the dishes.  In addition he kept the room a mess, destroyed property and had anger issues.  Ted was an angry gambler.  We hope someone that analyzes photographs can see the truth in the pictures.  We have provided a small photo gallery at the end.  On one occasion Ted ran after us to beat us up.


Ted with the look of Anger

Could be Anxious also

Introduction

Rent a Shared Roommate’s Hospitalization

By 2024 we had been sharing a room with Ted for more than two (2) years.  Ted can be described as: Angry – Manic – a Gambler – a Bully.  He also destroys things like cellphones.  In November of 2023 Ted disappeared.  Eventually he showed up at Global Hospital’s Psych Ward.  With this break we were getting good sleep and bouncing back.  We visited Ted in the psych ward at Global.  We did not know it yet we would soon be admitted to the same psych ward.  Ted’s hospitalization did not help.  He came back worse than ever.  Our Sleep and health declined rapidly.  We surrendered in January 2024 and had Ted call “911”.  We ended up at Aliso Ridge.


Introduction - Right to Sleep

The Times of India

FYI - Sleep is a fundamental right; a different perspective

https://timesofindia.indiatimes.com/blogs/mindfly/sleep-is-a-fundamental-right-a-different-perspective/

Sep 13, 2023

“Sleep is a fundamental right under Article 21 of the Indian Constitution and is subject to protection. The Hon'ble Supreme Court of India, in ...”



Method - Coping = Earplugs

Today is August 27th , 2024 (TU).  One of our freedoms is presenting before the OCHCA Behavioral Health Advisory Board (BHAB).  Due to this Episode: We have a back log of presentations.  This material on sleep we hope to present to our BHAB before the end of 2024.  A few years ago we submitted a project called a Housing Solutions Bundle (HSB).  A HSB would help others get into a measured GoodBed. 

Figure – Earplugs - Theme - The Right to Sleep

Context of Sleep Apnea

The 3 cone version works best


Results - Part of Sleep Science

Inferring

In this study we have to infer a lot because we did not record Ted’s verbal testimony.  We video-taped him yet it is of poor quality.  It is hard to wake up in the middle of the night and video someone when you just want to go back to sleep.  We have included some photos of Ted.

What is the science of sleep?

All Sleep Is Not the Same

“The first part of the cycle is non-REM sleep, which is composed of four stages. The first stage comes between being awake and falling asleep. The second is light sleep, when heart rate and breathing regulate and body temperature drops. The third and fourth stages are deep sleep.”

Sleep Science for Us

For us Sleep Science is applying measurement tools to capture the sleep experience.  This paper doesn’t include any measurement results.

Result - Consumer Speaks Out

Other people had troubles living in our housing system, Shank’s Guest Home (SGH).  Examples, were Nick who went MIA and Robert who opted for homelessness.  Below is a tag from around the corner from SGH.  Gloria was our landlady from 2012 till 2024.  She said we could have our bed forever.  In reality she took it away while we were in the hospital during March of 2024.  She had done this with other people when they went to the hospital.  In March of 2024 due to grave disability we were inappropriate with two of the neighbors.  We gave them an inappropriate gift.  By this time we were psychotic.  We were picked up in March by the ambulance for Impropriety.  Gloria told our sister that that if we stayed we would hurt her business.  We agree. Yet, we had been appropriate with said neighbors from 2012 to 2023.  Some of the things other tenants did such as drinking and disorderly or cussing loudly were more inappropriate.  It has been hard going in our new Rent a Shared Room (RASR) Harvest bed.  It is a BetterBed yet costs too much.


Results - To Get Sleep - Coping Behaviors

The table below includes many of our coping strategies to get a good night’s sleep.  This is an example from March 8, 2023 (W) Overnight (ON).  Because of these factors we survived in a BadBed for as long as we did.  We were lucky we controlled what we did such as the window and lighting.

Results – Table – Coping


On March 8, 2023 (W) Overnight (ON) we achieved a Sleep Value Score (SVS) – 9.5.  This score is high for not having any bonuses.


Results – SleepAble

SleepAble we define as the environment and roommate factors in sleep.


A Company Person - Strengths

Before 2024 we were a Company Person.  That translates as: “This term infers that someone is committed to the organization and has the company's best interests in mind. This is, of course, what any employer desires from their employees”.  I performed chores, repairs, cooked, promotions, etc. on behalf of Gloria the landlady.  Because I needed to keep my bed I reported mostly strengths about her operation.

