Holidays in NZ

Holiday Beach Bach.  Families come back to the same beach/holiday home for 5 plus generations.

Proud of the fish and Rock Lobster caught on holiday

Launching a boat by tractor at the beach

Kids playing with family at a skate park during school holidays.

Sushi making over the holiday with Jack and Dad/Scott

Kids on  holiday, enjoying a chat!

Holidays in New Zealand are like stepping back in time and grabbing onto the traditional values of family time and relaxing together.  The schools have three two week breaks from school, where families plan short vacations or visits to their holiday baches.  The break over the Christmas holidays, summer, is about 6 weeks, in which many parents take off of work, stores limit hours, and it seems that the country just slows down for family time and holiday.  Many people own these holiday homes/baches and often have had the bach passed down for many generations.  I was able to go on a long Labour Day weekend with the Lees’ who have been coming to the same beach for 5 generations.  They have only shifted homes once, and couldn’t imagine not spending the summer vacation here.  Many barbeques occur, along with the fish frys and sausage sizzles that are so popular.  I am so thankful that some of my family will be coming to join me in this wonderful tradition of sharing quality time together, just relaxing and enjoying each other.

Suicide

Disclaimer:  Contains hard information.  Today, I wanted to put down a few words about suicide.  This week, I experienced  the first professional/work related suicide of a young girl that I was working with.  I had only briefly visited with this young 24 yr old, who had just moved to Palmy 6 months earlier.  She had only experienced one episode of drug induced psychosis four years ago, but he just recently sought out help, because she was feeling some of those feelings and wanted some help.  In the four days that she had been on the ward, she had shown improvement, but had still had enough risks that the doctor wanted to only let her have day leave for a few hours.  She went out on leave from the ward, and was found shortly after from her one friend in town, dead by hanging.  I received the word at work on arrival on Tuesday, after the long holiday.  It was a shock for me, and difficult for me to hear the psychiatrist say that she didn't see it coming, and then we moved onto the next report, just like that.

I have seen suicide profoundly affect the lives of some dear friends and seen the many years of aftermath of fallout from that experience.  Even 40 years after my friends' event, the ramifications are still resounding in the lives of the children and former spouse of the one who died.  The ones who are left behind are tasked to make sense or not of it, and use this to shape their perception, perspective and lens on life and the world.

Hopefully many of my faculty will not be reading this, because there is not one reference in this, just gut reaction and reflection.  I have seen that many times the suicide may be caused by impulsivity.  This could be caused by a previous head injury and the damage to the frontal lobe, or a bad decision, or an accident or by altered judgement by substance abuse or a zillion other things.

In the end, we have a responsibility to let people know that we love them and that we care.  We have the responsibility to let people know the resources available to them, and give them access to those resources.  In the end, the individual has the responsibility to use these resources, choose to live with supports available and to not use anyone else for an excuse or scapegoat or reason.

I hope I don't get in trouble for this, without adding the numerous links to supports and help available, but I just needed to talk.  The debriefing or "resiliency training" that we had as an opportunity to share as involved staff was also a wonderful way to process the experience, and what it means to each of us.  It was humbling to hear the psychiatrist and the numerous psychiatric nurses also question their role and if they missed something or could have done something different.  There are so many people who care, and are interested in helping in whatever way available.  Sometimes it just doesn't seem fair.  It is important to know that there is hope.  Thanks for listening.

What is Wellness?

This past week has really made me do quite a bit of reflecting and thinking about what is wellness, and what is mental health and what is mental illness, and where is the line between them?  What gives some people the training and skills to diagnose and discern the difference and determine a change from one state to another.  I am working daily with about 11 Psychiatrists (which includes the Junior Doctors at this teaching hospital) many Psychiatric Registered Nurses, many "Key Workers"-Clinicians in the Community and one Social Worker, besides myself.  Each person has been specifically trained to identify, assess, diagnose and be a part of the treatment of the individual who is presenting to them.

In the past five weeks, I have worked or met with over 100 different people who have passed through Ward 21, each have a very difficult experiences, and have ended up in the Acute Mental Health Inpatient Unit.  Many have stories that include difficult childhoods, or tragic experiences; others have significant losses or unbelievable histories or present situations.  I have seen doctors adjust and juggle the medications, nurses balance out the time for the individual in leave, seclusion, protection checks, and behavior modification.  I have seen (and been) the social worker negotiating benefits with Work and Income, trying to find accommodations for someone who is at risk for self harm, or needs supported services, but none are available in the community of choice.  Sometimes the best thing for the individual is just not attainable with the current resources, so we settle on second or third best.

