Building Rapport: The Case of the Reluctant Resident

“Hi, Mabel!  Do you have some time to talk to me?”  Mabel, I knew, had all the time in the world, since she refused to go to activities.  She sat across from the nursing station, her hefty frame filling her extra-large wheelchair, watching the nursing staff, the other residents, and the passersby.

“If you want to,” she replied without enthusiasm.  “What are we going to talk about?”  Her greeting hadn’t warmed during the six weeks I’d been seeing her.

“Well, let’s get started and see where we go,” I said, slowly wheeling her into her room.  “Your social worker says you’ve got a photo of yourself when you were young.  I’d love to see it.”

She started rummaging through the frayed and bulging pocketbook on her lap, pulling out paper after paper.

“What are those?”

“Menus.  They’re mementos.”

“Mementos?”

“I get three each day, and there are seven days a week, so that’s 24 a week.  I’m saving them to make a scrapbook.”

“I see.”  Her poor math skills took a back seat to the revelation that she was collecting the daily meal stubs distributed with each resident’s food tray.  “Is that a hobby of yours, collecting menus from when you traveled?”

“No.”  She pulled out her wallet and removed a tiny snapshot, bent in one corner, showing a shy, smiling young woman in an elegant dress, one hand resting on her slim waist, a flowered hat upon her head.

“Wow! Look at you!” We spent the rest of our time together reminiscing about the old days, and I left her smiling, back in her position across from the nursing station.
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“Hi Mabel! Want to talk?” I asked her the following week, hoping we could build on last week’s good will.

“What are we going to talk about?” Her question held more suspicion than curiosity.

“Oh, I don’t know.  We had a nice conversation the last time.”  I took her lack of refusal for acquiescence, and we sat in her room discussing her interests when she was young and active, trying to create a bridge to pursuits in which she could partake now.

“I’ve done it all,” she remarked proudly.  “There’s nothing left for me to do,” she added, explaining her current disinterest in social activities.

Stymied, I asked to see her photo again.  “I’ve already picked out the picture I’m going to post in my room when I’m a resident,” I told her while she searched her overstuffed bag.  “It’s me dressed as Wonder Woman for Halloween.”

Mabel looked at me and smiled, then continued hunting through her bag.  “Here it is.”  She handed me the tiny image.

“Maybe I can enlarge this and we could hang it on your bulletin board.  Would that be okay?”

She looked around her barren room.  “Okay.”
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Downstairs, I showed the enlarged photograph to Mabel’s social worker.  “I have a frame!” she told me.  “You could mat it.”

I returned to Mabel and showed her the large gold frame holding the image of her smiling, young self.   She stared at it in amazement, and then grabbed me by the hand.

“It’s beautiful!” She gazed at the photo and then looked back at me.  “Thank you so much!”
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I approached Mabel for our session the following week.  “What do you want to talk about?” she asked me sullenly.