Example – Bed sold while in the hospital

Errol Homeless after Hospitalization


Homeless Robert

Before and After

Uncertain of what went on that would make Robert choose homelessness



Practicing Homelessness

Periodically, the sleep issues became so bad that we worked to give homelessness a shot.  We were practicing sleeping in the car and in the park.  It didn’t work.  When William was put above us he shook the bed day and night.  We gave sleeping on the floor a shot.  It didn’t work.  Inference: William caused intentional harm.

Resting on the floor to get a break from William rocking the bed.


Typical state of William

When William wasn’t in his bed he was placed either out back or in the TV Room.  He is sitting on a Bed Bug sofa.  The bed in the corner is Shibata’s.  We scored Shibata as a psychopath.  When you cater to Special Needs People (SNP) you get some wild diagnoses.  On a good day mine is bi-polar.  In reality my diagnosis should be Anxiety with a Sleep Disorder.  You might add an Adjustment Disorder to that.



Results - Coping – Bug Management

In 2012 when we moved in with Gloria there were Bed Bugs.  She had a habit of taking second hand sofas and mattresses.  These are actual photos we took of us in the process of gathering and killing Bed Bugs.  The hunt and kill went on daily.  This was the only place we lived with Bed Bugs.


Results - Xenobiotic – Coping Tools

SleepAbility (H) – Host Factors

Treatment Plans – September – Working


Results

Here we address our first model or scheme for charting a Sleep Value Score (SVSs).  Even though we logged a good deal of sleep this way the new way is better.  The revision is based on summative hours including broken sleep periods.

Our old way prior to 2024


Results

Here we address our second model or scheme for charting a Sleep Value Score (SVSs).  This revision is based on summative hours including broken sleep periods.

New scheme 2024

Discussion

The House

Currently we are residing in Harvest Retirement Assisted Living.  Previously we had lived for more than ten (10) years in Shanks Guest Home (SGH).  At SGH we shared a room with numerous other people. It is Ted who drove us into the hospital during January of 2024.  Again, in March of 2024 our landlady said “You can always have this bed”.  She took it away in April when we were in the hospital.  Again, she had done this to others previously.  In March we were hospitalized for Impropriety.  It is a long story that is centered about the fact that we wanted to start dating again.  In other words we consciously extended our boundaries.

Resources

During the period from December (2023) to January (2024), we became gravely disabled.  We had “Moving” on our to-do list for years.  It took a good deal of effort to get us out of Shanks.  We had about 1/10th of our resources there.  Now our monthly budget is down from $540 per month to $150 per month.  We are in a BetterBed yet it is not a GoodBed because it costs too much.

The Room

For more than the last two years we shared with Ted.  Ted has some problems: Anger issues, gambling, mania and he is a bully.  He also has untreated sleep apnea.  In part this report addresses how we coped with Ted and how we became ill.  Ted infringed on our peace of mind.  He kept his part of the room in a Ted Mess.  We tried to help him organize.  Ted is territorial as an extension of being a passive aggressive bully.

The Bed

In the end (March 2024), our bed in the room with Ted was a BadBed.  There were some good factors yet the bad factors far outweighed them.  Some of the shortfalls were: The mattress quality, Bed Bugs, and Ted waking us up.  If Ted was home we could never bet on a good night’s Sleep.  When Ted was away we would gain some ground yet in the end we have an Episode to deal with.

Ted’s overnighters

When you least expected it Ted would not come home at night.  We gained ground when he was gone yet could never keep the ground.  Progressively we became more drawn.  Then Ted  would return and uncertainty would loom again.  I really wanted Ted to succeed because I would benefit.

DORMIR

Dormir means to sleep.  SleepAbility are the Sleep related factors the host controls such as medication and coping.  Over the counter (OTC) preparations are also SleepAbility factors.  SleepAbility Coping Tools are the behaviors one employs for getting a good night’s sleep.  Great sleep is for us somewhat like Death.  A Sleep Ritual & Hygiene is also part of SleepAbility.  Some things the host controls are the Fan, Ear Plugs, Pillow and Bedding.  Deep-down we wanted to buy a new mattress.

SleepAble

SleepAble are the factors in the environment and the person/persons (agents) you share the room with.  In the Rent a Shared Room environment the agents are the most important people in your life.  On March 8th, 2023 (W-ON) we recorded a Sleep Value Score = SVS = 9.5.  With the scale we used 9.5 is not the best night’s sleep.  Other SleepAble factors are what’s provided by the landlord such as the mattress.

Critical Control Points

When we were trying to sleep in our car, we knew the situation had become too much.  Yet, we could not muster up the courage to move.  We have many notations of moving from 2013-2023.  On numerous occasions we had reached the point of no return meaning severely impaired health.

