Death of a client...

Has anyone here worked in the social services, and experienced the death of a client?

I am a case manager working with people who were formerly chronically homeless and are now in housing. I have been there just 10 months and have had two clients pass away in that time. The first one was an amazing experience for me. It was scary and upsetting in the beginning when they started to get sick, but because I was able to help them reconnect with family, and to do a lot of things to help them transition over (bring in spiritual leaders, surround them with things that were sacred to them, etc...) it ended up being a very healing and special experience for me. I found peace in it.

This time around, there were uglier circumstances surrounding the death, and it's been traumatic for me. I don't mean to make my client's death all about me, but it impacts me. This person was being mistreated and used by another person (they knew it, but weren't really in a position to make decisions for themself). They stayed trapped in that situation because of an addiction that impaired their judgment. And they refused medical treatment. I knew they were very sick, and tried to get them to go to the hospital several times in the days before they died. But they wouldn't go. I talked to other staff members to try to get ideas on how to motivate them... nobody said anything but "they can take care of theirself" and "they're an adult, there is nothing you can do." They weren't able to take care of themself in the state they were in. IMO, they weren't capable of making decisions about what was best for them. But this person was an adult, and there really was nothing more I could do.

Still, I am left with guilt, and tremendous regret, and a feeling of powerlessness. Not to mention, I am sickened by the person who was mistreating them, and the ugly things that happened there. And I keep asking myself if there was something, somewhere along the way in my work with them, that I could have done to impact this situation. This life.

My job is so hard.

And here I am, applying to graduate school to become a psychologist. What will I do if I have a client someday who dies of suicide? How will I cope? I'm not sure I am cut out for this field.

SC it has been so good seeing your name around again. Sorry that you're here in this forum due to circumstances but you get what we mean....

As for being cut out for this work? This is HOW you find out whether or not this is what you want to do and are able to do. By actually going through the losses and finding out how you do cope and what areas you might need more support for getting through.

You're not the first person to enter your field w/ questions of being "cut out for it" and you certainly won't be the last.

It is good that you've posted as hopefully others w/ similar professional experiences will be able to reassure you that you're not alone in how you feel and what you're thinking.

We've had many friends work hospice and through their tales we've known much good, bad and everything in between. From that we know we're not cut out for that particular type of work.

Sorry that work brings the harsh realities of life and death into such close scrutiny.

You've accomplished so much academically and personally and been gracious enough to share much of that journey here in this community. You're quite an amazing work in progress SC!

Tks so much zh. This has been such a rough couple of days

((((hugs)))) I am sorry you are going thru this. I can only imagine how you are feeling but just know there was nothing you could do to make it better for this person. I believe no one goes til it is their time. it was this persons time hon. don't beat yourself up. God knew when it was time. it was time for the suffering to be over for them.

((((((((((((sweetcrusader))))))))))) im sorry. i'm sure though you made the quality of the days that your client had on this earth significantly better. Im sure that person is grateful for you.

I think its hard for most Ts when a client leaves or dies. If not, they are probably so disengaged that they wouldnt make a good T. But i do think you should talk about this with your supervisior. I hope you never have a week like this though.

We had 2 clients die from suicide in 40 years, they were both 19 year old girls.

If you didn't care about the death of clients, you certainly wouldn't be "cut out" for this work.

(((((Sweet Crusader)))))

<font color="purple"> ((( HUGS ))) - </font> I am sorry for the stress and guilt you are feeling from the death of another and I want to take a moment to second what others have already said...... The death was NOT your fault and there was nothing you could have done about it for the person was an adult.

Please take what time you need to relax and receive some PeAcE back into your life...... and know that the grieving of ones death comes in many ways and forms.
I know this from personal experience as I used to blame myself for my daughters death as she was handicap from birth and I was away on a much needed mental vacation many states away when she was ten years old and became ill and was rushed to the hospital..... I blamed myself for her death for I often felted that she might have survived if I had just been there for I would have noticed that some thing was wrong with her sooner than her care giver did.

.... But now I know that we all have a time to be BORN and a time to DIE and no one can change that.

