Celebrate the little victories

As I mentioned earlier, after I dropped William off at his assessment, I met another client at Jobs and Family Services to help him apply for Medicare. He was thousands of dollars in debt from medical bills. He had Part A Medicare, which covers medical care, but not Part B, which covers doctors. For a while, he was in and out of the hospital every couple weeks for depression. His stay was covered by Part A Medicare, but every time a doctor came to see him, he was slammed with another bill.

At the service center, we were able to get him Part B. He also qualified for the Qualified Medicare Beneficiaries (QMB) program, which is for people who receive Part A Medicare and whose income is 100% below the poverty line. The state will pay the premiums for services covered by Medicare. He also qualified for food stamps.

I’m so happy. The little victories really do help.

High as a kite

A couple weeks later, I went to visit William at the housing complex. (He hadn’t moved out after all.) He seemed like a different person. He was calm and answered my questions. He even agreed to let me take him to our office to get an assessment after I promised him a bus ticket home. I was pleasantly surprised by his demeanor. I checked him in at Recovery Resources then was off to Jobs and Family Services to help another client apply for Medicare.

Later that afternoon, when I returned to the office, my supervisor told me she received a call from the assessment department about William. They were unable to complete the assessment because he was “high as a kite.” I was in shock.

As I said before, you never know what the day will bring.

"I'd rather sleep on the street."

I haven’t met all of my clients. I know most of them, but there are some that I have yet to talk to for various reasons.

A couple months ago, I got a call from a housing manager saying that one of her clients, William,* needed case worker services. He hadn’t been acting himself lately and missed a month of rent. William was one of these clients I had never met. I inherited him from the case worker before me.

Arriving at the housing unit, I met the manager who filled me in on her history with William. He had always been a good tenant and paid rent on time until recently. When I finally got the chance to talk to William, he was irritable. He was mad at himself for spending all of his money on cocaine and alcohol, then got mad at me when I suggested a solution. The housing manager and I agreed a payee—a third-party handler of his money—arrangement would be best. William’s Social Security check would be sent to the payee, usually a bank, who would write a check for William’s rent before depositing the remaining money in his account. However, William was adamantly opposed to this idea and insisted on having full control of his money. I tried to persuade him, but was unsuccessful.

He then decided that he didn’t even want to live there anymore. “I just want to leave,” he said. The housing manager and I tried to tell him that even if he left now, he’d still be responsible for the missed rent, as well as incur a fine for breaking the lease without proper warning.  He didn’t seem to comprehend the situation and instead began insisting that he would rather sleep on the street than live in this complex. It was obvious that something was up. Was he under the influence now, as we were talking to him?

Nobody in his right mind chooses homelessness, I thought.

Constant evaluation

When I was with Paul, and when I’m with any of my clients, I’m constantly evaluating their responses and behaviors. If they’re acting a little off, I want to figure out why. Is there a relationships issue with a family, friend or significant other? Have they been sleeping well? Did they not take their medication? Did they start using alcohol or drugs again? Round and round in my head their answers go, as I try to make sense of all of it.

Their answers, and the solutions, are as varied as the clients.

"You're not listening!"

One day, my two morning appointments canceled and then Paul,* one of my afternoon appointments, called.

“I don’t have any food, and I don’t have any money to come to the appointment,” he said, so I decided to pay him a home visit. I wanted to take him food, too, so I tried to research food pantries near his house. I finally found one he was eligible for. The people at the pantry were nice enough to let me get food for Paul after I gave them all his information to ensure he wouldn’t double dip later in the month.

Paul’s apartment building was difficult to find but I finally located it. “Sorry it’s disordered,” Paul says as he opens the door to his apartment. “It’s how I’m feeling right now.”

After he thanked me for the food and put it away, we went outside. The fire escape was the only place to sit. He sat down and I sat on the ground. Paul pulled out a long white cigarette, lit it and began talking.

After filling me in about his week, Paul drifted to another world and his disease started talking. “I can see the stage, I can see the performers on the stage, but I can also see what’s behind the curtain…Do you know what I discovered? Humans have the ability to have their eyes open to many different worlds at once.”

I ask him about his next Dr.’s appointment and ask him when he last used drugs. He gets very frustrated. “You’re not listening to me!” he says, then begins to talking to himself.I am listening to him, though. I hear him say that he wants to get his life back together and go back to school. I’m trying to help him achieve his goals. He seems worse than last week, and I’m trying to figure out if it’s because he’s using substances again. I want to help. That’s why I became a case worker.

Everything will be ok

Another one of my clients had her kids taken from her by the court. Since then, she’s been compliant with medications and meetings, so I wrote a letter to the judge telling him what I knew and faxed it to her lawyer. The lawyer gave me all the information about her next court date. She is worried that she won’t get her kids back, but I tell her everything will be okay. She’s not being charged with abuse or neglect, just issues of dependence. It’s through no fault of hers that her kids were taken away. It’s because of her mental illness.

You can't fix the world

One of my clients tried to commit suicide. He’s a family man and is upset he can’t support his family. He’s been out of work for four years. He was down on himself because he couldn’t buy anything for his son’s birthday. Luckily we were able to stop him in time.

As a case worker, you learn you can only help your clients so much. You can’t fix the world, but you can help some people in a small way.