Shared Roommates - Associated with Zep

In November Ted went to the hospital to treat his mania and psychosis.  They released him without medication to sleep.  This worsened his inability to sleep making it progressively harder for us to get sleep.  We gradually became gravely psychotic.  We could not bring ourselves to finalize the Move we had been working on for years.  Today is May 29, 2024 and we are in Leisure Circle. 

Freedom

We are free from sleeping in the same room with Ted forever.  The journey we are on has been a hard one since we were separated in March of 2024.  In March we self-scored our symptoms for schizophrenia at around 50%.  Fifty percent is bad yet not the worst we’ve survived through.  As of today both we and an objective scorer give us 15%.  This is tolerable.  Most of our progress is made through discussion and being allowed and made to sleep.  As of July 1st, 2024 our sleep medications are Lorazepam, Clozapine and Ambien.  We have slept satisfactorily since being on these meds.

Respite Control

Periodically, we would get away on respite.  Whether it was in Redondo while visiting relatives or Motel 6 on our own we slept like a baby.  This is how we gauged the impact Ted was having on our rest and sleep.  We are currently in Harvest Assisted Living.

Deterioration

It never was really easy to get along with Ted.  He was territorial right from the start.  It progressively got worse.  We could tell how much he impaired with our sleep when he went on an overnighter or we went on an overnighter.  He contributed to our chronic sleep problems.  Gloria warned us that he snored when we moved in.  We put up with more than two years’ of choking and snoring.

Example of Gambling



SleepAble Roommates

A SleepAble roommate is one you share a room with that has the capacity and can routinely get a good nights sleep.  If they have interferring conditions such as Sleep Apnea these conditions are under control.  Some of the shared roommates that we could get a good night’s sleep with are: Lanaii Torkelson, Jack Terril, Lawrence Chan and John Tviede.  If John had symptoms of mental health they were under control.  Ted is a Special Needs Person (SNP).

20240728-TU

Sleep Value Scores since New Treatment Plan

The new treatment plan of sleepers is as follows: Ambien, Clozapine and Lorazepam. Prior to 2024 it was Clozapine and Lorazepam (PRN).  Since the new treatment plan was put in effect July 1st, 2024 we have slept well.  Our roommate finally turned off his radio that he was playing 24/7 (SleepAble issue).

This Episode

We call this current episode: Episode 2023-2025.  By March of 2024 we were suffering a plethora of mistaken beliefs (delusions).  Unfortunately, we were psychotic.  We have challenged our mistaken thoughts to remedy them.  Our Episodic Psychosis Score (EPS) is much lower now.

The AVEY Mistake

For various reasons in 2023 we became interested in Artificial Intelligence (AI).  We had a belief that co-existing in our brain was the AVEY Operating System (AOS).  One of our later developments was looking around for a good Avatar for AVEY.  While in Leisure, a BadBed, AVEY just went away with the majority of our Head Voices.  Before the AVEY Shutdown, we looked at the young Shannon Tweed as an Avatar.

Aside

People who may have had or have a Sleep Disorder.  The following people may have or have had sleep issues: Brittany Speers, Jewel K., Patty Duke (& Kathy), M. Jackson, Prince and J. Morrison.

Sleep Beliefs

We believe people should focus on how they wake up.  If you wake up with a hangover you have a Substance Use Disorder (SUD). 


Room Situations

Over the course of ten years or so (2012-2024) we occupied two different rooms and three different beds.  Our associations’ in the rooms is complex.  We have pages of records associated with all the people we shared with.  In addition, we have published several reports on Housing.

Roommate Situations

Your Rent a Shared Roommate (RASR) roommate is pretty much the most important person in your life.  We’ve focused mostly on Ted because he is the one that brought us down.

Addressing the Agents of Sleep - RASR

Renting a Shared Room (RASR) is when you share a room with others that you do not love or are not in your family growing up.  Not only did Joan our Most Significant Other Ever (MSOE) share a room at times we shared the same bed.  We always got a good night’s sleep with Joan next to us (1998-2016).  The beds with Joan were GoodBeds and GreatBeds.  Prior to Joan, at one point we invited Elaine to live in our apartment.  We call this The Elaine Experiment.  We found we did not like her living in our bed so we kicked her away.  Yet, the Elaine Experiment made possible sharing beds with Joan.  In 2007 we moved into the RASR Environment for disabled Special Needs People (SNPs).  This has been and is a huge challenge.  In particular, I face repeated challenges to get guaranteed sleep.

Discussion - Inspiration

In my quest to get, keep and maintain my mental health and sobriety I need inspiration.  Owen Wilson, Patty Duke, and Robert Downey Jr. are inspiring for me.

