Today, I learned of the death, on Saturday, 9 March 2013, of Lois, a former client, at the age of fifty-five. Lois was probably the most difficult person I ever housed. She was a practicing addict and alcoholic who turned tricks to supplement the disability payments she burned through. She was a survivor of multiple traumas, including the loss of one husband in a fire and a second to a heroin overdose, as well as the loss of a seven year old son. And she suffered from acute cognitive impairment and other mental/emotional health issues which, due to her personality and lifestyle, were not thoroughly diagnosed and often went untreated. Judy, a colleague who worked in a Community Health Centre, asked me to work with Lois after watching her tear through one housing worker after another, and determining that she might well be beyond help.
During the nine months or so that we worked together, Lois was given to spontaneous outbursts of venomous, verbal abuse and other forms of gross behavioral inappropriateness. She would forget appointments, or decide in the middle of a meeting that she had to go and get a drink. I was told that once, during an interview for housing, she kept excusing herself to use the washroom, where she progressively drank herself to a staggering intoxication, leading to the housing offer being withdrawn. With another worker, while on the way to another interview, she jumped out of the van at a stoplight and couldn't be found for the rest of the day. Because of such antics, I knew that preparing Lois for interviews would be a slow process.
There are very limited housing options for those with concurrent disorders (having both an addiction and mental illness), and Lois added to that package a demand for independence of movement and freedom of companionship. Other behavioral characteristics that would make housing in any group setting challenging were her propensity to lose her own belongings, in particular, her keys, and the matching tendency to pick up interesting and attractive items left around by others – a trait that exposed her to frequent accusations of theft. Opportunities for appropriate housing couldn't be wasted.
But the slow pace of application and preparation infuriated Lois. Despite her dysfunctions, she was very bright, articulate, had a great memory that clicked in and out, and was quick to take offense at any suggestion that she was in any way incapable. She was full of accusations that no one – I, in particular – was willing to stick with her and help her. And so she was often intoxicated when she arrived for our meetings, occasionally dismissed me in a screaming tirade, or she simply didn't show up.
And yet, I loved working with her. Despite the miseries of which she so regularly complained, Lois was full of life, and of the joy of life. She enjoyed people and wasn't shy about speaking her mind, so a major challenge involved managing her interactions with others when we travelled together, especially in the confines of a bus or streetcar. One minute she might be complimenting a woman on her handbag, in the next, describing the detached rectal lining that caused her great discomfort, and then screaming at the top of her lungs at an eaves-dropper who turned to her with a raised eyebrow.
Because she was so often consumed by a grievance or a mission, some distress or preoccupation, it could be extremely difficult to move forward with the task of finding housing. So early on, we two devised a tactic for working together, which was to take turns. Our meetings sometimes began with a twenty minute Lois rant about the injustice of being barred from yet another shelter, sometimes with a memory of better times that she wanted to share and relive, occassionally with a song, sung in a soft, childlike and lilting voice. When she was done, she's say, "Your turn." and we'd proceed to business, generally with no more substantial disturbances that day.
As is so often the case, much of Lois's disruptive behavior was both a way of dealing with her own anxiety and fear of disappointment in the housing game, and a rigorous test of workers, to see who would stick. As Lois became assured that I would stick, she revealed more of her fears to me, rather than act out on them. And gradually, a calmer and more focused Lois did emerge. And penultimately, she did obtain housing, in a low-rise apartment building where she had a self-contained unit, and her own key, with staff on hand to give support, and a level of tolerance for residents like her, who'd lived so many years in street culture.
I don't know how things ended for Lois. I continued in a support role for a couple of more months, before handing her on to another community worker she'd had the chance to bond with. Ultimately, that housing situation deteriorated and I learned that she'd been moved into housing in another part of town. I don't know what brought about her death this past Saturday, and perhaps I never will. One of her fears had been that she'd die on the street, and I hope that wasn't the case. It was obvious that her life didn't suddenly become rosy because for awhile she had a place that felt to her like home. But she was proud that she'd survived what had been a long passage of years without one.
