Monday, 22 March 2010

Sleep Disorder

I am in the office alone updating all of my Support Plans. I’m making sure I’ve signed each page of each Support Plan in the correct place; after all efficient bureaucracy is obviously the key to ensuring progress in our resident’s lives.

All of a sudden, a slightly obese, uncouth twenty one year old female member of the underclass storms in to the office. It’s Kirsty, Kenny’s current girlfriend. She immediately starts shouting.

“This place is a f**king joke,” she growls.

I agree with her but for very different reasons.

“First of all, calm down Kirsty. Please don’t walk in to the office on the offensive. For a start, you should knock and wait to be invited. If I wanted to talk to you I would knock on your door and wait until you opened it.”

However, I never want to talk to Kirsty. Sometimes I have to but I can’t get away from that. She ignores my comments and continues her rant.

“Where is Brendan? I want to talk to him?” she asks.

“He is keyworking some one.”

“Well, I put in a request for a wake up call with the night worker and they wrote it in the book and then I only got called once and so I slept in. I had an important appointment and it’s this place's fault I missed it. I specifically asked to be called three times within half an hour,” she remarked.

“Well Kirsty, for a start we are not a hotel we shouldn’t be doing wake up calls and if you had asked me I would have told you to use the alarm on your mobile phone to get yourself up. We are supposed to be helping you to become independent. We are not servants. You should not have been told you could have one wake up call never mind three. However, you did have one and should have got up then. We have other things to do. If it had been me working you wouldn’t have even got one.”

“Look, I’ve got a disorder where I can’t get up easily in the morning. I’ve told the Doctor about it and all so you can ask him about it. I have to be woken several times or I just fall back to sleep.”

I didn’t know being lazy and stupid was a medical disorder but there you go, you learn something new every day in this place. I wonder is her inability to get and keep a job or stay on a course a disorder as well. The fact she is two stone overweight is also probably a disorder called Repetitive Shoving of Pies Down One’s Gullet Syndrome.

I somehow doubt that Kirsty’s Doctor would validate her insistence that her laziness is an illness. You never know though after all many in the medical fraternity believe addiction is an illness as opposed to the results of people’s choices.

“I think you may find that a large proportion of the country suffer the very same difficulty with getting up in the morning, but they have to make sure they get up as they don’t have keyworkers,” I comment.

“You lot are supposed to help us and you hassle us when we are not doing anything. I had to go and see about a job this morning and thanks to this place I’ve lost that chance,” she barks.

“Well you are going to have to learn to get yourself up. If you cant get up for an interview how the hell are you going to get up for work?” I ask.

Kirsty shrieks in frustration at such straight talking, partially because she isn’t exposed to too much of it around here.

“I’m putting in a complaint form about this, it’s not on,” she says as she wobbles in her tracksuit out of the office.

You do just that Kirsty. It’s your right after all and as our Complaints Charter states:

We treat all complaints about the qulaity of our services and the conduct of our staff with serious concern…We endeavour that all our service users are comfortable and confident in making complaints about our services. To do this we will provide as many different options to make complaints as possible, including text, telephone, in writing, email and in person.

Now, with policies like this is it any wonder we have people making complaints about not getting the sufficient number of wake up calls. What is worse is that Kirsty’s complaint will be dignified with a written response from management. Personally, I wouldn’t waste the paper. Then both her complaint and the manager's response will be placed in a file which will be scrutinised, as part of an audit, by bureaucrats from the Department of Communities and Local Government.


Anonymous said...

I watched Survivors on tv the other day - and I can't help thinking that the world would be a much better place if 90% of all people suddenly died. In the remaining 10%, there would be no time to mollycoddle lazy and stupid people or people who didn't do their fair share of the work. People like Kirsty would starve within a week.

Oswald Bastable said...

Eugenics?- Is it really such a bad thing...

Boy on a bike said...

It would take the silly fat cow more than a week to starve. It's more likely that she would die of thirst, being too lazy to fetch water for drinking.