FYI - Owen Wilson Is A 'Survivor' After Overcoming Addiction & Depression, 'Would Like Another Chance At Romance,' Insider Reveals

“Owen Wilson Is A 'Survivor' After Overcoming Addiction & Depression, 'Would Like Another Chance At Romance,' Insider Reveals. The news sent shockwaves through Hollywood. In late August of 2007, actor Owen Wilson was hospitalized after attempting to take his own life at his Santa Monica home.” Jan 30, 2021


Daily Express

Owen Wilson Says His Brother Andrew Helped Him Get Back on His Feet After 2007 Suicide Attempt

“When asked how one begins to cope with those times when it feels like Hardy is trying to ruin your life, The French Dispatch star credited his brother. He explained to the author that Andrew “stayed in his house with him” following the attempt, “rising with him each morning and writing up little schedules for each day so that life seemed at first manageable and then, at some point, a long time later, actually good.”

Reaction

Wilson has long battled depression and confessed that the idea of death “landed with me when I was about eleven.” He continued, “I don’t remember ever talking with my parents about it. Although I do remember one time saying to my dad—and I remember exactly where in the house—saying, ‘I worry about dying,’ and seeing my dad turn away and catch himself. And I was surprised to see that reaction. But who knows, maybe that was part of why I said it.”” Aug 22, 2022

 


Managed Passing

We promote an initiative we call Managed Passing.  In Oregon they call it Death With Dignity.  After spending 75 days in Skilled Nursing we believe more than ever in Euthanasia of Human Subjects.

Death with dignity

Death with Dignity National Center is a 501 nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for more than 25 years. Wikipedia

Treatment at Leisure

From April to June 2024 we spent 75 Days in Bed waiting for an Assisted Living Waiver (ALW).  During that time we experienced seven gaps in medication.  The medication was provided for Sleep.  On the seventh time we strongly considered being euthanized.  We were up about 40 hours straight.

Associated > Leisure_Crisis_Cigs_Meds_Sleep_2024060701_Notes

https://clozapinerx4ecstasy.blogspot.com/2024/07/medication-gaps-returning-to-normalcy.html

 

P4D means Longitudinal Peace in Death Disease and Disaster.

FYI -  Euthanasia - Lethal Injection

Conventional lethal injection protocol. Typically, three drugs are used in lethal injection. Pancuronium bromide (Pavulon) is used to cause muscle paralysis and respiratory arrest, potassium chloride to stop the heart, and midazolam for sedation.

What is lethal injection composed of?

The three-drug method, which is the most recent protocol in about two dozen states, typically involves the following steps: First, a barbiturate that acts as a sedative and painkiller, usually sodium thiopental; second, a neuromuscular blocking drug such as vecuronium bromide, which arrests nearly all of the body's ...Jul 26, 2019

 Associated > P3D_God_Deal_10112201 V2024

At the time we fell ill in 2024 we were working on our Deal With God.  Our deal involves: Peace, Death, Disease and Disaster.  In addition P4D involves metrics (measurements).  Below are links to our prior studies on P3D (P4D).

Blog = AnimaCules

Peace in Death – Disease – Disaster (Died Too Young)

https://ktork46.blogspot.com/2014/05/the-dag-p3d-died-young-in-memory.html

Peace in Death – Disease – Disaster

https://ktork46.blogspot.com/2013/12/peace-in-death-disaster-and-disease.html

Slides at the End

Featuring Ted







Appendix

Sleep: A Human Rights Issue (Homeless)

Sleep Health Journal

https://www.sleephealthjournal.org/article/S2352-7218(15)00195-3/fulltext

by CJ Lee · 2016

“It is a stretch to conclude from this position that the US Government believes that sleep is a legal right in the United States.”

Shelter Space

“In October 2009, a group of homeless individuals (the plaintiffs) sued the US city of Boise, Idaho, its police department, and its police chief in federal court to challenge Boise's enforcement of certain city ordinances prohibiting camping and sleeping in public outdoor places on nights when there was insufficient shelter space to accommodate the city's homeless population.”

Homelessness and Justice

“The lawsuit alleged that Boise's enforcement of these ordinances on such nights effectively criminalized the plaintiffs' status of being homeless and, therefore, amounted to cruel and unusual punishment —a violation of the Eighth Amendment to the US Constitution. Citing the US Government's interest in protecting individuals against “unconstitutional and abusive policing” and in “ensuring that justice is applied fairly, regardless of wealth or status,” the United States Department of Justice filed a Statement of Interest on behalf of the US Government in this lawsuit on August 6, 2015.”