((((((((Angela))))))) When I was critically ill, my psychiatrist of nearly a decade came to visit me in the hospital. Against long odds, I made it, and the first time I saw him in his office after getting out of the hospital, I thanked him for coming to see me and told him it had meant a lot to me. He said it had to him too, and that in fact, he had tried to call me a couple times after that and I didn't pick up (probably sleeping, did that a lot!), and spent an entire afternoon totally freaked out, until he had a minute to call the nurses station, that I had died and no one had told him.

You can't imagine what that meant to me. And I know you to be the same kind of loving, compassionate person. It has to be so hard to sit by and watch, heck, it was a bite when my dad was dying and there was nothing I could do. But I would stake anything on your clients knowing that you care, even if there wasn't really anything you could do. And you would be much less than human if it didn't affect you.

You're going to be a first-rate psychologist, sweetie.

SweetCrusader,

What wonderful work you do! And it’s nice to know that you’re not there just to collect a paycheck that you care about the people you work with! They’re very lucky to have you!

Of course you’re sickened by the abuser and the abuses that took place. (((((SweetCrusader))))) Thanks you for seeing the ugly side of life and seeking ways to fix them.

But don’t feel guilty. I was a CNA in a long term care facility for many years. I’ve seen death many shapes and forms. Sometimes you just have to accept the fact that some people don’t want medical treatment. My husband and I have had living wills since we were in our early twenties (long before they were legally recognized.) What it boils down to is if I break a bone, I’ll have it set, I’ll seek medical treatment for things such as sinus infections, and depression. But if it comes to a life threatening disease, cancer or heart disease I will not seek treatment, comfort measures only. I’ve seen too many people die in inches to seek that existence for myself. I’ve watched 4 Aunts, my grandmother and a cousin all battle breast cancer going through horrible horrible things only to buy themselves a couple of extra months of miserable existence.

I’m not knocking those that choose to fight and go through treatment; I was the main care giver for my grandmother and supported her decision to fight, even though she was 72 and in poor health to begin with. I’m just saying that I’ve made a conscience decision not to undergo any of those types of treatments. It’s a decision that I made nearly twenty years ago when I was young, healthy and of sound mind.

(((((((SweetCrusader)))))))
First I would like to say that it feels sooo good to hear that you actually care for your clients and not there because its "your job".

Death is difficult in any type of relationship whether family, friend, client...etc. But like others I agree that we have a time to be born and a time for our death and no matter the circumstances surrounding us when its time...its time.

Look in your heart....did you do everything in your power to help that person with the knowledge you had? By the sounds of it you did and more. Unfortunately we can not force adults to make the decisions that is best for them.

I did not have a client die but I understand the feelings of should have, could have, what if syndrome. We second guess our actions of the time but we must fall back to "we did the best we could at the time" if in deed we did do the best we could. And by the sounds of it you did.

Of course its always easier said then done....I know from experience. I still struggle with second guessing myself in a death.

Just know that you will make a wonderful psychologist if you work from the heart. It sounds like you are on the right path.
Snowy

Recently I've begun to remember how I've felt when I've been extremely ill, how "out of it" I've been and how quickly things can go (or how days just kind of fold into one another so they can't be told apart) and realize that what the person watching feels and thinks (with all their faculties) and what the person experiencing the event experiences, are very different things?

I think it is a little bit like when people over-humanize their pet's experiences with life, death, and pain. As animals, our bodies are gifted with pain and mind dullers and bad experiences are not necessarily as horrific as the person watching "imagines". That is what helps me, realizing that my imagination is giving me a harder time often then someone else's suffering. I cringe when I watch nature shows where one animal attacks another but I know the one being attacked does not feel or experience it like I do. So for other people's hard deaths or experiences, I try to think of it like lions and gazelles and remember my own actual experiences instead of letting myself get my imagination, own wishes, and feelings into there.

(((((((((((((((((((((( S C )))))))))))))))))))))))

I'm so sorry for the loss of your client. I also work in social services, but with those who are disabled. Sometimes, they too become homeless and it's a struggle to get them into a safe environment and to help keep them healthy. Most of the folks I care for have either family or court appointed guardians to make decisions for them, yet some of them are their own personal guardians.

