Last week saw my yearly visit from a social worker to assess my current level of funding. It was a non-start carnival of fun! Because if there is one thing guaranteed to highlight how dependent one is on other people, it is arguing for continued maintenance of the current level of funding. One emphasizes the physical limitations one has, what one cannot do for oneself and the risk of serious harm if one were to do so. It’s like the opposite of the song ‘You’ve got to eliminate the negative / and accentuate the positive.”
Initially the social worker had phoned me some weeks earlier requesting an interview the very next day. I managed to postpone him, managing in the meantime to gather supporting statements arguing for my continued level of funding from various professionals. Only a cynic of the very highest order would suggest that by requesting a short notice interview it would prevent the gathering of such information and strengthen the hand of social services to cut funding. However, I’m not a cynic. If I was I might also believe that his assertion that social services had no record of my timetable of hours was nothing more than a trap, given that the council had to sign off on the transfer of funding to me in the first place
The social worker that came to see me was, it must be said, charming and courteous, even if he did throw his coat on the floor and had a rather ill advised hairstyle for a man who’d reached his 40th birthday some years ago. He’d slicked it back into a ponytail that revealed a pronounced widows peak at the front with less of a ponytail than a rats tail at the back. If anything, he was the warm reassuring presence that is designed to lull one into a false sense of security, rather like the nice man whose dog has just had puppies and his flat is only a short walk away. Would the child like to see them?
He was all affable concern and keen to know exactly how me being able to direct the spending of my budget had benefited me. Free from council control I’ve been able to switch care provider, from a local council appointed one (and the fact that the agency my council had chosen charged the council the lowest rate per hour was just a happy accident.). I was also able to engage the services of a wide range of professionals whose efficacy – or not – has been due more to my lack of motivation than their sterling efforts. He was at great pains to identify exactly how many hours I needed and managed to suggest that this was all for my own good, in case of a catastrophic failure in care provision necessitated that the local council provide my domestic care. Dealing with domestic matters was not as difficult as dealing with rehabilitative matters, as a council has a legal duty of care to ensure provision of domestic care, but rehabilitative care…not so much. So it was in my interest to present them both as inextricably linked. So I most certainly did not when he asked about speech and language therapy articulate properly, which required him blankly to look at my friend and she translated it for him. I then explained that he’d provided a good example of why speech and language therapy was needed. If he, in a quiet room couldn’t understand me, then what chance would I have competing with a listener battling background noise?
Thankfully I’ve made no secret of my battle with depression from the outset. As I’ve noted here before, the depression is as a result of my injury or more likely a combination of my injury and my inability to accept what has happened to me. Be that as it may, my psychologist wrote the following in support of my continued funding. She wrote;
One of the key aims of our sessions has been to reverse the downward spiral in which low mood leads to loss of motivation and confidence which results in disengagement from social activities which leads to poorer quality of life and thus to deterioration in mood which feeds into hopelessness, self-neglect, poorer health generally and increased dependence on others.
We have now reached a stage of less frequent sessions in order to allow X time to start putting some of the identified changes into practice. These sessions will end soon and it is his support worker who will be crucial in enabling him to continue to make progress and thus improve his mental and physical wellbeing, and hopefully avoid the need for re-referral to mental health services. This is because the activities that provide social contact and intellectual stimulation and thus help maintain mood and motivation would be extremely difficult for X to access without support due to balance problems (and therefore risk of falling) and speech impairment (and therefore difficulty communicating his needs). Without a support worker there is the risk that X would be largely confined to the house, and the downward spiral described above would continue.
This was echoed by my consultant who first treated me at the rehabilitation unit and has now transferred to a hospital near me where I am under his care. He wrote;
I don’t anticipate that there will be any dramatic improvements in his level of independence, but I am convinced that his current level of therapy involvement is maintaining him safely in the community. If this were to be any way reduced, I fear that he would become much more dependant, and the long term consequences both for X and for his funding agencies would be very severe.
Together with their supporting statements there were also supporting statements from a plethora of professionals and care workers. These not only had the benefit of being something he could take away and read at his leisure, they also helped enforce the notion in his mind that I was a highly organised person. This is important when one considers the motivation of social services. Namely a) are they going to cut funding to someone who appears highly organised and they think might make life highly difficult for them or are they b) going to choose someone else to cut? In this effort I was aided to a great extent by my housemate Old Blue Eyes, who not only made it clear that she was aware of all aspects of my care but more importantly let slip that she was a freelance journalist – which if he Googled her would bring up links to all her articles and programmes (although as she will read this I must be fair and point out she didn’t actually say that), but if he’s got more brains than hair, that’s what he’d do – and that I’d previously written a blog for a national newspaper.
Of course I resisted the rather obvious temptation of asking him exactly how many funding reviews the council had carried out and how many of these had resulted in a recommendation that the funding be increased. Because a funding review suggests an increase is as likely as a decrease. If not it is a cost cutting exercise dressed up as a funding review. It takes the fun out of a funding review!