I write this memorial of sorts because it brings me comfort. I was able to be a bit of a plus in the equation that was Lois's life. But Lois is also a powerful lesson to me. I started this essay by referring to Lois as probably the most difficult person I ever housed. But she was by no stretch the hardest person or the most difficult case I've worked with. It's simply that hers was the most challenging case that met with a small measure of success.
Lois was in the borderland between what the social net would consider a "workable" client and one who is "unworkable". Lois was bright. That helped to make her workable. She had a solid grasp and a vision of the concept of housing, and a strong, focused desire to obtain it. She had the ability, over time, to adapt her level of drug and alcohol consumption when circumstance demanded it, and to manage her fears. She liked other human beings enough, and was charming enough, that I and others wanted to work with her, enjoyed her, and so were able to stand by her, despite the abuse and sabotage. In some measure, the social safety net has expanded in recent years to take in the Loises. The "Housing First" philosophy – which basically means, provide shelter 1st, then worry about the addictions and all the rest – made housing Lois possible. But essentially, it was Lois who did most of the adjusting that made her housing possible. She found and climbed into the net. Despite being barred at one time or another from just about every shelter, drop in or Health Centre that she depended on, and despite her numerous arrests, and assaults of various kinds, both administered and received, Lois managed to negotiate and survive the system.
A key thing I learned from working with Lois, is that our system of care does not and cannot provide much help to the most dysfunctional and most mentally ill of the homeless. There are so many others who cannot make the adjustments she did, who cannot manage enough of the jumble of requirements that stand between them and access. So many others are so cognitively damaged, traumatized or otherwise disabled that they remain beyond the reach of programs like mine.
Housing resources are so strained – particularly supportive housing resources, that the numbers alone dictate against needs being met. Clients end up competing against one another for spots. Sometimes survival goes to the more needy client, but just as often it goes to the less needy, because the program can only deal with and support the lesser need. And it's a sad trick that, after housing someone like Lois, a worker feels he or she has done something exceptional. Because, after all, why should securing housing for anyone in need be exceptional?
Lois, you are missed. And you will be remembered.
I just received the following update from Judy, the worker who originally connected me with Lois:
"By the way, according to ..., she got into her building but couldn’t find her apartment key. So she lied down outside her door and fell asleep. I think staff found her body later and it was on Saturday. So according to that version of the story, she died inside where it was warm and dry, in her sleep."
During the nine months or so that we worked together, Lois was given to spontaneous outbursts of venomous, verbal abuse and other forms of gross behavioral inappropriateness. She would forget appointments, or decide in the middle of a meeting that she had to go and get a drink. I was told that once, during an interview for housing, she kept excusing herself to use the washroom, where she progressively drank herself to a staggering intoxication, leading to the housing offer being withdrawn. With another worker, while on the way to another interview, she jumped out of the van at a stoplight and couldn't be found for the rest of the day. Because of such antics, I knew that preparing Lois for interviews would be a slow process.
There are very limited housing options for those with concurrent disorders (having both an addiction and mental illness), and Lois added to that package a demand for independence of movement and freedom of companionship. Other behavioral characteristics that would make housing in any group setting challenging were her propensity to lose her own belongings, in particular, her keys, and the matching tendency to pick up interesting and attractive items left around by others – a trait that exposed her to frequent accusations of theft. Opportunities for appropriate housing couldn't be wasted.
But the slow pace of application and preparation infuriated Lois. Despite her dysfunctions, she was very bright, articulate, had a great memory that clicked in and out, and was quick to take offense at any suggestion that she was in any way incapable. She was full of accusations that no one – I, in particular – was willing to stick with her and help her. And so she was often intoxicated when she arrived for our meetings, occasionally dismissed me in a screaming tirade, or she simply didn't show up.
And yet, I loved working with her. Despite the miseries of which she so regularly complained, Lois was full of life, and of the joy of life. She enjoyed people and wasn't shy about speaking her mind, so a major challenge involved managing her interactions with others when we travelled together, especially in the confines of a bus or streetcar. One minute she might be complimenting a woman on her handbag, in the next, describing the detached rectal lining that caused her great discomfort, and then screaming at the top of her lungs at an eaves-dropper who turned to her with a raised eyebrow.
