So… you’ve been waiting 24hours and FINALLY IT IS HERE, the second part to this fascinating entry based on the experiences of a social work student.
I saw Ada on several further occasions when there was no further repetition of these events. On one occasion, Ada fetched a box from the kitchen to show me some documentation and, once finished with, placed it at the side of a cupboard in the front room. It struck me at the time that this might relate to how things ‘moved’ or went missing, providing an alternative explanation for what she’d said. Together, we addressed the needs identified on the support plan to reduce her isolation. She disclosed information relating to her relationship with her ex-husband relating to domestic abuse. This gave me information to consider in relation to Bowen’s (1966) Family Systems Theory, where each member of the family are influential in affecting every other member of the family in ways that can be longstanding. Her interactions with her children could replicate the interaction with her husband and her sense of resentment, which she disclosed to me.
On another occasion, as I sat and asked how things had been, Ada said ‘no-one believes me’. I asked what they didn’t believe and she told me that the previous Saturday, she had seen hundreds of witches flying around among the trees opposite her window. (She has a large picture window, which she spends a lot of her time looking out of). She told me that she’d seen more that morning before I arrived and that no-one believed her and she thought that she was going mad. I was aware that she had macular degeneration and had to have injections into her eye to try and control it. As a family member has a similar treatment, I suggested that what she was seeing was related to this. She replied that she thought it was a result of her stroke. We discussed it openly, considering whether it might be a combination of the two and Ada seemed to become calmer, though she said that she thought she was going mad. We arranged an introductory visit to a lunch club and I left.
When most of the actions on the support plan had been completed, I visited Ada to find her quite distressed. As I entered, I saw her seated in a chair, with her arm raised, swatting at something. She said that her daughter was being a problem and again she swatted at something. I thought it might be a fly, but it seemed a strange movement. I asked why she thought her daughter was being a problem and she said that she was flying around the room all the time and if she managed to get hold of her, she was going to ‘squidge’ her. She then swatted at something again. I asked if she could see her daughter now and Ada said yes, swatting again. I acknowledged that she was seeing her, but said that I couldn’t, saying that I believed that she was seeing her. I had taken an Attendance Allowance claim form to complete and she was focused while we were doing that. Once we finished, I pointed out to Ada that she hadn’t been bothered while we were doing it, and that maybe she needed to be more busy to reduce her distress as she would be focused on other things.
Reflecting afterwards, I thought about the relationship with her daughter that might be influential in Ada’s hallucinations. Lawler (2014) talks about the development of identity being related to the ‘space between people’ more than individual factors. I considered how Ada’s background might have been instrumental on the formation of her identity and how the stroke might have significantly affected them. Ada was aware that what she was seeing was unusual and thought herself mad, but that didn’t mean that she could stop herself. I thought about this in relation to Bronfenbrenner’s (1979) Ecological Systems Theory, how her upbringing and the cultural time that she had been raised in would affect her interpretation of what was happening now. She is a lady who has worked all her life which, using Bronfenbrenner, might predict that she would find it difficult being isolated and alone. Her relationship with her ex-husband might predict the difficulties she has now being positive about other people, affecting her trust in others and preventing her from taking the first step to build friendships. I decided that taking Ada to visit a lunch club with another person who was going to start would be beneficial with both.
I arranged to take Ada and another person I was working with to the local lunch club and, although both were a little wary, they did communicate in a positive way with each other. Unfortunately, the event had been cancelled without notifying me and I had to return them home. When I walked Ada to her door, she hugged me and thanked me for taking her out. I wasn’t sure what reaction to do, thinking immediately of boundaries, but as it was outside and in full view, did nothing.
Reflecting on it afterwards, I considered whether Ada is getting too dependent on me, and what I should do about it. I have had minimal contact with others involved with her, so feel that my perceptions are likely to be influenced by her perceptions. I have spoken to her son and the manager of the project and I’m aware that other agencies are involved. I have been told that she’s receiving treatment from a psychiatrist for psychosis but, when I asked her about this, she said she wasn’t.
The issue now relates to how I disconnect from her. The support plan is virtually complete and her 3 month review is about due, at which point Ada’s case could be closed or allowed to continue for up to a further 3 months.
If you are a practising social worker, a social work student on placement or even if you’ve just got something to say about welfare- let us know, we’d love to hear from you.
You can reach me at firstname.lastname@example.org