De-Institutionalised Skills

Not long ago I broke a bone in my hand. By not long gap, I mean to say that it was about four months ago. Still fairly recently, all things considered. It took about six weeks before I could tentitively use it again, and twelve weeks before the occupational therapist allowed me to go back to ‘full use, so long as I was gentle about it.

The injury itself was a fracture of the lowest bone in my pinky finger of my right hand. For all intents and purposes, I am right hand dominant. Not using my hand fully for twelve weeks dropped the strength of my right hand squeeze to two thirds of my left (that is, my left hand was now one and a half times stronger).

Four months later I still find that my right hand reacts poorly to impact and when people give me a hard squeeze in their hand shake I am fully conscious of the possible damage to my bone. Sometimes I even imagine that I hear or feel the bones crunching. I frequently notice that I am using my right hand to hold things while my left does the ‘real work that my right hand use to do, or that I am carrying things preferentially with my left hand.

My occupational therapist told me that the best way to regain full use of my right hand was to use it. Just keep using it. Easy words, hard to do when I have unconsciously promoted the use of my left hand. Whenever I notice that I am using my left instead, I stop and use my right.

Why? If my let hand can do the jobs just as well as my right, why not let myself become left hand dominant? At least that would then match my left eye dominance. I may even become a good pool or snooker player.

The reason is that my right hand isn’t disabled, it is institutionalised. If my right hand no longer functioned, or could never function as it once did, then learning to compensate for the loss makes Spence. This changes me from disabled to differently-abled. According to my medical experts, my right hand isn’t disabled, it has just lost skills. My choice is between becoming differently-abled and reclaiming my skills by de-institutionalising. I choose to reclaim.

For many who loose skills via an institution, this too becomes a real issue. Perhaps many miss the point where they choose to become differently-abled instead of reclaiming their skills and ability. It is the moment where you they say something like “I can’t” when really, with a bit of time, trust and effort they could.

I am currently working in post hospital rehabilitation with a select transitional residential target group. One of the constant team decisions is “are we having a therapeutic effect on this person?” If the answer is ‘yes’, and we have time, then we keep the person to continue delivering the benefit of being in a our institution. If the answer is ‘nom then we move them as quickly as possible. This has nothing to do with the client being a success or failure, but in a n effort not to institionalise the client unnecessarily.

Just being in a supportive environment when you no longer need that support can unlearn your living skills. Examples of this is cooking for yourself, planning your day, making decisions, mediating yourself, cleaning your area, paying bills, seeking socialisation and choosing your life instead of drifting in someone else’s.

By supporting my injured hand, I initially gave it the supportive, nurturing environment where it could heal and have the greatest potential to come good. My hand no longer has any injury based reason not to grow back to it’s former functionality and strength. What threatens my hands recovery was not the injury, not the supportive cast, not the occupational therapist, not my desire to keep getting help from other, but my laziness in not using my right hand when given the opportunity, my laziness in not exercising my right hand, my laziness in not consciously using it as my first choice. By being lazy to my old injury, I risk institutionalising my own right hand.

The power to reclaim my old skill, strength and ability lies in my conscious decision to heal and grow.