Today, I completed a day training in Mental Status Examination, which reinforced the teachings at UAA and University of Wyoming, to take a snapshot of the person at that point in time, and cover the various items to include in this report.  It was interesting to see the video presentation of the interview, and also the amateur assessment that the three groups came up with, as well as the video critique from the Psychiatrist of the Junior Doctor who did the interview.  Many of these assessments were different and that is because each person comes into the interview with their own education and experiences, and prejudices, etc, and the professional really needs to know what is their stuff, and what is the person, who is being interviewed, stuff.

I still don't know what is wellness or what is un-wellness, but I do know that people are doing the best that they can to make an assessment with the information that they have, keeping the wellness and involvement of the individual as the priority.  I also know that many of us are only one incident or crisis away from being unwell for a period.  Life is precious and short, and I am committed to contribute what I can to this world, and to the health and "wellness" of all of us.  I guess that most professionals are just trying to do the best that they can to assist others to wellness and health.  It just makes me more mindful and thoughtful about the assessment and the discernment that is needed when working with others, and importance of assisting and empowering these individuals to find and hold onto the strengths that they hold inside call upon that resiliency to grow or even just survive.

Big week, and hoping everyone has a healthy and good week.

Another weekend visit to the Lee's farm

This weekend was another mental health break for me at the Lee's farm.  It has been a wonderful and magic place for me to de-stress and take some unplugged, down time to do some physical work, and get back to nature.  This weekend, I fed the pig a few times, helped to shear some sheep, found a dead sheep in a paddock and helped to drag it to a place to dispose of her, weeded the garden, drove the four wheeler, so that Greg could drive the tractor down, and helped to put an orphan lamb into the skin of a dead lamb, so that the mama who lost her lamb, but still had milk, would smell the dead lamb skin on the new lamb, and think that it was her baby.



I have found that after a really intense week, working daily with people who are really unwell and in the acute mental health situations, this debriefing on the farm does wonders for my mentally, physically, emotionally and spiritually.  I will head into work tomorrow, anticipating finding out about the individuals whom I am working with.  I'm hoping that the weekend of rest and some medication has given some peace to a few of them.  I find that it is really helpful to see some folks get from this tough space, to a much more stable and healthy place over the course of their stay in Ward 21.  The average inpatient stay is over 10 days, so I have seen many people filter through in my 4 weeks at my internship.

Benefits for all

http://www.workandincome.govt.nz/individuals/

Today, I wanted to talk about benefits a bit, since much of my day is taken up with trying to assist people to apply for or get the documentation needed for benefits.  In Alaska, I am familiar with our National benefits, Medicare, SSI, SSDI, and our state benefits, APA_Adult Public Assistance, TANF/ATAP-Temporary Assistance for Needy Family, but not too much more than handful of other benefits for individuals or families, and we have our 60 month limit for the ATAP.

In New Zealand, they have so many benefits and it has been a very interesting journey to navigate them.  There are benefits for Accommodation Supplement to help with rent, board or cost of owning a house-Housing NZ subsidy, Advance payment of benefit, to pay for school, uniforms, rent, and “Away from home Allowance” if you have children ages 16-17 years old living away from home to go on a training or tertiary/University course, or a Domestic Purposes Benefit, if you are ove16-17 and legally married, or age 18 and over, and raising children, or caring for someone sick or infirm OR a woman alone aged 50 or over.  For someone like Anise, who has had multiple birth, you can have a domestic emergency or need domestic support with things like housework, cooking or childcare.  There is the Training Incentive Allowance for people on Domestic Purposes, Widow’s or Invalids benefits, or Emergency or Emergency Maintenance Allowance, who are training to improve their work skills.

I have helped several people change their “Sickness Benefit” to a “Invalids benefit”, which is for people who have a permanent and severe sickness, injury or disability.  Although the title is not quite politically correct for our people first language, it still provides an opportunity for people who experience a mental health issue, or a disability to receive some financial assistance to live in the community.

One story from my flatmates:  Yesterday, Emma took 9 yr old Jack for a chest X-ray for his bad cough.  She went into the doctors office without her wallet, because she knew that there wan not going to be a cost.  If she had private insurance, she says that she would have to pay about $60-70.  I contrast that with my own visit to Urgent Care in Juneau for my cough the day before I flew over here.  I was charged $287 on the spot, which I may get part of back, but since it is counted toward my annual deductable, I will not get any.  I still don’t know what to make of all of this or the systems that we work within.

Thoughts on Seniors

I was planning on blogging about my impressions about seniors and care for them in NZ, but this weekend in New Plymouth, with old friends, has changed my impression, so this blog will be a significantly different blog entry than I thought it would be.  First off, an observation is that the Maori elders are highly respected by the younger generation, similar to what I have seen in the Tlingit and Haida community with Alaska Natives.  That is very good to see.