Anonymous said...

Feel for you Winston. Hang on in there, if only to keep your readership informed.

The country is broke. Those of us that work & save are paying for this nonsense. It has got to stop - and it will stop soon anyway, perhaps not in a manner or at a time of our choosing, because the IMF will impose action.

Policies need to be adopted that reflect the views of we mugs who pay for this lunacy - and also real experience from the front liners like Winston. The same is true for the NHS, policing and so on, as we know from the blogosphere - not the MSM.

We could have better services at lower cost, but where is there a political party with the integrity to tell it like it is? Where are the public sector workers with the integrity to implement it? With a few notable exceptions (Winston, Gadget, Grumble et al), they seem to be part of the problem.


Anonymous said...

Hi Winston,

Hope this post finds you not too stressed.

I know last time you said this was a blog for you to vent (often, it appears, justified) feelings of frustration - but I again wonder if you're not undermining your case a bit by quotes like:

"You never know though after all many in the medical fraternity believe addiction is an illness as opposed to the results of people’s choices."

As far as I am aware this is highly contested - as with many things there is evidence for behaviour and environment being factors on the one hand; and genetic factors of predisposition on the other.

For example: current research indicates that that alcoholism has significant factors that are inherited -

Example source: Dick DM and Bierut LJ, The Genetics of Alcohol Dependency, Current Psychiatric Reports 8 (2006) 151-7.

Of course factors relating to choice and behaviour are relevant; but I'd take issue with the statement that you've made here - particularly given your position.

In relation to the rest of the post; yes it does appear that 'I told my Doctor about it' as opposed to 'my Doctor diagnosed me with...' is more than a little suspect.

Also I worked in a hotel for five years (four star) and I'm pretty sure that three calls in half an hour to one guest would have raised a few eyebrows - especially during that busy time of the morning

Take care,


Anonymous said...

...and an interesting development from the Association of Teachers and Lecturers

Anonymous said...

I am a foster carer and find your blog seriously depressing as you are describing the future of the child I care for. He wasn't taken into care until he was nearly 7 inspite of horrendous abuse and by that time he was so damaged he may never be able to function independantly. He has been told by social workers that he has 'rights'. I tell him its my house and my far he accepts that but won't as he gets older, social workers will back him against reality and he will risk ending up in prison.
its no way to 'rescue' children!!

Anonymous said...

Anonymous 06:46 . . .

My wife and I have discussed fostering because we thought we might be able to help some kids now that ours are long grown up & gone. We never pursued it because, being white, middle class protestant atheists able to read, write & do arithmetic, we thought we'd be unsuitable.

Do you write a blog? Are there any decent blogs out there, written by foster carers, as a window onto the reality?


Anonymous said...

I feel for you Winston.

Some years ago, one of my tutees at University had a smiliar sleep disorder. The individual couldn't get up in the morning due to having a dysfunctional body clock and regularly missed tutorials/classes/exams/appointments/practicals despite repeated assurance and promises to the contrary. All of this was medicalised and had to be taken seriously because the student had a medical note.

It was funny though, how this sleep problem would manifest. If, for example, the student had to be up early to organise or rehearse for the University amateur dramatics group, there seemed to be no problem. In fact quite the opposite. The University Student Rag heaped praise on the student for their organisational skill and dedication. It was a shame this didn't transfer over into the rigours of study and some academic graft.

Lazy, idle b*******

Exile said...

Congratulation on getting on the long list for the Orwell Prize this year. It's how I found your blog...

OK, I blog a fair bit about the social work industry since you are the gift that just keeps on giving for the bored blogger. Whenever I am stuck I just investigate your industry's latest bit of stupidity and bingo - off I go with a posting that almost writes itself.

Before you criticise your trade too much had you ever considered that in spite of all claims to the contrary, most social workers are actually thickoes with poly degrees? And if your industry was ever closed down you would be flipping burgers in the private sector?

Jim said...

