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
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
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
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
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
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