Because she was so often consumed by a grievance or a mission, some distress or preoccupation, it could be extremely difficult to move forward with the task of finding housing. So early on, we two devised a tactic for working together, which was to take turns. Our meetings sometimes began with a twenty minute Lois rant about the injustice of being barred from yet another shelter, sometimes with a memory of better times that she wanted to share and relive, occassionally with a song, sung in a soft, childlike and lilting voice. When she was done, she's say, "Your turn." and we'd proceed to business, generally with no more substantial disturbances that day.
As is so often the case, much of Lois's disruptive behavior was both a way of dealing with her own anxiety and fear of disappointment in the housing game, and a rigorous test of workers, to see who would stick. As Lois became assured that I would stick, she revealed more of her fears to me, rather than act out on them. And gradually, a calmer and more focused Lois did emerge. And penultimately, she did obtain housing, in a low-rise apartment building where she had a self-contained unit, and her own key, with staff on hand to give support, and a level of tolerance for residents like her, who'd lived so many years in street culture.
I don't know how things ended for Lois. I continued in a support role for a couple of more months, before handing her on to another community worker she'd had the chance to bond with. Ultimately, that housing situation deteriorated and I learned that she'd been moved into housing in another part of town. I don't know what brought about her death this past Saturday, and perhaps I never will. One of her fears had been that she'd die on the street, and I hope that wasn't the case. It was obvious that her life didn't suddenly become rosy because for awhile she had a place that felt to her like home. But she was proud that she'd survived what had been a long passage of years without one.
I write this memorial of sorts because it brings me comfort. I was able to be a bit of a plus in the equation that was Lois's life. But Lois is also a powerful lesson to me. I started this essay by referring to Lois as probably the most difficult person I ever housed. But she was by no stretch the hardest person or the most difficult case I've worked with. It's simply that hers was the most challenging case that met with a small measure of success.
Lois was in the borderland between what the social net would consider a "workable" client and one who is "unworkable". Lois was bright. That helped to make her workable. She had a solid grasp and a vision of the concept of housing, and a strong, focused desire to obtain it. She had the ability, over time, to adapt her level of drug and alcohol consumption when circumstance demanded it, and to manage her fears. She liked other human beings enough, and was charming enough, that I and others wanted to work with her, enjoyed her, and so were able to stand by her, despite the abuse and sabotage. In some measure, the social safety net has expanded in recent years to take in the Loises. The "Housing First" philosophy – which basically means, provide shelter 1st, then worry about the addictions and all the rest – made housing Lois possible. But essentially, it was Lois who did most of the adjusting that made her housing possible. She found and climbed into the net. Despite being barred at one time or another from just about every shelter, drop in or Health Centre that she depended on, and despite her numerous arrests, and assaults of various kinds, both administered and received, Lois managed to negotiate and survive the system.
A key thing I learned from working with Lois, is that our system of care does not and cannot provide much help to the most dysfunctional and most mentally ill of the homeless. There are so many others who cannot make the adjustments she did, who cannot manage enough of the jumble of requirements that stand between them and access. So many others are so cognitively damaged, traumatized or otherwise disabled that they remain beyond the reach of programs like mine.
Housing resources are so strained – particularly supportive housing resources, that the numbers alone dictate against needs being met. Clients end up competing against one another for spots. Sometimes survival goes to the more needy client, but just as often it goes to the less needy, because the program can only deal with and support the lesser need. And it's a sad trick that, after housing someone like Lois, a worker feels he or she has done something exceptional. Because, after all, why should securing housing for anyone in need be exceptional?
Lois, you are missed. And you will be remembered.
I just received the following update from Judy, the worker who originally connected me with Lois:
"By the way, according to ..., she got into her building but couldn’t find her apartment key. So she lied down outside her door and fell asleep. I think staff found her body later and it was on Saturday. So according to that version of the story, she died inside where it was warm and dry, in her sleep."
beautiful
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