Anon said: "I know last time you said this was a blog for you to vent (often, it appears, justified) feelings of frustration - but I again wonder if you're not undermining your case a bit by quotes like:

"You never know though after all many in the medical fraternity believe addiction is an illness as opposed to the results of people’s choices."

As far as I am aware this is highly contested"

Chairman Mao 'cured' millions of opium addicts by threatening to shoot them if they didn't quit. It's unlikely this method would have worked with tuberculosis, and this fact says something about the medical nature, or otherwise, of addiction.
Not suggesting we should shoot addicts of course (though maybe a few big time dealers wouldn't be missed).

Another interesting post Winston - if only more people could see through their eyes instead of the filters of their beliefs.

shijuro said...

According to the Radio-bore programme 'Moral Maze' this wed evening- addicts cant say no... New research states that they just cant as a brain fault prevents this.

It reminds me of those awful pictures of people I saw in the Auschwitz museum - none of them appeared to have the fat gene... or maybe they did and thats how they survived?

back to your blog... Winston -keep smiling! (and taking the tablets...)


WinstonSmith33 said...

Hi Shijuro and Jim. As someone who has experienced drug dependecny many years ago I completely disagree with the notion that addiction is either:

1) an illness

or 2) that there is no choice involved.

Yes, when in the grips of addiction it is very powerful and one's choice is distorted but at some point I had to make a choice to stop and I did. I know many like me.

With relevance to it being a 'disease' I just completely disagree and the Mao solution highlights how the disease seems to cure itself once the incentives to clean up are strong enough.

Whilst I acknowledge that addiction is a complex issue and affects and damages the individual involved on many levels, as well as society, it is nevertheless a consequence of repeated pleasure seeking behaviour. Those with psychological deficiencies due to early childhood are definitely more predispossed towards unhealty relationships with drugs/alcohol as a means of escape but this doesn't remove the fact that the individual chooses their behaviour.

Anonymous said...

'Chairman Mao 'cured' millions of opium addicts by threatening to shoot them if they didn't quit.'

That's not really an argument against what I've said above. Stalin made lots of people with non-lethal illnesses in Gulags work through them until they died or got better.

This doesn't mean they weren't ill, or didn't suffer through it; or indeed that they weren't genetically more vulnerable to certain ailments than others.

I addition, this claim that Mao got rid of addicts solely at gunpoint is just false (and originates with Theodore Dalrymple as far as I can tell). For two more reliable and truthful accounts see last 4 paras here;

and this volume

This is of course getting off the point because drug taking is complex issue where often different factors are affecting usage.

For example; large numbers of Heroin addicts have been observed to have had preexisting anxiety disorders which are factors in their decision or predisposition to use.

Taking this into account is what is known as the ecology of drug use; looking at the environmental, biographical and behavioural factors which may influence usage.

Personal choice is of course a major factor but the way in which people develop patterns of understanding and behaviour - which form the bases on which they make such choices - are influenced by genetics and environment.

In spite of what people like Theodore Dalrympe may 'believe' the evidence is not supportive of either a pure rational choice model or a disease model. It continually points to a complex set of interactions which crucially change over time as the addiction develops.

Best book on this I've read is Darin Weinberg's 'Of others inside - addiction, mental illness and belonging in America'.

Bodies and the worlds they move in are complex systems which unfortunately for us, don't neatly subscribe to the populist dogmas of Left of Right political persuasions.

Boyo said...

Why either\or? Type 2 Diabetes is clearly a disease, and your risk of developing it is dependent both on your genes and your choices about diet.

rielouise said...

It sounds as though Kirsty has factitious disorder.

