Posts tagged long read
Posts tagged long read
When you raise the subject of over-eating and obesity, you often see people at their worst. The comment threads discussing these issues reveal a legion of bullies who appear to delight in other people’s problems.
When alcoholism and drug addiction are discussed, the tone tends to be sympathetic. When obesity is discussed, the conversation is dominated by mockery and blame, though the evidence suggests that it may be driven by similar forms of addiction.
I suspect that much of this mockery is a coded form of snobbery: the strong association between poor diets and poverty allows people to use this issue as a cipher for something else they want to say, which is less socially acceptable.
But this problem belongs to all of us. Even if you can detach yourself from the suffering caused by diseases arising from bad diets, you will carry the cost, as a growing proportion of the health budget will be used to address them. The cost – measured in both human suffering and money – could be far greater than we imagined. A large body of evidence now suggests that Alzheimer’s is primarily a metabolic disease. Some scientists have gone so far as to rename it: they call it type 3 diabetes.
A couple of years ago my book club read a book called Still Alice by Lisa Genova, an almost hilariously juvenile account of a Harvard professor of cognitive psychology grappling with her diagnosis of Alzheimer’s and eventual complete lose of her short term memory. (My book club tore it to shreds.)
Still Alice did affected my world view of people suffering with Alzheimer’s, for better or for worse. But I forget if Alice was overweight or had a poor diet. As I recall, she thought it might be a genetic thing.
Then [a scarcely regulated food industry] can turn to the government and blame consumers for eating the products it sells. This is class war, a war against the poor fought by the executive class in government and industry.
We cannot yet state unequivocally that poor diet is a leading cause of Alzheimer’s disease, though we can say that the evidence is strong and growing. But if ever there was a case for the precautionary principle, here it is. It’s not as if we lose anything by eating less rubbish. Averting a possible epidemic of this devastating disease means taking on the bullies – both those who mock people for their pathology and those who spread the pathology by peddling a lethal diet.
In the year that I have worked at the Lighthouse, of our long-term tenants, two have passed away. When I started my co-workers informed me that it was part of Lighthouse lore that a tenant passed away every six months and that we were now due. Both people who passed away were in their 50s. I have begun to learn when people ask how old our tenants are it is a safe assumption that almost all are under 65, the age at which you can receive pension here. From my observations, the majority of the people I work with have lived in poverty their whole lives and the majority of them won’t live past 65.
When I took one of my client’s to move into a care home, I stayed with her while she went through the intake process-first the nurse, then the client care administrator, then the accounting assistant. All were amazed at my client’s age-because everyone who interviewed her at the care home was older than her. In her early 50s, my client was constantly falling, incontinence problems, and difficulty swallowing liquids. She also suffered from crazy mood swings which I attributed to a cigarette addiction but which I could now also connect to a poor diet.
(Side note: Losing your teeth and not wearing dentures ages you like nothing I have ever seen. Within one week of clients having their teeth pulled they look like they have aged 5 or more years. (And poor dental hygiene is common among people living in poverty.) (Also smoking does not help the whole youthful look but you have already accepted this as a fact.))
Currently I am helping with a local week long event called the Food Basket Challenge, which challenges local ‘celebrities’ (Saskatoon has no celebrities, but you know) to eat out of a food hamper that one typically receives from the local food bank. I truly believe people still do not understand, poor diet leads to early death.
Here’s a little video I shot of Nicole White, AIDS Saskatoon’s Executive Coordinator on how nutrition effects those who are diagnosed with HIV.
I believe Alzheimer’s is one of many diseases that is exacerbated or directly linked to poor diet. Not to say all those who are diagnosed with Alzheimer’s have poor diets but that those who have poor diets are more likely to suffer ill health and die much below our average life span in the industrialized world.
Sad to think in another 5 months I again will be leading tenants at the Lighthouse in an a capella version of ‘Amazing Grace’ as we remember another member of our community who has passed away too soon.