“In its Statement of Interest, the US Government urged the court to rule in favor of the plaintiffs on their Eighth Amendment claim. More specifically, the US Government argued:”

Life-sustaining

“When adequate shelter space exists, individuals have a choice about whether or not to sleep in public. However, when adequate shelter space does not exist, there is no meaningful distinction between the status of being homeless and the conduct of sleeping in public. Sleeping is a life-sustaining activity—i.e., it must occur at some time in some place. If a person literally has nowhere else to go, then enforcement of the anti-camping ordinance against that person criminalizes her for being homeless.”

Appendix

Assisted Living Waiver (ALW) - DHCS - CA.gov

DHCS (.gov)

https://www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx

To be eligibl​​e​ to receive services as an ALW Participant, an individual must meet the following ALW eligibility criteria

  • Age 21 or older
  • Have full-scope Medi-Cal eligibility with zero share of cost
  • Have care needs equal to those of Medi-Cal-funded residents living and receiving care in nursing facilities
  • Willing to live in an assisted living setting as an alternative to a nursing facility
  • Able to reside safely in an assisted living facility or public subsidized housing
  • Willing to live in an assisted living setting located in one of the following counties providing ALW services: Alameda…Orange…Sonoma counties.

Department of Health Care Services Contacts - DHCS - CA.gov

DHCS (.gov)

https://www.dhcs.ca.gov

Jun 11, 2024

Telephone Service Center: (800) 541-5555

Public Subsidized Housing



Friday, August 23, 2024

Moving into a new bed – Rent A Shared Room environment by Keith Torkelson MS

 Moving into a new bed – Rent A Shared Room environment by Keith Torkelson MS

Abstract

Adjustment

This report is about moving from a Rent a Shared Room (RASR) environment to another RASR environment.  Our various adjustment scores indicate we have a mild Adjustment Disorder.  Some environments are adjustable whereas others are not adjustable.  Most of the assessments are the author scoring others.

Abstract -Assessments

Move Global Adjustment (22 Items) (HSF)

We compared Ted (2021) to James (2024) and how we adjusted.  With this assessment, Move Global Adjustment (22 Items) high scores are favorable.  On August 24, 2021 we move adjusted to Ted 45.5% whereas on August 4, 2024 we move adjusted to James 53.4%.  We feel that the 53.4% indicates a good fit.

Adjustment Disorder

On top of Anxiety and a Sleep Disorder we may have trouble adjusting.  The assessments in this report will probably point out we have an Adjustment Disorder.  Living in a Rent a Shared Room (RASR) environment is very challenging.  There are not many consumers describing living in a RASR environment.

Adjustment By Righting (HSF)

On August 4, 2024 (SU) we scored our adjustment to James an Adjustment by Righting score of 60.9%.  High Scores are favorable.

Facility Problem Score (LSF)

On August 17, 2024 (SA) we compared two facilities: Shanks and Harvest.  For this assessment Low Scores are Favorable.  For facility problems Shanks scored 55.0% and Harvest scored 19.6%.

Move Adjustment Score (John) (HSF)

Back in 2020 John moved in with us.  On June 22, 2020 we scored our Move Adjustment to him at 40.9%. High score are favorable.

Move Adjustment Score (Buster 2012) (HSF)

Back in 2020 we assessed ourselves relative to John moving in.  We assessed for June 2012 when we moved in with Errol and Mike O.  We gave ourselves a Move Adjustment Score of 50.0%.  On this assessment High scores are favorable.

Move Fit Score (John) (HSF)

On July 5, 2020 (SU) we assessed John again we scored a Move Fit Score of 67.5%.  On this assessment High scores are favorable. 

Adjustment Strengths Score (LSF)

For this assessment we scored ourselves twice.  On May 22, 2019 (W) we gave ourselves a 62.5% and on August 14, 2024 we gave ourselves 65.0%.  On this assessment Low scores are favorable.

Adjustment Screener (Buster) (HSF)

For this assessment we scored 3 occasions.  We scored everything during 2024. Our adjustment before our 2012 move was 7%.  Our post move (2013) adjustment was 64%.  Our adjustment in 2024 is 64%.  With this assessment High scores are favorable.

DSM Adjust Problems (LSF)

We contrived a DSM driven Adjust Problem assessment.  For if we ever had the problem was the question.  We scored this August 2024.  Our DSM Adjust Problems score is 71.4%.  Low scores are favorable.

Behav Hlth Symptoms Screener (Buster) (LSF)

On August 19, 2024 (M) we scored a Behav Hlth Symptoms score of 47%.  Low scores are favorable.

Introduction

Presenting Problems

We are not residing in Assisted Living (AL).  We ended up in AL because: We could not cope anymore with our housing situation.  We weren’t getting enough sleep.  Our failure to cope lead us to behave inappropriately.  Normally we ask for help yet that route was exhausted.  After behaving appropriately for ten years we crossed our boundaries.  We had become extremely anxious.