Anonymous said...

i think the problem lies with the management, I have had similar complaints made in a home I worked in, the response in writing, would have been very similar to your verbal response, its your own responsibility to get up in the morning, would be a condensed version, which is fine, Managements fear of prosecution leads to the rights and needs of the young people being exaggerated or ignored, The staff team should be fully supported by their manager and properly trained regarding the legal aspects of their job, A duty of care covers staff and young people, in another post you mention a horrific car journey In the same situation firstly the young person should not have come out for a ride to collect someone who had absconded and such behaviour in a car should result in the car stopping due to the danger presented, the two day car ban was laughable, good luck with your work the care system needs people who think and care too, it burned me out.

Anonymous said...

I was interested in reading this blog for a few minutes, despite the ridiculous use of the term underclass. Then I read this and thought, I have no need to read this person's thoughts anymore.

What on earth has her weight got to do with anything? If she were skinny, would you still think she was lazy and stupid? Maybe you should read up about the Healthy at Every Size movement if you really want to help empower young people.

Whatever your objections to the complaints policy or the way young people might choose to abuse it, you completely undermine yourself by making such absurd judgments about the appearance of the young people you work with.

Anne said...

I am a journalist (for the Guardian, among others) and have just searched out this article after reading it on the Guardian website. I don't think I have ever been so angry in all my life.

No, being lazy and stupid is not in itself a disease, but people with sleep disorders are no more lazy and stupid than people in wheelchairs. You DO realise sleep disorders like narcolepsy are a) neurological disorders, not mental health conditions, and people can't just decide not to have them, and b) disabilities?

How dare you. How absolutely dare you. There is a serious crisis in this country for people with sleep disorders, which are neurological and/or respiratory diseases. There is no structured training for sleep physicians and there are serious barriers to GPs referring patients because - in spite of very clear guidelines - they do not perform the correct history-taking procedures. Most people with these conditions take between five and fifteen years to obtain a diagnosis, even though with the right questions they could be referred to the right specialist in no time. I spent seven years fighting to get a diagnosis and treatment. I have slept through fire evacuations before now and cannot cook while alone in case I burn the house down.

One of the key symptoms of these disorders is something called laborious wakening - people do not hear alarm clocks, it's like our senses shut off. This is combined with something called sleep drunkenness, which is like literally becoming drunk on sleep.

And riddle me this. If you had a sleep disorder, which made you permanently tired and groggy (I spend my entire life feeling like you would feel while jetlagged) would it be such a surprise if you put on some extra weight?

How dare you describe a legitimate, recognised condition as laziness and stupidity. You wouldn't do it to cancer patients, I'm sure. Or paraplegics. These conditions are not whimsy - there are very set diagnostic criteria and very thorough physical tests.

So let's start with this statement:

"I somehow doubt that Kirsty’s Doctor would validate her insistence that her laziness is an illness."

Really? You think so? I think you'd find that if she had suffered EDS for more than three months and scored highly on an Epworth questionnaire, then yes, a doctor would validate it. She could be narcoleptic, among many other possibilities.

Then there's this bit:

"I think you may find that a large proportion of the country suffer the very same difficulty with getting up in the morning, but they have to make sure they get up as they don’t have keyworkers,” I comment."

No. It's not "the very same difficulty". Because there's a difference between people who have a bit of trouble getting up in the morning, and people whose brains are literally wired the wrong way.

You have done a disservice to everyone with a sleep disorder. And if you're still not convinced I would be delighted to point you in the direction of some of the UK's leading sleep-specialist neurologists.

You have a duty of care towards people like the ones you mock. I don't know why you have been shortlisted for any kind of award. And I am about to email the Orwell Prize people and tell them as much.

WinstonSmith33 said...

@Anne above,

I am aware that real sleep disorders exist one of my friends suffers from one.

However, I have worked closely with the young woman I refer to in my blog post and I know for a fact that she doesnt suffer from any kind of medical sleep disorder.

You seem to think that she does but you have no evidence what so ever for this? Did you work with her? You are jumping to a conclusion based on your own prejudices.

I am basing my opinion on fact and direct working experience so I think in relation to this young woman you dont have a clue what you are talking about. So before you take the moral highground you should make sure you know what you are talking about.

