Monday, November 30, 2009

'Something Happened' is Testing My Reading Patience

I've been reading Something Happened by Joseph Heller for the past week and I'm a bit torn. On the one hand it reads fairly smoothly. It follows Bob Slocum, an American middle aged man's stream of consciousness. Initially he's thinking about staff at work (who's afraid of who), the women (young women) he has affairs with, then he turns his focus on his family, his wife, daughter, and two sons (and who's afraid of who). It reads authentic to me. A string of uninhibited (as they tend to be) thoughts as he's going about his day.

I like that Bob contradicts himself at times, sometimes in the same passage (I do that too sometimes -- though it's also true that at times a characteristic that bothers me). Though I don't easily particularly identify with him, I understand some of the feelings he shares. Dealing with mundane, drudgery routine (what's so wrong with that?). 

A lot of thoughts have been going through his mind these past 430 pages though. So much that I hope I didn't miss anything happening. What's keeping me going is wanting to find out how it's resolved.

Sunday, November 29, 2009

Staff Curiousities

A program manager stopped in my office and held up a public aid application with the top part cut off and asked if I had the complete form. I gave her an extra copy. 

Two days later: I stop by her office and notice her incomplete copy still on her desk. Amused, I  wonder to myself if she's going to keep it as her example of what the incomplete form is when she asks someone else, "Say, do you have the complete application? I'm missing part of it." 

Friday, November 27, 2009

What Do You Do All Day?

Back when I was in college each quarter brought the much anticipated seasonal question: "What'd you do over [fall/winter/and on] break?"

I took on to making up answers to see what I could get away with. Similar to how I deal with weekend questions, I would try to think of a creative activity on the spot. These could include "learned how to camel race" or "interned at a seashell farm." No one needed to know how many hours I spent slouging about.

Similarly, when folks ask me "what do you all day?" once I've said I'm a case manager, sometimes if it's -- or if I gauge it to be -- the right kind of audience I don't go right into my old "no typical day really" but answer it differently. Last example:

"What all social workers do. I don a superhero outfit and fly around with my harp and my fishing rod, handing them out to the community."

 Still want to know what I do? Visit Homelessness Prevention and Emergency Assistance.

Tuesday, November 24, 2009

Past Three Years in a Few Numbers

40-50 folks on my active caseload (number has stayed pretty consistent)

2 clients have passed away

2 clients I've interacted with only while they've been under influence of alcohol*

3 clients have cried in my office

1 time I started crying right after one of these clients left my office

1 time I had to walk out of my office during an appointment with a client because I was about to lose my cool (to the point of shouting back; I asked another case manager to step in)

>25 times residents have left messages asking me to call them but left no number

40 pages: longest fax sent

8 days, (and going) longest period I've spoken with a provider only through our answering machines

3 nights (in the last week) that I had trouble falling asleep because I was thinking about work (typically about specific clients)

More times that I can remember: Clients making me think, making me laugh, challenging me, and making a connection.

* It's the level that I can smell it on their breathe but it's manageable (they stay composed).

Sunday, November 22, 2009

Book Review: If Today Be Sweet

Tehmina, a Parsi woman from India comes to Ohio following her husband's death and upon an invitation from her son to move in with his family. During her stay (not her first in the US) in a suburb of Cleveland, Tehmina is both happy to be with her family and pained at her separation from her home and late husband. Tehmina has a short time to decide whether she wants to stay with her son's family permanently or return to her apartment in India. 

I enjoyed Umrigar's window into Indian culture (here and in Bombay Times). Cross culturally I liked reading Tehmina's comparisons of what she was familiar with in Bombay compared to American customs. Umrigar did a particularly good job developing Tehmina and her son, Sorab's, characters. Both had a good deal of insight into their behavior. Umrigar let them have natural reactions to other characters or developments but gave them a good deal of empathy as well. Sorab's wife, Susan, was less well developed but overall a likeable character. I would've liked to have gone more in her mind, but I appreciate Umrigar's choice not to do this, giving Susan more of an outsider presence.
Spoilers ahead:

It seemed that, for Tehmina, whatever life threw at her during If Today she got through it. Not only that, from the halfway point I had to increasingly suspend belief by how everything worked out so well and smoothly. But the characters felt real. And frankly, it feels good to read a heartwarming (in an 'all's well that ends well') book like that every once in a while.