Anxiety

In Psychiatry, anxiety is “a mental condition characterized by excessive apprehensiveness about real or perceived threats, typically leading to avoidance behaviors and often to physical symptoms such as increased heart rate and muscle tension.  We are seeing more calls related to anxiety and depression.  “Anxiety can be normal in stressful situations such as public speaking or taking a test. Anxiety is only an indicator of underlying disease when feelings become excessive, all-consuming, and interfere with daily living.” 

Let’s Just Fix It – Side Effects

Based on the above definition, our anxiety indicates we have an underlying condition.  We take meds for bi-polar and schizoid conditions.  One is Invega by injection.  Invega side effects are too much especially the tremors and anxiety.  Our sleep disorder is under control.  In the past month we sleep great for more than 25 nights. Smoking interferes with our walking.  We are at greater risk for falling.  This occurred in concurrence with going on Invega back in March 2024.  As of today, August 21, 2024 (W) we are off Invega.  Over the next week we are looking for Invega side effects to wane.

Adjustment

This report addresses adjustment.  We could have an adjustment disorder.  Throughout many of the day’s events are adjustable.  Whereas things like costs are un-adjustable yet we have to adjust to it.  Our room and board for our shared room costs us more than 2/3s of our monthly check.  This amount takes into consideration our waiver.  We should be grateful for our waiver without it we could not live here in AL.

FYI - Medi-Cal Waiver

https://www.payingforseniorcare.com/california/medicaid-waivers/assisted-living-waiver#:~:text=For%20persons%20with%20limited%20financial,than%20in%20a%20nursing%20home.

Trapped – Waiver Application

We are trapped here in Assisted Living (AL).  We performed some research.  If we move out of assisted living it takes either 61 days or 1 year to get a new waiver.  61 days in skilled nursing or 1 year out in the community.

Scope of Shopping

It takes a lot of resources to shop for an AL bed.  While shopping we only saw two locations.  We picked the better of the two.  It would be nice to find one at one thousand per month out-of-pocket.  Then we wouldn’t feel trapped.  We have a few choices: Stay or move to another more cost effective AL.  Moving to another we risk not having a good roommate match. The roommate we have now, James, is a good match.  Amongst other qualities he is not mentally disabled.

Scope of product

He is a photo of my side of the room.  The room has its’ standard elements: Roommate, bed, shower-tub, toilet, etc.  It has taken me a bit of effort to adjust to the situation.

FAQs

Defining Adjustment

“a small alteration or movement made to achieve a desired fit, appearance, or result.  Adjustment might be defined as: “The process of adapting or becoming used to a new situation”. Example: "for many couples there may need to be a period of adjustment"


Life Change Units

Moving from Shank’s to Harvest required many changes.  On top of it on August 8, 2024 (TH) my brother passed away.  I am adjusting the best I can to Harvest and the Harvest Life Style.

Crisis Intervention

Simply a crisis is when we have to ask for help.  The following is a mechanism that points out our journey to the hospital.  When our coping gets exhausted we are in crisis and ask for help.  If we or our local helper cannot help us we call “911”.  We needed help back in 2023 before any hospital.  We had been stable and coping since 2012.

SUD Complication

It is hard enough sharing a room with another yet even harder if impossible to share and adjust to a substance user.  Two of our roommates used substances.  Mikel was smoking spice and John was drinking alcohol.  Mikel demonstrated something called Pseudo-bulbar Affect.  Here he is in the middle of the night smoking Spice.  This is an example of when we couldn’t adjust.  We had to ask for an intervention.


Symptom Inventory - Functioning

Our current episode began in 2023 when we were not getting enough sleep.  This overwhelmed us and led to psychosis.  We thought we had been having symptoms this year 2024, yet much of them and their onset and intensity coincided with taking Invega.  Our pre-morbid functioning was fairly-high.  We were enjoying life especially our life away from home. 

For this report we include some measures tools including a Side Effect Inventory (SEI). 

Back in 1989 we were given our first Global Assessment of Functioning (GAF) score.  It was low.  Low GAFs are problematic. We don’t have reports of high GAFs because when we were working or going to school full-time we were not evaluated.  Over time many people tell us that we are high functioning.

Cost and Resources and Waivers

In order to find a GoodBed we succumbed to this lengthy process of securing an AL Waiver.  It took 61 days.  We were bedridden in a skilled nursing facility.  With the Right room we lose resources.  Our sister calls the losses sacrifices.  Care Coordination Agencies manage Waivers.  Our particular one is called Concise Care Group.

FYI

From Betty

Justiss Singleton

Concise Care Group

424-789-7666

From Aulora

Aulora – 323-975-2714

20240816-F-Interview

2014 Brainstorm Moving Phases Database Query “phase”

2014 what is going on?