If she had a sleep disoreder we would have known about it when we interviewed her to come live at our project or it would have become known to us in support meetings months before she claimed she had it. She managed to get up for a job she had with no assistance for several weeks and lost the job not due to a sleep disorder, she got up on her own with no problems but quit because she didnt like having to work with old people.

Anne said...

The issue is not whether this person does or does not have a sleep disorder - it's the general attitude towards someone claiming they have one. I'm not sure why I'm bothering to argue with someone who clearly has no respect for the people to whom they have a duty of care.

I don't know what sleep disorder your friend suffers from, but I can tell you it's not actually out of the realm of possibility that the girl you are bitching about does have one, or some other medical problem. For the record, it's disingenuous to assume that being able to get up in exceptional circumstances, or unexceptional ones for that matter, means someone doesn't have a problem with it. I have always suffered terribly with my own condition, but I also managed to get up for work 95% of the time before I was diagnosed.

I don't think she does have one. I just don't think you should be so quick to declare she doesn't and write it off as laziness. Moral high ground? I'm not the one writing a blog bitching about vulnerable young people who have probably been failed by everyone else in their lives before they had the misfortune to cross paths with you.

You will know she does not have a medical issue if her doctor confirms this. Otherwise, your opinion is just that.

Anonymous said...

I cannot believe you are all debating whether this girl has a sleeping disorder - you have obviously never worked in childrens homes!! If she did have a disorder it would be clearly documented on her file, all staff would be fully aware and they would do everything they could to meet her needs!!! And i Mean eveything!! If only to show Ofsted they are 'outstanding!' This excuse by this girl was just that - an excuse!! Children in homes are untouchable - they don't have to take responsibility for their actions - they look for and blame disorders of some sort for everything they do or don't do! This debate you're having just enables them to do that!! Its about time we stopped giving labels to these children and instead taught them some sense of responsibility!! Labels such as'conduct defiance disorder' just excuses learnt negative behaviours. They don't help the children at all but excuse carers for not making a difference.

I have worked in a number of childrens homes throughout the country and only the accent of the abuse is different. Its not the staffs enthusiasm but the rules and regulations that prevent effective care - and lots of staff do indeed care - a lot! Yet care leavers have limited life chances - thats a fact and until we do something to change the system, that will NOT change!!! I left residential social care years ago because I was frustrated and angry about the lack of genuine care for these children. All senior managers are bothered about is ofsted grading and acheiving charter marks! Well I will be honest - a childrens home near us got outstanding by Ofsted and I would not even leave my ferrets there never mind my children!! It is disgraceful!! Paperwork might be good but childcare is terrible!!

Now I social work to prevent children coming into care at all costs as I know it is not a good place to be and will not help with childrens behaviour! Its not a better place for the majority of teenagers. Although financially they would be far better off! They often know that and ask to go into care to get substantial pocket money - despite being abusive, violent and causing significant damange, more clothing money than I can afford (as a registered professional with a degree) AS WELL as money fomr their parents and families and clothes from them too. Parents love it as they have them overnight when they choose and pay NOTHING for the care of their children - in fact parents borrow money from their childrens pocket money!! One fmaily I worked with loved their duaghter being in care as the father (who was very wealthy) no longer had to pay £150 a week maintenance to his wife) In fact he no longer had to pay anything at all!!! (And t was child protection - it was S20 - voluntary accomodation at the parents request!)

Winston - I think you are a very brave genuis!! I have taken your article into work and staff think it is amazing - you have summed up what we all think. I would rather my son was brought up by a pack of wolves than go into a childrens home(if god forbid he didn't have any family!!) He would learn a lot more and be a much nicer person than if he went into a childrens home!! Something has got to change and SOON!!!

Anonymous said...

Anne, read this blog more carefully.
Then read some newspapers.
Then look at Jeremy Kyle.
Then go for a Walk in Brixton wearing a gold Rolex.
Then realise you and your attitude are part of the problem, not part of the solution.

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