Saturday, November 21, 2009

I'll have my answering machine call your answering machine

My computer works again! In other news...

A few weeks ago a client became homeless.
A coworker recommended me a housing program and gave me Corrie, the intake worker's contact info (I already had an application but saw more info was requested). Last Friday I left her a few messages and finally Tuesday she called me back but I wasn't available so she left me a message. I decided to be more detailed in my message back and asked what info she needed to process my client and later found a message from her asking for my fax number. Got a list requesting over 15 items, from IDs to income info to mental health records to what my client had for breakfast. Some items that I wasn't sure what they referred to. So I left another message following up on them. So far we've been successful in moving the process along somewhat, although of course not as quickly as we could have if we would've caught each other on the phone. In fact, I don't remember the last time I've conversed this long with another provider solely through voice mail.

Wednesday, November 18, 2009

No Computer, No Computer, No Computer

I haven't had a working computer in two days. I just have this box in front of me, screen black, cut off from everything. Some problem with the hardware. Until that's fixed, I'm experiencing a world from the past. The other week my agency actually closed 10 minutes early because computers for all staff needed to be shut down for a network update. As if we can't find anything non-computery to do for 10 minutes.

But so many tasks can't be done. I haven't been able to record case notes and knowing I'm getting behind is honestly distressing me a little (the thought that not 10 years ago coworkers used to record their notes by hand impresses me deeply). I needed to write down my schedule because that too was saved on the computer. Couldn't listen to my CDs. Come on, it's not like I can use some alternate device that plugs into the wall and is capable of playing music.

One good thing is that my interaction with other staff has exponentially increased since I've been fairly frequently dropping by their offices to ask to use their computers. A few minutes here to write a letter on behalf of a client, and a few minutes there to make a quick search in the internet. With a little planning, no one else will be able to work!

Monday, November 16, 2009

Yes, could I reimburse my plane ticket through petty cash?

Message from a client on my answering machine:
"Anatolia! I won $10,000 in sweepstakes! But I have to go to Rome, Italy to get it. I need help to get there and I need someone to go with me. Call me as soon as you get this."

Sunday, November 15, 2009

Verse for a Manager

One visitor to my site, hailing from a country in Southeast Asia, found me by searching for "Verse for manager who's leaving." I wonder what kind of verse they were looking for.

The weight of wallowing projects on his brow,
Her steps are cautious and confident;
The path she leads us seems sometimes unclear,
But at destination I understand.

Two years into my job, I'm so grateful to work with my supervisor, Fiona. She's supportive, she's almost always available at a moment's notice for a word of advice, and I feel very comfortable with her. Sometimes we informally debrief after work hours are done, meaning I step into her office and we talk over how things were. It helps me think out the day out loud.

Though she's amazing in so many ways I sometimes give her a hard time. Mostly I swallow my comments and later share them with my parents or a friend. Working closely with someone for a few years we get to know each others' strengths and weaknesses very well. And weaknesses, well, like a married couple they seem blunt after a few years.

One thing that takes a good deal of patience to deal with is her difficulty in making certain decisions. Small example: Shopping for raffle presents. Fiona could stay at the store for two hours rethinking the pros and cons for each choice. Or sometimes she tells me to do something by saying, "You should do this. Or I could do it. Or [other case manager] could do it." Ba! Just tell me to do it. Though admittedly she's gotten much better about that. I don't want to go into too many examples for sake of anonymity -- but let's keep in mind the number of decisions a program manager needs to make on a daily basis. Times 30, it can get stressful. For her. And for me. That's why I'd like her to actually delegate to me and the other case managers more, but Fiona believes she's part of the team and has to be a part of all programs we do. Which, if the decision was made prior on how a program would go, it's great. If not, discussions abound.

