The First Challenge: Health

When I sat down to write a plan of care for V's adult life, my first concern was maintaining her optimal health so that her quality of life would not be compromised.
One obstacle to this goal was V's tendency to obsess over food and her inability to understand the importance of healthful eating habits and healthy weight. V loves potatoes, rice, ice cream, and many other things that when eaten to excess, can cause problems in this area. At home, she will keep returning to the refrigerator or pantry again and again, as long as one of these highly preferred foods are visible, until she has eaten it all, and will become agitated if told that she can't have more. For me, it means that I rarely buy ice cream to have at home and if I buy sweets or chips, they have to be hidden. Hiding leftover mashed potatoes or rice is trickier.
Community outings present further food related challenges. There seems to be nowhere to go that doesn't offer food. The bowling alley always has a snack bar open. The zoo requires that everyone pass through the gift shop where chips, soda and ice cream are for sale. The state parks have vending machines in the boat house where sodas can be purchased when she goes for a pedal boat ride. The concessions at the movie theater are unavoidable at times. Even the gym has root beer and energy bars for sale at the check in desk. The only places I can think of where food is not an issue is the library and the outdoor playgrounds.
Once, we took V to the Petsmart to buy dog food, and she became convinced that a dog treat at the checkout counter was a candy bar. The only way to avoid a full blown tantrum was to let her see for herself by taking a bite, after failing to convince her it was not a candy bar, but a dog treat. The look on her face as she handed it back was proof that she finally figured out that I was telling her the truth.
One way to address the issue of healthy weight was to build in opportunities for exercise in her plan of care. Physical activities are limited for V by her hip dysplasia which causes a severely pidgeon toed gait and by her impaired motor skills.
Adapted Aquatics Instruction
I remembered how much she had enjoyed playing in the pool as she was growing up and how she enjoyed her weekly adapted aquatics lessons at Longview School, and so Adapted Aquatics lessons became part of her plan of care. Who would provide the instruction and what it would cost were two questions that I had no answer for at first. I had hoped that the instructor at Longview School or Stephen Knolls School would be willing to work with V after school or on the weekend, but their schedules were too busy. I found adapted aquatics instruction in Texas online and used the hourly rate that was posted there to create a budget and hoped that it would be acceptable to whoever I eventually found to provide the instruction here. In the end, it took a year of searching the internet, sending emails, and making phone calls before I finally found someone qualified and interested in the position.
A facility where the instruction could take place was another requirement. I selected the healthtrax fitness center, which had a heated lap pool, and an even warmer therapy pool. The management agreed to allow 2 personal support staff to accompany V on her visits at no charge, as well as her adapted aquatics instructor. The advantage of this location is that there are other opportunities for exercise if V is not in the mood to get in the water on any given day. Recently, she has been learning to use the stationary bike.
... to be continued.