Unless they have appointed guardians, there really is nothing one can do when they make poor choices (or what we perceive to be poor choices). All we can do is council them, support them the best way we can and help them to pick up the pieces. There are times when they make choices that are out there....and we wonder how in the world they could do that.

Many years ago I was a caretaker in a nursing home. I had my first experiences with death at that time and it was oh so hard to work through. It broke my heart when their families never came to visit, or when they didn't even want to be notified of the passing of their own family. I would be so angry!!!!

Eventually, I learned that our involvement was limited yet very important in their lives. I learned that we cannot control the inevitable....we cannot control what others do or don't do for themselves. I also learned that what we CAN do and DO do for these folks is very important to them. Even if they don't see to reason....or don't acknowledge our help or take our advice, it doesn't mean that you weren't a stable and helpful force in their life.

It's so hard to watch people we care about and try to help care for make decisions that often times are hurtful. And it's a learning process for us to work through these times when it all falls apart. Know that your heart is what makes you right for the job. It's because you care that makes the difference. Whether or not you can work through these hard things will determine if you continue in your quest or change your direction.

Wishing you much strength and love as you process through this difficulty. Please remember that you did everything you could do......and that counts for a whole lot even if it didn't turn out the way you wished it had.


sabby

(((((AAAAA))))) I know what you mean. I too have an agreement with Moggles that I do not want heroic measures, I have DNR on file with Hospital. I trust moggles to carry out my wishes if I should be incapacitated to do so.

SC, you went into that to help people, and there is one thing you can do to help yourself with this: some people refuse to help themselves and no matter what you do, they win out. With that in mind...help as help can, but know when to step away and protect yourself. Another thing that might help seeing as how you were comforted by what you did the 1st time around is to get yourself soem candles, and give yourself some quiet time to ponder and reflect and gain inner balance. Do it as often as needed...Having so sort of plan like that helps a lot. I know one person wrote a letter type reminder to herself that said just how far she would go before backing off. Your resources can go to another person when one doesnt want your help.

melanie

TRIGGER....

I worked as a psychiatric tech in a state run hospital. One case really got to me. A woman who I had been working with for some time was due to be released but was not ready. She told me she was going to commit suicide. I tried to convince the head nurse, the social worker and even met with her psychiatrist... he pointed out to me that he was the professional and better able to make the decision for her release. Not only did they release her, but they gave her enough medications for an overdose. Which she promptly took when she was discharged and as a result died.

I questioned my role as a psych tech and whether or not I was suited for the job. After much soul searching, I decided I was suited for the job--I had done everything in my power to help this person. My efforts were in vain in this particular case, but there were other times where I made a difference in people's lives. Just like you made the difference in the person whose death was peaceful--you helped bring about that peace. That is a very special gift you gave to that person. But, sometimes, some situations are out of our control.

Due to other reasons, I am no longer in the psych field...but I do miss the special moments we have when we connect with a pt/client and help them in some way...even if it is a little thing, it all makes a difference.

((((rhapsody)))))

the kindness of shared healing.

Peaceful blessings....

Perna..... a very cool perspective. Gives me a fresh understanding. New point of reference. Applies universally. Can maybe stop those imaginings from replacing one's reality. From obsessive rethinking and regretting actions and presuming another's reactions and thoughts. Thought provoking viewpoint with many applications.

As caregivers and as human beings we are challenged to balance the drive to preserve life and to honour death. We experience death when we die. Before then we are driven to preserve life and left to image death.

((((SweetCrusader)))) your name says it all.... you are a very special caregiver. No small challenges on your path. You are to be treasured.

Please take the time to treasure yourself. Life isn't very fair and kind and pretty sometimes. Spend some time seeing the beauty in you for a little bit and just remember how many lives have been refreshed and made more fair and just and pretty because of you. I celebrate your beauty today SweetCrusader. May you bath in it yourself today.

Blessings......