One day I was griping to my parents about something that happened with Fiona and my dad interjected with, "Well, you'll do it differently when you're the supervisor."

"Uh-- Well--" I stumbled with my words. Of course everything's that's not working is painfully clear when you're not in charge. But -- and I have recognized this from the first few months -- Fiona does a lot of managerial duties very well that I don't think I can at this point. But sometimes you just need to vent. Though, ah, maybe less often than I've been doing.

Thursday, November 12, 2009

Beating the Clock

During the past week I've been focusing a lot of energy into a client who's going through a crisis situation. As I've been doing this some of my to-do-tasks get postponed, and slowly build up one on top of another. Though it's not like my entire day is devoted to my crisis client, each day I've been making half a dozen (sometimes lengthy) calls on behalf and to her as well as meeting with her nearly daily. And as I do this, life doesn't stand still for clients who understandably contact me with ongoing concerns or questions.

As I was sitting in my office yesterday, listening to my voicemail and thinking about a new intake I was about to meet with I started hearing the Sorcerer's Apprentice theme in the background. Or in my head. Later I amused myself with an idea of a case manager's video game. This would be in similar concept to restaurant games where you're Yoshi, the shushi cook, or Betty, the cafe cook and you need to cook orders for dine in and to go. Playing the cook, as you complete levels and move up orders come in faster and the dishes are more complicated. Imagine that in a case manager's setting... A case manager sits in her office. Phone rings, a person asks for a food bag. You click on your 'tasks' list for food bag to fill the request. Someone knocks on your door. Rental request. Click on 'rental assistance' to fill request. Coworker stops by and asks for mental health agency info. Click referral. Schedule pops up with "Lead budgeting workshop." Click workshop. 'Appointment' client and 'walk in' client arrive at the same time! Another rental assistance request! Client's hot water isn't working and management won't spray for bed bugs, need to call landlord! E-mail arrives, phone call to get medical records, homevisitmailpaymentmakereferralwalkinclientsitkeepsgoingonandonandon. Oh this would be a hit in no time.

Monday, November 9, 2009

Attending a Client's Funeral

From my seat in the back I had a good view of folks shuffling in and stopping at the casket. I had thought that I would maybe feel self conscious going to Ruth's funeral since I only knew one person there apart from her, but people weren't looking as far back as where I was sitting, but rather were focused on seeking Ruth's immediate family and folks they recognized. I saw people coming mostly as an outsider.

I had spoken with Ruth's brother when I came in and hugged him. It was the first time we met -- we had talked a couple of times before Ruth passed away when she had gone to the hospital.

While I sat in back of the room I thought, little do these folks know. Who I was for Ruth and who she was to me. She was the third client who was assigned to me. She had come through intake asking for rental assistance because she had lost her job due to a mysterious, almost constant pain. She soon found out she had terminal illness. We started working more and more intensively together, coming to the point where we talked nearly daily.

I didn't know Ruth when she was a child or in high school or when she partied or had children.
I only knew her during the time she was in great need. A woman I didn't get to say goodbye to, and deeply regretted it later. I want to describe who she was but don't want to capture her image solely as a person who was in pain. In some ways i don't think I could do her memory justice for knowing her for such a short time. I knew she played the guitar and once saw a photo of her looking very cool strumming on one with her eyes closed. I'm fairly certain pain changed the way she thought, the way she behaved. When I was at the service I felt a little exhausted, a little in shock, pained, and upset that all these people attending the service didn't help Ruth enough while she was alive the way they could have. Later I was able to think about the situation differently, but some things didn't change. I continued to carry her with me.

The funeral is our opportunity, us case managers at my agency, to give clients a last formal recognition and the most final goodbye we can give. I don't remember her as a woman in pain but I remember the connection we made.

Sunday, November 8, 2009

Working and Living in the Same Community

It hasn't happened too many times, maybe around a dozen, that I've spotted clients outside work during the weekend. A couple of times happened in my neighborhood, once four buildings down from where I live. I don't live on the other side of town from where I work so these incidents are not unexpected. But a lot of my clients tend to stay in their neighborhoods. And truthfully when I see clients on the weekend it's a bit odd, like seeing a teacher outside school.

