Monday, July 10, 2006

Setting Reasonable Boundaries

In an earlier post we discussed allowing our complex children and adults to experience life with its’ normal risks (such as a burn on the stove). Besides the risks we all experience in life there are boundaries we have to accept. Adults are not necessarily free to do everything they want to do despite being independent adults. With all that has happened with Billy Ray’s physical problems and other significant changes in his life (finishing his school eligibility, moving to a new community, hiring a new weekday support staff) we are having to think more about what is reasonable to allow Billy Ray to experience and to expect from him.

Billy Ray is testing boundaries long established in his life. There are probably several reasons for that. The structure in his life has been impacted by recurrent health problems and the significant changes noted above. It could also be that he is becoming more and more adult. As shared here, Billy Ray is demonstrating some higher functioning skills that he experienced prior to the seizures that changed his life 12 years ago.

Boundaries have to be looked at it terms of future planning as well as present living situations. There are things that will apply to both. However, if patterns are set at home it may be difficult for him to adjust if he had to be in a group setting, etc.

His present situation is that he lives with his Mom and stepfather with a support staff coming in during the weekdays to give Mom and “Dadgert” some break to do needed things. Dad and Mom alternate being his one to one support the rest of the day weekdays and all weekend. As I state in our staff manual, while this is effectively a residential treatment center for one, it is still a family home to three of us. Billy Ray doesn’t have free rein to go into our bedroom, my office, etc. and get into our things. We have a right to our boundaries too.

If he were to be in a group home or in apartment with a roommate, he would need to respect others’ boundaries too. Lately he has wanted to come out into the living room in nothing but his underwear. Part of this is because his beloved western jeans are not comfortable with his abdominal pain but we have comfortable sweats or even his bath wrap as an alternative for him during those periods. In a group home or other setting he wouldn’t be allowed to run around in his underwear. Additionally, it is inappropriate here because of visits from Larry’s granddaughters, etc. This is an example of thinking about a boundary both presently and in the future.

Present support staff has been with him just less than a year so is a bit unsure of prior boundaries. Billy Ray has been sick all of the time since he has worked here. Additionally, Billy Ray is coming out of the out of control he was demonstrating when staff was hired last August. Billy Ray was very much
The Explosive Child as in the wonderful book I am reading by Ross Greene. I think part of the reason for his explosions has been sudden onset of pain. He has never handled pain in the way many children do (crying for Mom to kiss it and make it better). He interprets pain as something that someone is doing to him and it makes him mad! Staff is understandably a little hesitant to invoke the explosiveness. We need to support staff in understanding how to enforce realistic boundaries.

Billy Ray is smart enough to play Mom v. Dad v. support staff game as I wrote about so he is going to test his limits for all they are worth. In a way, he feels more secure when limits are established because he knows how far he can go and no further. Thus, it becomes important for all parties working with a child to be on the same page and as consistent with the other as possible.

No matter where he lives there needs to be boundaries. Observing realistic ones now will help his future to be more successful.

Until next time,
Peggy Lou Morgan
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