The Healing Power of Laughter

This past weekend Tracy and I went to Kansas. Tracy’s mom and dad both grew up there. Tracy’s mom grew up on a farm. The land was homesteaded by Tracy’s great-great grandfather in 1892. When his grandma passed away, we bought the farm land from her estate. It was important to Tracy to keep the land in the family.

We share crop with a local farmer, but there is still plenty of upkeep, so we go several times a year. We keep a camper there to stay in. The farm house was moved into town when Grandma was in her eighties, so that she would be closer to other people. Her health was beginning to fail a bit, and the family felt better about her being in town.

Tracy’s dad’s family were also farmers. Some of their land was taken by eminent domain by the government to use for a reservoir. Tracy’s grandpa said, “If you’re going to take my land and my livelihood, you’re going to need to put me to work.” He began working as an ironworker, and made his way to Colorado, following the construction jobs. Tracy’s dad and one of his uncles also worked as ironworkers.

When Grandpa Kastle retired from iron work, he returned to Kansas and farmed the remaining land with his family. This land was passed down to his children, Tracy’s aunt and uncles. None of them live in the area anymore, but they were also in Kansas this past weekend. We had them over to our place for a barbeque. It was so good to see them. We even got to see a couple of Tracy’s cousins that we haven’t seen in a while.

We were asked a couple of different times how is Travis doing? And rightfully so. Some of our family members have a pretty good idea because they read this blog.

My go to answer? The same.

I can tell they are worried about him. And probably about me.

I dream of a day where I will be able to say, he is doing better. Or he is doing good.

I took Travis to see his doctor last week. At first I was excited. They weighed him and he had lost 30 lbs. since his doctor appointment in May. He is a big boy, so he can afford to lose even more weight. I took him to his appointment early, thinking we would get his blood work done at the in-office lab before his appointment. Only I didn’t know they took a two hour lunch.

We went back to the lab after the doctor visit. The phlebotomist behaved tentatively. Travis doesn’t do well with needles. So he needs them to talk with him, distracting him, while they are in and out before he has time to object.

She went from arm to arm and then to the back of his hand, looking for the best vein. She asked if she could use his hand. Right away I’m thinking, oh no. He said yes, which surprised me. Then she said let’s count to three. Inside my head I am rolling my eyes.

Then I watched her miss the vein, and move the needle around trying to get it. And my big boy was out. When he came to they asked him if he knew where he was and he said in the hospital. Doctor’s office, but close.

They ended up giving him some juice and peanut butter crackers. So much for fasting.

The took his blood sugar and it was 295. I was shocked. They took it again after the juice and it was 330.

I was expecting it to be better than the last visit in May. When it was 230. I thought the weight loss would mean the other numbers would be better. And the fact that the doctor doubled his Metformin prescription.

Once he started to feel better I took him for a bite to eat and then home. He had to fast again, then I took him to the regular lab I usually take him to, and he started to tell the phlebotomist about the day before. She just nodded, told him that wasn’t going to happen today, and was in and out of the vein before he realized what was going on. That’s how you do it. No counting to three.

His glucose was 339 and his A1C was 11.8.

We got in the car and I contacted his nurse. I asked him if Travis was taking both doses of Metformin each day. The nurse would be able to tell when he refills the med box each week how many are left untaken. He said maybe 75% of the time.

The doctor prescribed 5mg extended release of Glipizide. And asked me to bring Travis back in three weeks.

Travis’s live-in aide moved out in February. Travis asked if we would give him a chance to live on his own. He thought he was ready.

It doesn’t look like he is ready. He has a med box that sounds an alarm to remind him to take his meds, and still misses 25% of his doses.

He is only wearing his BiPap 60-70% of nights.

He is getting sicker.

On top of his health issues, the non mom approved “friends” are back. Once they figured out there was no longer an aide to screen who is coming and going, they started hanging around again. Stuff is missing.

Travis has had five different live-in aides. It’s hard to find a qualified person to take that job. We offer free rent and utilities. And allow the person to work or go to school during the day. It’s not enough pay to get the right person.

A couple of weeks ago Travis’s case manager contacted me to let me know that the Colorado General Assembly had authorized an additional 667 enrollments for authorization. Foothills Gateway, our county community center board (CCB) that manages the state waivers in our county, will be receiving 41 comprehensive slots. Let me explain.

Individuals with an intellectual/developmental disability (IDD) can receive either supported living services (SLS) or comprehensive services on the state waiver, depending on their individual needs. Travis had been on the SLS waiting list for a few years when the Colorado General Assembly made several hundred SLS slots or authorizations available. Their goal was to get rid of the wait list.

It took agencies a couple of years to gear up to provide services to all of the individuals coming off the list. They eventually got to Travis and he started to receive his SLS services. If Colorado hadn’t done that, it is likely that Travis would still be waiting, even today.

We also knew back then that the SLS list was moving faster so he would at least get some services quicker.

Our goal was that Travis would receive all the services he needed through the SLS waiver. Because Travis kept putting himself into dangerous situations, his name was added to the comprehensive services waiver list with a “safety-net” designation. Meaning the team was keeping an eye on whether he may need a greater level of support, so they were holding a spot for him on the list. Just in case.