I want to write more about my experiences working at an emergency shelter and supported living facility-about the effects of poverty, mental illness, drug abuse, mental and physical abuse, all these things I see around me every day at work. But something has held me up for a long time- it’s because I wrote this- where I wrote about advocating for a client till she got the care she needed.
I phrased it that I did it because I loved her. What a bunch of bullshit. Now I read that post and think what a stupid thing to say. I did and do love her, but what about all the other clients? The ones I don’t know that well, the ones I don’t like, the ones whose mental illness has robbed them of their personality? The ones who smell so bad I have to run away and dry heave over the nearest garbage can?
I don’t just help the ones I love. Or do I?
This past month I’ve questioned myself a lot because of two tenants.
The first tenant I call Uncle Bobby*. He’s the next on the list of people who need more care than the Lighthouse can provide. He carries on a conversation with himself out loud pretty much all the time. He’s often out ‘picking’, teetering on his long, worryingly thin legs because he’s had some toes amputated. We’ve never had a full conversation-I’m sure he has no idea who I am.
Uncle Bobby’s main vice is binge drinking cleaning fluids once or twice a month, which results in him defecating himself. He doesn’t have the presence of mind to clean up or change his clothes, and sometimes wears his soiled shorts for days on end. You can imagine why this is tough when 80 people have to eat eat together in a dining room.
He’s not lovable. Yet I still need to work on making his life better. And it’s going to be just as tough, or tougher than the last one. So far we have the baby step of having a scheduled sponged bathed twice a week for him with Home Care. Although he won’t stay home for the appointments, so it’s not really working out.
The other tenant whose forced me to question my whole “I love my clients therefore…” motto was a wonderful lady, I’ll call Grace*. A very nice, pleasant lady in her early 50s, who lived at the Lighthouse. She has a very serious hoarding problem; her washroom was so full of stuff she could not use it. Grace was diagnosed with an inoperable brain tumor sometime in late winter and was given six months to live. Unfortunately it progressed very quickly and the pain became unmanageable, and she spent her last two months at St Paul’s hospital in the palliative care ward.
My co-workers went and visited her. “She asked about you,” they said, “she wants you to go visit her. “But prepare yourself,” the other said, “it’s pretty bad.” Her tumor had spread and had become very disfiguring.
And I stalled and I forgot. I hate hospitals with a “I may have a panic attack” fervor. And I didn’t want to go because it’s hard to find parking.
My “love” for my clients obviously doesn’t cover the fact I may have to inconvenience myself.
About a month ago I finally went. Stopped in quick, brought her a word search book. Her room smelled of rotting food and infection. Her family was there so I only stayed briefly to ask how she doing. She said she was experiencing very little pain and smiled.
She passed away the next week.
It’s not “love” that’s going to keep me going at this job-the people or the circumstances are just too unlovable sometimes. The post about loving my client so much I’d call agencies and tell-off managers, bathe her myself, move her myself, buy her cigarettes at her new home so she would get along with others, double and triple check her first month’s rent was paid- damn, I did that. But I need to do that not just for the lovable ones.
*Not their real names
Last week was a bit crazy around the Lighthouse, as the letters we had sent out the previous week encouraging our tenants who were late with the rent to come talk to the managers made some clients very angry.
Many people came and paid this months rent plus what they owed in back payment (some people just need a friendly reminder). Another gentleman told us he needed to pay his cable bill so therefore he would not be paying back his late rent.* With so little money given for living allowance it is very hard to pay back old rent if a person on social assistance gets behind. This would make most landlords evict the tenant and try their luck with someone else. Often lack of rent payment burns landlords so bad they stop renting to people on social assistance and sometimes renting to any one at all.
At the Lighthouse we try to be understanding and give grace where grace is needed. But one gentleman thinks we ‘owe’ him and is insulted every time we ask for the rent that is due us. He came charging into the Housing Manager’s office. The Housing Manager and our GM tried to have a civil conversation with him but it quickly elevated to swearing and threats from him. I stood in the hallway to try to prevent him from not going towards the door which leads out of the wing of offices.**
This client, with a history of drug abuse, suicide attempts right in front of us, and mental illness starts saying, “Boy you’re lucky I won’t throw you out the window,” and “You’re suck a bleepin’ goof,” and “Let’s take it outside!” He’s ranting and ranting and eventually ends up on the other side of the glass door which separates the offices from the lobby.
