Adapt or Manage Oneself

Adapting and managing oneself refers to the abilities to regulate emotions, control behavior, and maintain well-being in a work setting. This article contains key criteria that DDS will assess, tips on gathering information, and examples of functional descriptions.

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NOTE: Beginning January 17, 2017, this area of mental functioning  replaced Repeated Episodes of Decompensation as the fourth area of mental functioning. Repeated Episodes of Decompensation will continue to be addressed throughout all four revised areas of mental functioning.
This area of mental functioning refers to the abilities to regulate emotions, control behavior, and maintain well-being in a work setting.
 
Aspects of "Adapt or Manage Oneself" can include:
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Managing psychologically based symptoms
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Making plans for self independently of others
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Managing money
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Distinguishing between acceptable and unacceptable behavior or work performance
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Personal hygiene or proper dress/attire
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Reading, writing, spelling
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Setting realistic goals
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Awareness of normal hazards and taking appropriate precautions
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Bodily complaints that affect managing oneself: headaches, back pain, muscle cramps, nausea
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Bizarre or challenging behavior if  routine is changed; responding to demands or changes
How does DDS utilize this information?
DDS uses information related to the applicant’s ability to adapt and manage him/herself to determine a person's ability to respond appropriately to work pressures and his/her capacity for self-management at home, work, and in the community. As in the other areas of mental functioning, DDS is assessing the applicant’s ability to function independently, appropriately, effectively, and on a sustained basis.
 
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SOAR Tip:  The applicant must be able to function in these areas consistently over time.  One day they may be able to handle taking the bus without incident and get where they’re going, but the next day they can’t.  This, of course, might mean that they could get to work one day, but not another.
Gathering Information:
Remember that your observations are important!
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How does the applicant react when an appointment time is changed? Does the applicant act aggressively or do you observe challenging behavior?
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Do any of the applicant’s goals or plans appear to be unrealistic or grandiose?
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Do you observe that the applicant has difficulty in maintaining personal hygiene, or wears clothing that isn’t appropriate for the weather (e.g. wearing heavy coats in summer)?
Important questions to ask the applicant while you are interviewing them for the MSR include:
 
Managing daily activities
  • How do you spend your days? What time do you get up in the morning and go to sleep? How do you sleep?
  • How many meals do you usually have in a day? What times? What do you eat? If you don’t eat regularly, how come?
  • If you needed to shop for food to last a few days, would you need assistance or is that something you can tackle yourself? Do you usually have someone go with you to shop? Who? What assistance does he or she provide?
  • What do you know how to cook? When was the last time you were able to cook? What are your favorite foods to prepare?
  • About how often are you able to bathe or shower? Is this what’s been your usual routine? Do you need any assistance doing this? If the person doesn’t bathe regularly: What keeps you from bathing or showering? (You want to distinguish between access and ability)
  • When you have your own place to live, what kind of housekeeping things do you do on a regular basis? What kind of chores do you find difficult to do? If the person lives with someone else: How are the chores split up? Do you need reminders to do chores?
  • Are you able to do your own laundry? How often do you usually do it? If not: How come? Who does your laundry?
  • How do you usually get to places? Walk? Drive? Use public transportation? How does that work for you?
  • Budgeting is something we all struggle with. How are you at budgeting? Are you able to set up a budget and stick with it — or might that be something you could use assistance with? If this applies: When you have income, what usually happens to your money? Do you spend it right away or are you able to make it last?
 
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SOAR Tip: It is important to assess whether the applicant can manage their money independently. If an applicant struggles with this area, you can provide evidence that a representative payee would be useful once approved for benefits. Having a representative payee does not need to be permanent and can be an opportunity for the beneficiary to learn about budgeting and managing money.
Adapting to change/challenges
  • When a major change or event happens in your life, how do you respond?
  • When a supervisor changes your tasks or expectations, how do you handle it?
  • If this applies: How do you handle times when you have physical pain while at work?
  • If this applies: You mentioned times when you feel . Does that ever happen at work? How do you handle it?
  • Tell me about some short term goals you have for yourself, then some long term goals.
 
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SOAR Tip: Many of these questions are similar to the previous area of mental functioning, Activities of Daily Living (ADLs). When the new rules go into effect on January 17, 2017, much of this information will apply to being able to adapt and manage oneself. However, information about ADLs will continue to be evaluated throughout all areas of mental functioning.

Putting it into Practice: Translating Gathered Information into Functional Descriptions

Observations / Information from Records
Applicant Statements
Example Functional Description
John has worn the same clothes during your past three meetings with him
 
His hair is unkempt and he is malodorous
He reports that he showers “maybe once a week…the shelter, all those people…makes me panic.”
 
Reports that he doesn’t do his own laundry (“I get all confused”). He receives clothes from charities and throws out others when they are too worn.
John reports that he showers “maybe once a week” and this writer has observed him wearing the same clothes during multiple meetings over a two week period. During appointments, John’s hair is unkempt and he is malodorous. He avoids going to the shelter to shower, stating, “all those people…makes me panic.” He says that he gets “all confused” when trying to do laundry, so receives new clothes from charities and throws out clothes when they are too worn.
When I had to re-schedule an appointment with Susan, she became angry on the phone and began to yell, “It’s this stuff that ruins my life!” and hung up the phone.
Susan told me that when she worked at the grocery store she got into an argument with her supervisor because she was asked to stock shelves to cover for a co-worker. “He couldn’t just do that. He has no right to change things on me.” She reports that she was sent home from work and explains, “He said I was yelling, but he was the one in the wrong!”
Susan experiences significant difficulties adjusting to changes in her schedule or routine. When asked to temporarily change job duties at work from cashier to stocker, she was sent home after yelling at her boss. She explains, “He couldn’t just do that. He has no right to change things on me…He said I was yelling, but he was the one in the wrong!” When this writer needed to re-schedule an appointment with Susan over the phone, she became highly agitated and yelled, “It’s this stuff that ruins my life!” before hanging up.
Employer statement from Quick Mart reports that she quit after the manager did not promote Jessica to a supervisory position one week into the job.
 
Former manager at Temp Hires says that Jessica was “let go” because she was refusing to follow instructions and was “shouting directions” at other employees.
 
Has had 10 jobs in the past 4 years.
When asked about Quick Mart, Jessica states, “They just don’t recognize talent. I was running that place – he was just intimidated.”
 
Regarding Temp Hires, Jessica states, “I don’t know what their problem was – I was telling them all how to do things right...I’m going to be a CEO any day now and they’ll regret letting me go.”
Jessica has been unable to hold a job longer than two months in the past four years, and has held 10 different jobs in this time period. She expresses the belief that she will go from entry-level to CEO in a matter of months and quit a job at Quick Mart because the manager would not promote her to a supervisory position after her first week on the job. About this position, Jessica states, “They just don’t recognize talent. I was running that place – he was just intimidated.” Her former manager at Temp Hires reports that he fired Jessica after she refused to follow instructions and was “shouting directions” at other employees. Jessica states, “I don’t know what their problem was – I was telling them all how to do things right...I’m going to be a CEO any day now and they’ll regret letting me go.”
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SOAR Tips: Be careful to distinguish between ability and access. DDS is evaluating if an applicant is unable to manage themselves due to lack of ability, not because of lack of access to resources or facilities. For instance, a person may not be able to cook because they are unable to concentrate long enough to complete a recipe, not because they don’t have access to a stove.
                 
It’s important to remember that the side effects of medication can impact a person’s ability to function – in any of the areas of mental functioning!
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