We thought that given time, he might learn, sometimes the hard way, how to protect himself, his home, and his things. We thought that his mental health would improve when he was no longer being bullied at schools. When the pressure of doing school work with a learning disability was gone.

Travis continues to struggle. Letting him suffer the natural consequences of his decisions is not teaching him anything. He makes the same mistakes again and again. He trusts the same people that have exploited him in the past again and again. He believes them when they lie to him, again and again.

When Travis’s case worker let me know that slots were coming available, she told me that it was time to take Travis from the “safety-net” hold, and put him on the list for an “as soon as available” slot.

The biggest hang up for me doing that was that most of the individuals that receive comprehensive services live in a host home situation. There are no longer any group home settings, at least in our county, as the provider agencies couldn’t afford to keep them open with the current payments they were receiving per individual from the state.

Initially my thought process was that if Travis was going to live in a family’s home, he could just live in his family’s home. I wanted him to live as independently as possible.

But I also realize, that a host home provider wouldn’t be able to meet his needs in their home. He wouldn’t be able to follow their rules. If he punched a hole in the wall of a provider’s home he would be out. They aren’t going to put up with that. Or the amount of “friends” he has coming and going.

If Travis lived in someone else’s home, he would have to use his SSI to pay for room and board. Meaning he couldn’t afford to have a car. Or anything else.

Then his case manager said that with the comprehensive waiver they could pay a provider to live in Travis’s home. Ok, now I’m listening.

So like a live-in aide, the provider would get free rent and utilities. But they would also get paid the monthly rate his level of need provides to a host home provider. This might be an ideal situation for someone that would like to be a host home provider, only they don’t own a home. And buying a home in our community is unaffordable right now.

His case manager said to me, “Please just let me do it. I’ve been thinking about it a lot and it’s time Glenda.”

I told her that I was good with switching him to the “as soon as available list”.

His caseworker thanked me for not making her give me a lecture.

If someone was there when the med box went off, they could tell him. I’m sure there are times when he is playing his Xbox with his headphones on that he doesn’t even hear it. Or if he is not at home when it goes off, it doesn’t occur to him to take them when he gets home.

I can stock his refrigerator with fruits and vegetables. He loves to eat salad if you take him to “Mad Greens”. Where someone else is preparing it, and he tells them what to add. They even put the dressing on it and mix it in. Even with all the ingredients he doesn’t make himself a salad. Ultimately I end up throwing away the fruit and vegetables away as they get rotten.

If a provider were there to help him with eating decisions, it would be good for his health.

If Travis fell asleep in his recliner, a provider could wake him up and send him to bed. Meaning he is more likely to wear his BiPap. I’m quite sure that the Bipap pieces and parts are not getting properly cleaned either. That can’t be good for him.

Most importantly, a provider could help him make better decisions about who can come and go into his home safely.

If everything I am currently doing now is not enough, he needs more support. I cook for him, I clean, try to keep the hoarding to a minimum, spend time with him, take him on errands and take an average of nine calls a day from him.

So I said yes. Because when friends and family ask me how Travis is doing, I say, the same.

Travis’s case manager said that Foothills Gateway usually gets about ten slots per year. Travis gets placed on the list in the spot he would be in when he was initially determined to have a developmental disability by the CCB, back in 2011. After using their 41 slots on the list, Travis is now number eight. Meaning he could get offered a spot within the next year or so.

Depending on how many waitlist exceptions there are as well. Per hcpf.colorado.gov:

“Enrollments into the HCBS-DD waiver may be reserved to meet statewide priorities which include those authorized through the exception to the waiting list protocol. Exception enrollments are categorized as either Emergency, Youth Transitions or Deinstitutionalizations.

1. Emergency enrollments can be requested when the health, safety, and welfare of an individual or others is in danger due to homelessness, an abusive or neglectful situation, danger to others, danger to self or loss or incapacitation of a primary caregiver.
   

2. Youth Transition enrollments include youth transitioning from the Children's Habilitation Residential Program Waiver (CHRP), the Children's Extensive Support Waiver (CES) or Foster Care into adult waivers.
   

3. Deinstitutionalization enrollments are for those Individuals residing in an institutional setting (Skilled Nursing Facilities (SNF), Mental Health Institutions, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) and Regional Centers) who are wanting to receive services in the community.”

Now that the decision has been made, getting his name to the top can’t come soon enough for me. I am tired. Travis’s case manager says that she is tired for me.

I am beyond grateful to have the support of all of my friends and family. It was so good to enjoy a cocktail and a meal with some of our family this weekend. And to learn more about the heritage of Tracy’s mom and dad. They are gone now, but are forever in our hearts.

We did lots and lots of laughing. Laughter is the best medicine. Wait a dog is the best medicine. But you can’t deny the healing power of laughter! It took my mind away from the worrying, even if just for a while.

“Laughter is the sound of the soul dancing”. - Jarod Kintz

“Laughter is like a windshield wiper, it doesn’t stop the rain but allows us to keep going”. - Author Unknown