Saturday, April 23, 2011

Photos of Elderly Animals

I was intrigued when I came across an article sharing photographer Isa Leshko's photos of elderly animals or animals at the end of their lives. I was intrigued by this project and the concept behind it. It's absolutely true that photos of ducklings, puppies, and baby ferrets are found all over as well as animals in their prime, as Leshko states. I liked the spotlight being turned on elderly animals. Her photos are touching and I get a sense of gentleness through them.

The back-story of the project: Leshko cared for her mom, who has Alzheimer's disease, for a year. She started taking the photos as a way of dealing with her feelings from that time.

More photos may be found on her site.

Wednesday, April 20, 2011

Pattern in Dynamics with Another Person

Me: "All right, so you're emailing me the document????"
Provider: "Yes, I'll do that right now!!!!"
Me: "All right thanks!!!"
Provider: "Sure. You're welcome!!!"

So went the last exchanges in a rather frenzied conversation with another provider. It was a positive interaction, and the fellow case worker helped in solving my client's quandary, but both he and I spoke in a tone that could best be described as stress!!!!! I could hear how the provider on the other end was already thinking of the next task he needed to take care of at the end of our conversation.

This got me thinking about how we respond to other providers or clients, particularly once there's an established relationship. We develop a dynamic with each person we meet and with each new relationship a pattern develops. We expect client A to resist our suggestions or look forward to client B's enthusiasm to tackle a challenge. Which means that from the beginning of our appointment my attitude with client A is going to be more guarded but I'm also going to expect that the session to be difficult which in turn may very well mean a difficult exchange. We do like patterns as people but sometimes they work against us.

Saturday, April 16, 2011

Sister Souljah and No Disrespect

One day, fairly early in my job at Empoder, I was leafing through the autobiographies section in the library and picked out No Disrespect by Sister Souljah. I wasn't familiar with the author but the title grabbed me. I read it half of it that night, captivated by her. Sister Souljah shares some background of her childhood, college experience, and life after graduation. As she enters college the focus of the book becomes her romantic relationships but throughout themes of race and racial injustice stand out.

Her strong persona intrigued me and more so, her perceptions on race and racial dynamics made me think a lot. My first reaction was defensive; "She comes off as someone who hates all white people. How can she mark off a people because of their color? Isn’t she doing what white racists do?" This came as a reaction to Souljah’s strong views on whites. In the entire book she didn’t share one positive experience with a white person. White teachers (as well as Jewish teachers) didn't encourage her intellect and she had to fight for every scholarship she received. Later, in college, the one white woman who stands up to her opinions on whites, talking about those who wanting to work together with minorities towards equality, is highlighted in a scene that further brings out Souljah’s disdain for white people.

As a sidenote, I didn’t grow up in the US. I studied US history in respect to racial relations, from slavery to segregation laws to civil rights movement but learned much more after moving here. Souljah’s book threw the volatility of racial relations in my face. Her writing came across as accusatory and holding nothing back. While I was able to understand her anger, what really shook me was how vehemently Souljah seemed to feel about whites, those in power and those not, seemingly clumping them all together. As a case manager who worked with dedication with people of all backgrounds this was hard for me as well.

I thought out loud to a friend about how I didn’t understand why Souljah's view on white people were so sweepingly negative. I don't remember her answer but I remember it made me snap out of it. I was taking Sister Souljah's message personally -- as a personal attack. I was reacting to it emotionally. What Souljah was sharing was a feeling of deep injustice. Maybe I wasn't able to fully understand it, having not come from a similar background, maybe even after understanding it I didn't agree with her on everything she wrote, but it wasn't about me. It was about her growing up in a tough life, fighting for everything she had, and feeling angry she had to fight so hard for it. It was about the system of inequality, in the US and globally. And presenting her views without holding back, without gently probing the topic or tip toeing around it.

Though at times she came across as arrogant she wasn't afraid to share deeply personal experiences concerning her relationships with other men and family and her writing was engaging. Following this book I would go on to read other books and essays about poverty, inequality, and so on but I appreciate I read a take no prisoners book early on. It's good to read books that remind me that it's not about me and as good to read something that is going to be challenging.

5/2/2011 To clarify: Sister Souljah (who I've seen in interviews and read beyond No Disrespect) has indeed shared views I disagree with. My point was to readers who may have had an initial reaction like myself, to encourage them to look beyond Souljah's statements that are wholly negative (i.e. her expressions that generalize white people) and not get distracted by them, but instead to focus on examining the actual system that Souljah is criticizing.