My relationships with clients are fairly well defined at work but don't exist when I'm off duty. More than that, staff is told not to address clients outside the agency unless they approach us first for confidentiality reasons. I understand this but it feels strange not to acknowledge someone you know. Some clients walk past me without saying anything. But others say hello, sometimes waving their hands from the other side of the street. Keisha had been upset at me once, early on when we were working together, when I didn't say hello to her. I explained that I did it to protect her privacy and she said, "No one know you're my case manager!" But I prefer to caution on the confidentiality side.

Wednesday, November 4, 2009

Richard Wright Writings

I can't leave a library without checking out a book or four. It's too hard to resist. Usually when I enjoy a book a lot I go on to read other literature by the author. I just finished Native Son, my second book by Richard Wright. My first was Black Boy.

I didn't want to relate to Native Son's main character, Bigger, after reading the book's sleeve. Bigger's acts of assault* weren't likable nor was he particularly likable, seeming a bully from the first pages. He didn't reflect much on how he treated others nor did he seem to have the ability to analyze his behavior. But I found myself thinking about the layers Wright gave him. Thinking too about the context, the world Bigger was living in, as a black man in segregated, limited (in opportunities) Chicago of the 1930s. Wright didn't excuse Bigger's actions but through him voiced his views on racial injustice. It was a risky choice, to do this through volatile Bigger. It was a powerful read.

The next Wright book I'm tackling is The Ousider.

Monday, November 2, 2009

During an intake

Me, verifying: "Do you have a disability?"
Client: "No, but sometimes my wallet feels disabled."

When I stop and think about all the personal information us staff gathers during an initial appointment with a client it's mind boggling. Sure, some folks answer questions with barely a yes or shake of the head for no and others tell you everything about themselves you ever hoped to know. Most clients share a good deal (we do let clients know that if they don't feel comfortable answering something they don't need to). And we ask quite a few questions, involving health concerns, work history, legal background, and the like. I typically learn a good deal about a new client from our first appointment, and when I ponder this fact I remind myself it can be a lot easier to share oneself with a stranger.

Sometimes my inquisitiveness leads me to ask follow up questions that I don't have to ask. For example, I've had a few female clients answer the education section (what is your highest level of education?) with a number lower than 12. Twice I asked if they felt comfortable telling me why they didn't finish high school, and twice the response was because they got pregnant.

Sunday, November 1, 2009

Just One Buddy

I work closely with Keisha, a client who's been involved in our supportive housing program for over 5 years. I've worked with her since my first month at the agency, around 2 years ago. A lot of the work I do with him is advocacy and referrals. Though we have good rapport I wish I had more of an influence on her in taking part in activities like exercise classes or other community activities (some offered through my agency). She's not involved with other agencies and knows the staff and other clients who come here so trying to bring her to attend our events has been a little (though not consistently) successful in the past.

I can't convince a client to do something she doesn't feel comfortable or interested in doing, of course, and discussions about eating well and stopping smoking (which Keisha and I have had) usually don't make a person make a change. I don't have to go much farther to finding friends and family who choose to continue smoking, for example, and it doesn't matter what others say. On the other hand, Keisha also complains about loneliness and her difficulty in making friends. Years ago she was diagnosed with mental illness. I believe she has a developmental disability as well though paperwork doesn't reflect this.
I look at her situation and I think about how it relates to my department's work in trying to create a sense of community at the buildings we provide case management for. We (staff) try to foster this in different ways -- through meet and greets at my agency, occasional social gatherings, workshops. Our goal is for folks to get to know us and each other -- to feel more comfortable with each other. In some cases it means to meet their neighbors for the first time.

And for folks like my client there could be a positive side effect. Making a friend with someone in her building. Someone who would knock on her door to get her out and active. One friend and a sense of companionship would be great for her. Some people find more motivation in exercising, quitting smoking, or just leaving their apartment if they're meeting a friend. But even just for friendship, just support. One person would make a big difference.