Sounds kind of like you are stuck between a rock and a hard place sometimes. You are probably going to have many situations in which your hands will be tied. Your coworkers seem to be a little callus about it. But maybe it is good to be a little harder, probably find middle of the road. As far as what you could have done for the patient you are referring to. I doubt you could have done more. You know your job and the laws and rules you have to abide by. It sounds to me you are very caring and did all you could do.

wow. and i see the dark side everywhere i go - so much pain, so much suffering.

i remember one time when i was visiting a friend in a state-run nursing home years ago. the stench of urine was horrible. the yellow walls became the stench of urine. food smelled horrible. staff were unemotional, uncaring. my friend's bedmate was aphasic, unable to speak, and sitting in a wheelchair, waiting. his urine soaked through the wheelchair and made a puddle underneath. our eyes met, and i didn't know what to do. i was not trained to care for invalids. i was only a visitor, but i felt i was supposed to do something. the staff had been peeking in the room, but did nothing for this poor old guy soaked in urine. as we left, i looked at the old guy once more. my heart was so heavy with guilt that i still cry over even to this day.

oh, i prayed for this guy's quick release from his physical form. walking out, i heard pleas and cries of patients wanting dignity, relief, and release. it was one of the worst place i've ever been. after i had left, the outside world was beautiful compared to that nursing home. what a nightmare it was, and i wasn't able to do anything about it.

the dark side is everywhere. it pains me to see so many people suffering like that. you're right, people make their own decisions whether to get help or not. we can only offer help when we can. and hope they take up that offer. stil, it hurts. it takes so much courage to do what you do in social services. i'm not in social services, but i come into many situtions where i see the dark side of life.

we need more people with compassion....... compassion means so much to me......... i have so much compassion, and yet, have disabilities. i live in my life along with my caring and loving husband and pets. in my dreams, i rise above my disabilities and offer my compassion. i offer it here, but yet i dream of physically offering it.

Thank you so much everyone for replying, and supporting me in this. I feel much better today, though not yet completely at peace. I think that will come in time. Today I treated myself to a massage to help me relax. I should do that more often.

I felt like a bit of a baby asking people to come respond to my thread, but I'm glad that I did. It turned out to be a good way to care for myself, too: seeking out support. All your kind words and sound advice have helped me settle down a bit.

_zh , ty for your kind words. It is nice to see a familiar name! I enjoy meeting all the newer ppl here, but I was also very glad to find that some of the same ppl I know, and who know me, are still around. It's a comfort.

ty bebop for reminding me that we are not in control of life and death. Sometimes it's easy to forget that things like this are so much bigger than the ppl whose lives are affected by them.

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If not, they are probably so disengaged that they wouldnt make a good T.

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If you didn't care about the death of clients, you certainly wouldn't be "cut out" for this work.

</div></font></blockquote><font class="post"> EV & Zorah that's a good point, though easy to forget. It's our humanity that makes the job hard, but it's also our humanity that makes us good at this line of work... and makes it worth doing. ty for the support! EV, it's good to be chatting with you again. You are such a sweetie.

Rhapsody ty SO MUCH for the hugs! I could almost feel them through the computer screen, and I needed them. I am so sorry about what happened to you and your daughter What a horrendous experience! I'm glad you've been able to find peace.

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my psychiatrist...spent an entire afternoon totally freaked out...that I had died and no one had told him.

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CB I think I know a small fraction of what he must have been feeling. I'm sure it meant a lot to you to know how much he cared. I hope my clients know that I care, even though I'm flawed and often not able to give them, or even really to know, what they need.

AAAAA ty for the hugs! I appreciate your validation... I really am so sickened to my very core by that man who took advantage of my client And so sad that they were in a position that they felt desperate enough to accept that treatment. The whole thing makes me physically nauseated. I know you have to accept people's choices about seeking treatment or not, but it's so hard when you're a caregiver...

Snowy ty for your hugs, too! </font><blockquote><div id="quote"><font class="small">Quote:</font>
First I would like to say that it feels sooo good to hear that you actually care for your clients and not there because its "your job".