We all breathe a sigh of relief, he’s mad but he’s far enough away he can’t hurt us and we can walk away from him, even if he refuses to leave the lobby.
I notice some donors in the lobby dropping of quilts with a terrified look in their eyes. I ask them to come to the door so I can let them drop of their blankets. As I open the door, the irate client tried to shove his way past me and back into the office, yelling the whole time. And I push him in the chest, out the doorway and then pull the door shut, yelling right back at him the whole time.
So not okay. The Housing Manager yells at me to get back in my office. I feel like a complete utter ass. Pushing a client? This is an extreme new low for me, and yet it was in the moment and it was self defense. I didn’t think about it, I was just protecting the staff and myself from this volatile person.
He continues ranting and raving but goes up to his room. We call the cops. By the time the cops come our councillor has been talking to the client and calmed him down a considerable amount. Him seeing the cops works him back up again, but the cops quietly and thoughtful say, “We can do this the hard way or the easy way,” and start putting on their gloves. They leave him to stew in his apartment.
The cops interview me. Nothing they can do, they say. Nothing they could charge him with. Which I understand, I guess. They say we should evict him. And, they advice, if they were us, they would evict him immediately. Immediately means at least two weeks to get a hearing set at the Rentalsmen. Which means the staff have to walk on eggshells for the next two weeks, while this person who has threatened us continues to remain in the building with us.
(Later that day this gentleman follows our General Manager on his walk home, berating and taunting him. Thank the Lord I drive.)
Anyways, eventually the ladies who brought the quilts were able to hand them over to me, and I threw them onto the floor. Not very nicely, as I am very thankful for all bedding as we are always in need of it. They see I’m all worked up and they say, “You don’t get paid enough for this dear.”
Good thing I don’t do it for the pay. But I sure as hell don’t do it to feel threaten and scared everyday either.
*Not okay with us but next to impossible to argue with this line of reasoning- all other things are more important than paying rent because he believes we won’t evict him. Another story for another time.
**Wing is kind-of a joke, there are four offices plus the front desk.
… Chief among those laws were strict new standards: only people who posed an imminent danger to themselves or someone else could be committed to a psychiatric hospital or treated against their will. By treating the rest in the least-restrictive settings possible, the thinking went, we would protect the civil liberties of the mentally ill and hasten their recoveries. Surely community life was better for mental health than a cold, unfeeling institution.
But in the decades since, the sickest patients have begun turning up in jails and homeless shelters with a frequency that mirrors that of the late 1800s. “We’re protecting civil liberties at the expense of health and safety,” says Doris A. Fuller, the executive director of the Treatment Advocacy Center, a nonprofit group that lobbies for broader involuntary commitment standards. “Deinstitutionalization has gone way too far.” According to Fuller’s group, there was one public psychiatric bed for every 300 Americans in 1955; by 2012, that number was one for every 7,000. That’s less than a third of what is needed, the organization asserts. The recession has made matters worse: since late 2008, more than $1.5 billion has been cut from state mental health budgets across the country. In the past two years alone, 12 state hospitals with a total of nearly 4,000 beds have either closed or are in danger of closing.
Already patients in crisis can spend several days in an emergency room waiting for a psychiatric bed to become available. In New Jersey, it can take as long as five days; in Vermont — where, as Bloomberg News recently reported, there are virtually no state psychiatric beds left — severely mentally ill patients have been handcuffed to emergency-room beds. For lack of other options, many patients who clearly meet the imminent-danger standard are released. “The lack of resources has triggered a devolution of the standard,” says Robert Davison, executive director of the Mental Health Association of Essex County, a nonprofit group that connects patients to services in northern New Jersey. “Twenty years ago, ‘imminent danger’ meant what most people think it means. But now there’s this systemic push to divert people away from inpatient care, no matter how sick they are, because we know there’s no place to send them.”