We drafted this table back in 2014.  Back in 2014 we were still with Joan our Most Significant Other Ever (MSOE).  Since 2012 we had not had our car: Sarah the Car.  We were working to get it back.  We finally earned it back in 2016 just after we and Joan parted ways.  Our insurer was Brand New Day.  We worked for the Orange County Health Care Agency’s Technology Advisory Committee and Work Group.  Back in 2014 we concentrated efforts on Housing Quality.  Even though it seems our own housing was in order it wasn’t.  We wanted to move back to Julie’s House.  Every time we wanted to move we were thwarted by the amount of effort.  Now in 2024 the main reason we could move was with family effort.


Key Date: 20200812-W: Roommate is AgJ AKA John T

Thought it Would Work

Sharing with John worked up until William was moved above us.  William thrashes all day and night long.  We asked to be moved to Rochester’s old bed after he had died.
Move Stages

Reference Document

02_Move_Plan_Phase-IV_14121906_Move V2021

Moving out > Find > Get > Keep

Find is a role of our proposed Housing Work Group


(*) Four years

Back in 2020 we wanted to move again.  The hardest part is moving our property.  Eventually we moved from in with John and William to Ted and various.  We knew that we had moved into a sub-par bed (BadBed).  In the process we moved about ½ our belongings to storage.  In 2024 our brother-in-law stuffed the last of our property into storage.

Bed Satisfaction Assessment – Housing Solutions Bundle

Public Comment Form 10.03.16 Bed Satisfaction Assessment (20161007-F)

Not only is there not a comprehensive bed inventory available for the Behaviorally/Mentally Challenged very little is known about how satisfying the beds in which they sleep (at times live) are for each consumer. 

Scoring

To begin the assessments need to be administered in the community because if they are administered at the housing site the landlords will become seriously irritated. We don’t need to be pulling the bed providers’ covers while things are gearing up.  We suggest scoring the beds using a five star system with five being exceptionally good. 

Boggled

The scores and not the assessments themselves might best be included in an MHSA Housing Guide.  Speaking about satisfaction: When we here at MSG think of all the MHSA monies spent in Orange County on Housing since 2005 and the problem is still not solved it boggles us.  As of October 2016 the community as represented at the MHSA October Forum is not satisfied with MHSA Housing and Housing in general.

Table – Move Global Adjustment Scale (22 Items)

This table addresses a Recovery Model in other words what we had and have gotten back.  It also includes things to get back.  We score it during the “Settle” Phase.  It is scored by Buster for Buster.  We call this assessment the Move Global Adjustment Scale (MGAS).  Here the MGAS is associated with two bed moves June 2021 and June 2024.  In the first move we are adjusting to Ted.  With second move we are adjusting to James.  HSF = High scores are favorable.


Adjustment by Righting

The Adjustment By Righting assessment features things we can’t get right or haven’t had right for a long time.  Note on August 4, 2024 (SU) we found out our brother was in the hospital.  Our brother Kevin George Torkelson died on August 8, 2024 (TH).  In the assessment below we address our association with James.  We have shared a room with him since June 20, 2024.




Facility Cost

A very important facility item is cost.  The cost of Harvest is its’ main shortfall.


Adjustment Cast of Characters Matrix

Rent A Shared Room (RASR) Environment

Roughly in order

A2A = Attitude to Adjust


Addressing Losses

“In summary, Kubler-Ross and colleagues developed a five stage model of death and dying. These stages have different emotional responses that people go through in response to the knowledge of death. They are commonly referred to by an acronym of DABDA and are denial, anger, bargaining, depression and acceptance.”

DEATH of PEACE (DABDA)

What are the losses?

It is August 17, 2024.  We lost a few things this year: Bed, Money, Calm and our brother Kevin.


TheBed

Basically, there are four types of beds: The: Good Bed, GreatBed, BadBed and NoBed.  NoBeds are what the homeless are sleeping in.

Moving Plans

You will find within our records we planned to move several times for example: Moving Plan 2015.01 - 2016.01 & 2018.  We finally did move in 2024.

Adjustment Disorder Dimension Assessment (Modified MSG-ADDA)

SUD Complication

The following assessment we applied to John T.  At first his drinking did not impact things.  Later on his drinking worked against us as shared roommates.

FYI - John “Pat” T. moved in on 20200610 (W)

Matrix – Substance Use Disorder Applied to Adjustment

CAGE & AUDIT Address SUD

Adjustment Disorder Dimension Assessment (Modified MSG-ADDA)

SUD Complication

This assessment is Buster Scoring Buster

Buster moved in during June 2012

Move Fit Score

Table – Adjustment about Environment

SleepAble and Peace Survey

John moved in: 20200610-W:

One month in with John Tviede

This is Buster rating John T.