I planned on writing about the impressions that I have from trying to find accommodations for people who had experienced mental health issues, and how difficult it was as a discharge planner in NZ to find suitable accommodations for them, when they were transitioning from the mental health unit of a hospital with any history of mental health issues.  I was running into walls in my contacts with  the rest homes in Palmerston North, because they had real concerns about caring for these folks; thus were not keen to even consider them for residency. I was beginning to feel that this country had not done a good job in planning for the bulge of baby boomers that are all beginning to age.

This weekend, I am happy to be visiting my friends in their 70’s who are living in a retirement community in New Plymouth NZ.  It is a very inclusive facility and I see that it has multiple layers of care for the residents, ranging from independent living to skilled nursing help.  I met several residents, and noticed that they were full of life and continuing to living it to the fullest.  I happened to be here for the Oktoberfest Celebration, which included limitless wine and beer, sausages, sauerkraut, a sweet sauce and strudel for pudding (dessert).

The staff were all dressed up in Norwegian clothing, even the gardener, posing as Helga, and an attractive one at that!!!  The wine and beer were flowing, and the residents were wondering if I was a new kid on the block.  Julie and I ended up visiting for several hours, and I had a lovely series of dances with Jack, who lost his wife only a few weeks ago.  He was great at leading, and we both enjoyed ourselves very much.  I had several other residents come up to me later to tell me that I had made his year by our dancing.  To me, I was so thankful to be in the presence of my elders who were so alive and appreciative of living.  I truly wanted to be a bit older to live in this type of grateful community of people.  I am sure that you must have the funds to be be to be in this type of community, that ranges from independent to skilled nursing, but this was the most alive community of older persons that I have ever been in.  It beat my Dad’s Falcon’s Landing hands down.  Sure beat the Oregon senior housing in Eugene, and rivaled the social program at the Pioneer Home in Juneau, and added some uninhibited fun for all. 

Tonight made me think that maybe they do have an infrastructure in place for many seniors as they age naturally.  It made we want to grow old in community with others, and share the experiences, and embrace new experiences, with time.

I am so blessed and thankful to have older people in my life, and am so thankful to be with others as they gracefully accept the challenges that aging brings with it.  I am thankful for my dear friend, Ramsey, who has Parkinson’s, and so thankful for the lessons of life that he and his faithful and sturdy wife Julie are sharing with me.

Here’s to seniors, elders, and those who have come before them.  May they know the immense impact that they have had on us, and know that the wisdom that they pass onto us is very precious and powerful.  I think that NZ is doing a fine job caring for their seniors, in their hospitals, clinics, residential programs/housing and benefits.

Benefits:  http://www.workandincome.govt.nz/individuals/

Age 65years old or over:  New Zealand Supperanuation, Living Alone Benefit, Extra financial support,

A woman over 50 yes or older alone or partner has died:  Domestic Purposes Benefit, Widows benefit.

Going to hospital or rest home long term:  Residential Care Subsidy, Special Disability Allowance. 

Top Ten Day in My Life

This is my favorite place!

Today at Lochlea Farm, working with Greg Lee on the farm, was one of the best days of my life.  We started the day with some bacon and fresh eggs, both from the farm, and went out with 2 Mums and daughters, backpackers, on an adventure for the day.  We went on the four-wheeler, and went into the paddocks to gather up the ewes and the lambs to accomplish a few things.  We drenched the ewes to keep the viruses away, and we separated all of the new lambs and we put a tight band around their tails, and also a ring around the testicles of the males, after pushing the balls up out of the sac, then clipped their ears to identify them, on the right for a male, or the left ear for the females.  We docked over 424 sheep today!

It was a really incredible process with a harness to strap one in, and then the three of us women each holding one lamb each (and later, just Greg and I) grabbed the lambs and cradled them for Greg to work his magic.  We herded many groups, with the help of dogs, and I got really comfortable in grabbing and pushing these sheep around.  The really aren’t very smart, but when it comes to mothering, they are AMAZING!  In social work, we learn how important the Attachment Theory is, and that early bond and mothering is.  Today, I saw numerous, hundreds actually,  of mama sheep-Ewes, separated from their lambs, for us to do our work, then put back into a huge paddock, and  within 30 minutes, they had found their own baby lambs and were nursing or mothering.  It is really important that if a ewe rejects their child, to “lamb them on” to a different mum that is lactating and can give the important nutrients to the baby.   Greg told me that if a lamb dies, the ewe will stand by her dead lamb fro two days.  Greg can then identify them and can take that lactating ewe and put her in a small pen with an orphaned or rejected lamb, and within a day, that grieving ewe will accept and mother this new lamb.  Isn’t that better than “good enough’” parenting?  I was very impressed.

I am in heaven!

Eating marinated lambs tails

The reunited Ewe and twins

Ellen Lee and Adam Lee

Anyway, the green, the nature, the birds, the people, the soul satisfying  connection is unlike any other for me.  I truly feel like I am supposed to be a farmer, here!