Self-Determination Part Two
The following are more scenarios from this week where the self-determination of our clients was in full effect and a common theme.
- We have a client that was successful at getting into an out-of-state substance abuse program after R.O.C. members consistently offered the opportunity for them to go for over two weeks. After being there a week, they got into an altercation with another member of the program and self-determined they would return to the encampment they were staying in here in Chattanooga once again. R.O.C. members made an effort to counsel the client on how choosing this option could be harmful. They attempted to have them process through how much of an influence the actions of others were on their decision to leave. Since returning, we have made multiple attempts to reengage the client on caring for their multiple health concerns and substance misuse. But there is now a noticeably different shift in our relationship with this client. We are assuming this shift is being brought about through the client’s perception that they have let us down or that we will shame them.
- There is another client we are working closely with that has recently had one of their legs amputated and is now struggling to adjust to surviving on the streets while constricted to a wheelchair. The client has failed to comply with any follow-up care at any health facility. Staff from Erlanger has been brought directly to the client to do basic wound care and check on their amputation site. During the last encounter, the client was advised and given the opportunity to be transported to the hospital due to concerns that their amputation is becoming infected and their stitches need to come out. After being given this recommendation and opportunity, the client self-determined that they would decline and stated they would be ok managing their care on their own.
- Another situation was brought to the attention of the outreach workers for the City of Chattanooga this week. An elderly mother and her physically and mentally disabled wheelchair-bound daughter were facing a 24-hour eviction from the motel that they had been living in. This would have left them with nowhere else to go but to the streets. The city’s team intervened as soon as they could and were able to get their hotel stay extended for another two weeks. Since then they have been able to present the mother and daughter with a housing option that would have the proper accommodations for the daughter’s limitations. They had to persuade and ask a favor of the property manager to let them bypass the extensive waitlist given the emergency of this situation. After being presented with this opportunity, they self-determined this would not be a housing option they would like to pursue.
- A couple who has been living in their vehicle for years was shown a newly renovated, fully furnished, one-of-a-kind apartment where the city was willing to cover the first 4 months of utilities and rent, and then after that everything would be 30% of the client’s monthly income. The city also had to persuade this landlord to overlook the fact that one of the clients is an immigrant without a current green card. Even before the tour of the apartment was complete, the couple self-determined this would not be somewhere they would be interested in living.
- Conversations were had with a client who sits out in the sun all day and sleeps on the streets at night about getting connected to resources and medical services to address their self-reported brain injury. The opportunity has been offered multiple times to be transported to Homeless Healthcare, and bus passes have also been given in an attempt to help them get there. They continue to self-determine not to come.
- A situation occurred between a client and R.O.C. members outside of one of the local emergency rooms. The client had been cycling through the local ERs for the past two weeks, and every time it came to beginning to provide medical care to the client for their severely infected wounds, they would self-determine to leave against medical advice and lay themselves on the public sidewalks adjacent to the hospitals for days at a time, while their health continued to decline. This cycle continued for so long and so often that at the time R.O.C. members got involved, they had to convince the client to enter the ER once more so that the end result would be the hospital doctors informing the client that their right to leave against medical advice was no longer an option for them due to the real chance that if they left again without treatment, they would die.
The logo for the R.O.C. is pictured below because it contains a message that relates to this topic of self-determination. The hands of the logo are interlocked through a grasp of each wrist. This is to represent the strong bonds we aim to form between ourselves and those experiencing homelessness in our communities. It is a message that we are all stronger when we are working together. And it is a message that no matter if the clients let us down, or we let them down, and a hand breaks loose, we still haven’t let them go. We haven’t and won’t give up on them.
#ROCAndRoll
#ROCRetrospective
#StrongBonds