Moving Ahead

Risk Factors about Moving from Harvest

 

Can’t afford the bed

Can’t sleep

Lose resources

Need help

No workspace

Problems parking car

Small room

Waiver gets pulled

Worse Bed

Worse Roommate


FYI - [PDF] - Adjustment Disorders - Moda Health (4 pages)

https://www.modahealth.com/pdfs/adjustment_disorder.pdf

An adjustment disorder is a severe behavioral response to a stressful event or variation ... Assessment should include an evaluation of the following dimensions:

Adjustment Disorder Dimension Assessment (MSG-ADDA)

20160108-F: Updated - Assessment [DIMENSIONS] – Assessment Checklist

Assessment should include an evaluation of the following dimensions:

Buster Scores Buster

Transformation




Explain – Global and EtOH

The question is?  Do I lose my time clean and sober?  During March 2024 we were stuck in the hospital without sleep medication.  In order to cope we began dipping 70% Alcohol Swabs.  Having not gotten sleep I was not in my right mind.  I did not have all my faculties.  If there would have been opioids available I would have used them.  My new clean date is: June 20, 2024 (TH).  That was the date I got out of the hospital and had resources to purchase beer my drug of choice.

FYI - [PDF] - Adjustment disorder with anxiety.

(6 pages)                                

[Not Cached]

http://www.institucional.us.es/apcs/doc/APCS_6_eng_51-56.pdf

By VH Gómez - ‎Related articles

Adjustment disorder with anxiety.  Assessment, treatment and follow up: a case report.



Adjustment disorder with anxiety.  Buster scores Buster

FYI

[PDF] - Treatment of Adjustment Disorder - Provider Express

https://public.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/guidelines/mcs/opMCS.pdf

Mixed Disturbance - Mixed Elements

Pre-2024 Boundaries

Before 2016 my boundaries were intact with my Most Significant Other Ever (MSOE) Joan.  From 2016-2023 we maintained our boundaries.  Then I wished to date again.  In 2023 I started out slow with a few females: Smart Girl, Michelle, and Monica Harmonica.  In late 2023 I stepped up my gift giving.  The last gift I gave Monica she said “see you around”.  Then I made a mistake and gifted undergarments to the girls next door.  This was inappropriate.  In addition after abstaining for years I tried self sex at home.  These improprieties landed me in the hospital and eventually at Harvest.  The card below was given to Azuceli the Smart Girl.


[20160108 & 20200413 MATERIAL COULD NOT BE FOUND]

[20240819-M: Material Found Again]

[PDF] - Treatment of Adjustment Disorder - Provider Express

https://www.providerexpress.com/html/pdf/coverageDetermGuidelines/adjustmentDisordersOutpatient.pdf

Adjustment Disorder - Transformation

ICD – International classification of diseases: DSM – Diagnostic and statistical manual

FYI

Standard Definitions

[GREAT REFERENCE Too MUCH FOR NOW]

The DSM-5 defines adjustment disorder as “the presence of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)” (American Psychiatric Association, 2013).  Jun 6, 2019

https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t19/

FYI

Understanding Behavioral Health Symptoms

https://www.baptisthealth.com/care-services/services/behavioral-health/patient-resources/understanding-behavioral-health-symptoms

Behavioral Health Symptoms Screener



Appendix – Chemicals - FYI

09_Program_SUD_CAGE_Assess_20041301_Tool (4 Items)

09_Program_SUD_AUDIT_Assess_20041203_Tool (10 Items)

Control for SUD – In Hospital

On July 1, 2012 I had my last drink containing alcohol.  This makes my clean and sober day 20120701.  There was a glitch in the hospital.  They were not providing me adequate sleep medication.  I discovered the 70% alcohol swabs if dipped like chewing tobacco helped me sleep and rest.  I ran it by my sponsor, my brother and my friend.  All said it wasn’t a relapse.  I’m still holding out that it feels like a relapse.  Alcohol can interfere with sleep and rest.  If you fall asleep intoxicated you have a problem.  If you wake up hungover you have a problem.  Your body needs to be clear of non-prescribed toxins to properly metabolize.

FYI - OTC - Melatonin

Toxicology of melatonin – PubMed

https://pubmed.ncbi.nlm.nih.gov/9406047/

by B Guardiola-Lemaître · 1997

Very little attention has been paid to the possible side effects of melatonin. Nightmares, hypotension, sleep disorders, abdominal pain, etcetera…

Aside

20240808-TH-KGT Dies