Tuesday, April 12, 2011

How My Job Has Influenced Some of My Perceptions

I was sitting on the bus today when a gentleman walked by on the aisle and his body odor was really strong. I suspected he was experiencing homelessness. A few people reacted to him. Conversation carried on. I thought for a moment about my own reaction. How has that reaction changed since I started working as a case manager several years ago?

At that time I would've likely reacted with a mixture of sympathy and aversion. I would've maybe thought a bit about where the person came from, his background, how he grew up, but it would've felt quite disattached from myself. After working as a case manager for some time and getting to know people of various hardships, housingwise, physical, mental, fixed (disability benefits) or no income, I was able to appreciate the depth, the story behind a person with these challenges. Through the years I also learned much more about the system, encompassing social reform in US, Medicaid, Medicare, disability, inequality in its various forms, and am still learning more.

I come from a privileged background. I realize what I wrote above may read for this to be the case. I grew up befriending people from different cultures and incomes but led a sheltered life in many ways. I felt the love from my parents and grew up in a stable household. I developed values that, left unchecked, are projected onto clients. I need to remind myself to carefully consider where clients are coming from.

My job hasn't changed some things. While I absolutely believe the system needs work and impending budget cuts (to programs related to health, housing, educational, should I go on?) concern me deeply I too believe in people's capabilities of being involved in some way in their community if they're unable to work*. Or even in doing something positive for themselves, learning their rights and obligations, developing skills to advocate for themselves, teaching other people skills. And on another end of it having a hobby, exercising, taking a class. People need to take ownership of their lives but as a society we do well to support one another (not to mention we don't all start off on equal footing, but that's for another discussion). And I suppose these values I learned from my parents and immediate community.

Yet, considering the magnitude of the impending cuts they do limit people's abilities to take actions that promotes their wellbeing. Severely cutting programs that serve people with low incomes, people with disabilities, and still expecting them to function as well in society does not sound right.

* Unable to work meaning they have a disability for which they receive benefits

Saturday, April 2, 2011

I'd like a New Case Manager

I had been at Empoder for 6 months when a client responded to my department's decision to deny her financial assistance by asking to get a new case manager. It was the first time I heard that request (request, demand) from a client. Though all financial decisions are made by the department's team they're delivered by the primary case manager. I had worked with the client for a month and met a few times which didn't help develop a strong rapport between us. I tried to suggest other options but my client was adamant. She wanted a new case manager. The truth was I wasn't really interested in continuing to work with her. I was annoyed by what I felt was her sense of entitlement and brash attitude with me. I responded that my supervisor would call her to follow up. Later, after speaking with Feona, my supervisor, I realized it would've been better that I referred my client to talk to Feona directly since she initiated that request.

Typically once clients work with a case manager at Empoder they'll continue to work with that person. Rarely do transfers to other case managers occur. When they do usually it's with newer clients or on a case by case basis where both case manager and client find it difficult to work together but there's still reason for the client to continue and receive services. It's also not unusual for case managers to collaborate on particularly intensive clients.

If I could talk to myself at that moment, six months into the job, I would tell myself that just because someone requests a new case manager it doesn't mean by itself that I'm not doing a good job.* I'd also tell myself (after I calmed down) to remember where clients are coming from in terms of their own difficulties, challenges, and lives before they walked in my office. Not to mention the need to not personalize other clients' anger or negative emotions when directed at me, something that would take me a while to fully learn and hey, something I still need to remind myself.

It's not necessarily unusual for case manager/client relationships to have ups and downs but ultimately they succeed for similar reasons. Rapport is essential for a good professional relationship. This is based on mutual trust, respect and something intangible. I add the intangibility factor because sometimes a case manager and client don't click and it's not necessarily something that may be anticipated.

A general request that my department honors is a potential client's initial request to work with a man or a woman. Matching client and a case manager based on this preference may set better grounds for a comfortable and trusting relationship. To a degree it helps that case managers' expertise be taken into account when matched with new clients. For example, case managers with more experience with people with severe mental illnesses may work more effectively with a person with schizophrenia as opposed to a CM without this experience. On the other hand, a case manager's work at my department is superficial compared to therapy work. We're not clinicians or therapists. Our job is often to refer and mediate, connecting clients with services they need, navigating health or benefits systems with them. It helps to have experience with a certain segment of the population but if that's not there, it's possible to work to connect with another person through respectful, empathetic, and patient approach. More so than possible -- it's necessary. Taking part in mental health (and crisis, motivational interviewing, and so on) trainings, which we all should do as case managers, should complement this approach.

* Regardless of an incident like this it's important to continue and reassess how you work, your skills and effectiveness as a case manager. For the sake of this post I didn't delve into this.