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Maryland offers "The New Directions Waiver" as a means of self-directing state and federal Medicaid dollars for individuals who qualify for supports due to their disability.

This offers the disabled individual the opportunity to use those dollars to best meet their own unique needs. However, it comes with the responsibility to create a plan, a budget, and find your own resources to make the plan a reality.

No centralized source of resources exists. The purpose of this blog is to direct others to resources in our communities and to provide one example of a self-directed plan. (*Caution: The self-directed plan described at the beginning of this blog is for an individual with a 5/5 needs rating, the highest possible rating in Maryland, and therefore the highest budget possible. Most will have a lower rating and a lower budget to work with.) It is also to share firsthand knowledge of experiences that may assist others who self-direct services.

Comments are welcome. Please share your knowledge with others.

Saturday, August 4, 2012

After Five Weeks of NAC

First, I want to say that I discussed the use of the NAC with V's primary care physician at the beginning of our use and he was fine with it. I also reported our use of the NAC to V's psychiatrist, who prescribes medications. I think that it is important when adding anything new to make sure that it is discussed with medical professionals to make sure that there will not be any interactions with medications.

We started using one 900mg PharmaNAC tablet each morning on June 26 and it is now Aug 5. Around the same time that we started the NAC, we also eliminated some activities that were not so popular with V and so they contributed to irritable behavior. It is reasonable to conclude that those changes would reduce irritable behavior by lowering  V's stress level as much as the NAC might.

What I have observed is that V is not waking up in an irritable and agitated state as she did often before.

She is working cooperatively and enthusiastically with her tutor, her speech therapist and her occupational therapist, regardless of the time of the day. She has never worked well with a tutor before, but she has had a new one for the past 3 weeks, and it has gone very well since the first session. She worked well with the tutor, flying through all of her activities, in spite of no rest after all day out in the heat, and in spite of having her grandfather in her room painting her walls while she worked, furniture all pushed into the center of the room.

She has had two of the best therapeutic horseback riding sessions that she has had in years during the past month. The trainer reported that she stayed on the horse most of the time allowed, asked to dismount appropriately and gave the horse kisses and pats.

This week, she remained relatively calm and flexible during a disruption to her routine while we repainted her playroom/bedroom area.

There are still periods of agitation, and I did not expect them to be totally eliminated. I hoped to reduce the frequency and severity of irritable behaviors based on the the study of NAC use in individuals with an autism spectrum disorder.

I am pleased enough with the lower level of irritability that I ordered more PharmaNAC online yesterday and plan to continue to give it, and perhaps try adding a second daily dose to see if we get further improvement. 

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