When I asked Davison for specific examples, he rattled several off the top of his head. A man who was convinced that aliens were on the roof and that bugs were coming out of the walls and who would not sit on furniture but only lie on the floor was not committable. Neither was the man who refused medication and mutilated his own testicles. Nor the woman who wouldn’t eat because she believed the C.I.A. was trying to poison her. “It is unbelievable the condition of people who are found not to meet the standard,” Davison says.
I’ve officially been working at The Lighthouse for a year now and I’ve made a commitment to write more about life at an emergency shelter and supported living facility.
It’s hard to though, because I want to say positive things. But I become so enraged over the way life is for people living in poverty or experiencing homelessness, it clouds my thoughts and often makes me forget the victories. When I started I was so excited to help marginalized people, share about what the Lighthouse does and make a difference in Saskatoon.
For you I was a flame
Love is a losing game
The Lighthouse is basically an old hotel that has been re-purposed, so the hotel rooms are now apartments for people in need, often because of being in poverty, having been homeless, having a mental illness or addiction, having an acquired brain injury, or other cognitive or physical disability.
When I started, there was a list of people whose needs were not being met. Out of 69 people, there was at least 4 elderly tenants who needed more care than we provide (all had mental health issues and incontinence problems). Since we wanted to help the people staying in our emergency dorms move on to an apartment, it is better for everyone if we move the higher needs clients to the right level of care in the wider community, so other people who are in need can have a suite with us.
I and the rest of the staff have been desperately trying to find better homes for these elderly clients. It has been an almost impossible task. If you are elderly, poor and have a mental illness in this city there are very few resources. There is such a low vacancy rate and such high demand for nursing homes, care homes, group homes, and mental health group homes, they can decide a client’s issues are too complicated to be able to help them.
Self professed… profound
Till the chips were down
Recently I got one of these tenant’s assessed. They did not qualify for a care home but were promised that services would be brought in to help them do better at our place.
The in-home services find every excuse in the book not to come. It gets to the point where they haven’t bathed in weeks. I have bathed someone twice since working here and I know other staff have as well. We are not paid to do this, nor do we have the time, or resources. We love our tenant’s and see them in need, so we fill in the gaps where other services are supposed to be.
Today I found out this tenant was turned down for a care home for a second time even though she wants to go to a place which provides more care. This person can barely swallow liquid, can’t manage stairs, is incontinent, and can’t maintain personal hygiene. The tenant doesn’t qualify because of ‘personality issues’ stemming from diagnosed mental illness and dementia. As well the in-home services to support her where she is currently living have also stopped.
I pleaded with the assessment manager to tell me what to do to allow this client of mine to have some sort of care. She suggested that I stay in the room the whole time anyone is there giving her help, to make sure the client was well behaved and compliant. I could also appeal their refusal of accepting her in a care home, which would require me to record all incidences including outbursts, tantrums, incontinence issues, dizzy spells, falls, and lapses in her memory for one week.
Played out by the band
Love is a losing hand
More than I could stand
Love is a losing hand
So I have a week to prove this tenant is in such poor health but has a pleasant enough personality for her to qualify for a nursing home. Because I love her I will try. The assessment agency is counting on the fact that I won’t evict her to make them actually do something. And that she will be allowed to live here, inability to swallow, incontinence problems and all, until she falls and breaks a hip, or worse.
I care deeply for the people I work with. Therefore I will try my best to provide my (what I know to be inadequate) services. The professionals who are paid to provide these services refuse to do so. It shouldn’t be that you have to ‘win’ services by fitting into the right categories. If someone needs and asks for help when their health begins to fail, it should be provided, regardless of economic status. People in poverty die from lack of preventive medicine and care, and treatable illnesses. The more I love my clients, the more I realize how society has failed them and continues to do so, no matter how much I fight for them.
Over futile odds
And laughed at by the gods
And now the final frame
Love is a losing game