</div></font></blockquote><font class="post"> I don't think anyone can do this kind of work when they don't care. There is very little reward anyway, but if you didn't genuinely care for the people you work with... it simply would not be worth it. I think that's true for almost everyone in helping professions. </font><blockquote><div id="quote"><font class="small">Quote:</font>
Look in your heart....did you do everything in your power to help that person with the knowledge you had?

</div></font></blockquote><font class="post"> I want to believe that I did... but it's so easy to second-guess myself. Thinking maybe I could have checked on her more often, found some way to motivate her to go the hospital, stayed on her case about it until she did... I don't know. Ultimately, she could not have lived. The damage was done over a decade before I met her, really. Still, it's hard, knowing that I make plenty of mistakes, to really feel sure I did all I could have. </font><blockquote><div id="quote"><font class="small">Quote:</font>
Of course its always easier said then done....I know from experience. I still struggle with second guessing myself in a death.

</div></font></blockquote><font class="post"> I'm sorry to hear that. It's an awful experience

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Recently I've begun to remember how I've felt when I've been extremely ill, how "out of it" I've been and how quickly things can go (or how days just kind of fold into one another so they can't be told apart) and realize that what the person watching feels and thinks (with all their faculties) and what the person experiencing the event experiences, are very different things?

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Wow Perna, that's an interesting way to look at things. Taking that perspective REALLY helps me. I really must thank you for opening my mind up to that. Her experience was undoubtedly very different from my end of it. I know that she had long been wishing death would come and relieve her. ty again.

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Eventually, I learned that our involvement was limited yet very important in their lives. I learned that we cannot control the inevitable....we cannot control what others do or don't do for themselves. I also learned that what we CAN do and DO do for these folks is very important to them. Even if they don't see to reason....or don't acknowledge our help or take our advice, it doesn't mean that you weren't a stable and helpful force in their life.

</div></font></blockquote><font class="post"> ty so much, Sabby, obviously you understand this experience all too well. Although I'm sorry anyone else has to go through this, it helps to feel less alone. ty for sharing.

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some people refuse to help themselves and no matter what you do, they win out

</div></font></blockquote><font class="post"> That's true of most of my clients... a harsh reality, but one I really do need to be reminded of a lot. ty Melanie (I love that name, btw). and ty even more for this reminder about self-care and limits </font><blockquote><div id="quote"><font class="small">Quote:</font>
know when to step away and protect yourself

</div></font></blockquote><font class="post">. It's much needed... I tend to neglect that too much.

DePressMe That is SOOOOO sad! I am so sorry to hear that this happened to you. I'm also impressed that you still worked at that job. Not sure I could have kept on under those circumstances. ***TRIGGER**** I once had a friend here on PC who told me she was going to kill herself, and then did. I wanted so badly to find her T and shake her awake... but couldn't find her info because my friend hadn't given me quite enough details Eventually, I received word from her husband that she had died of suicide. (She had offered to include me on the list of people to contact, which she included with her suicide note. I asked her to make sure I knew, if she did follow through. I didn't want to have to wonder. I needed closure). I tried so hard to talk her out of it, to no avail. Anyway, awful experience. I'd imagine yours was even worse, knowing your client IRL and feeling responsible for her care. So sorry you went through that!

Chocolatelover I know I've just recently started to get acquainted, but can I just say that already I love you?! My word, you write so beautifully. Your post warmed up my heart ty for your kind and lovely words. Are you a writer IRL? btw, I meant to tell you in another thread & didn't, but I'm Native as well (Chippewa). Nice to see you out there representing

ty Curley. You are probably right, that I need to find the middle ground between my coworkers' reactions and mine... I'm getting there. ty for your support and sound advice!

*hugs* all around. tks again everyone for your support!!!

Love, SC/Angela

So happy to hear you are doing well. A message.... what a good idea!! Taking good care of the caregive is very important to all your current and future clients. Good on you for taking such good self care. Yes, getting our attention to your thread was a good example for all of us to not give up when we need a helping hand. Thank you for your example.

And thank you for sharing your love with me. It means a lot to feel appreciated. I am a writer..... of sorts in real life. While I aspire to write novels and such I currently make a living writing funding proposals, policy manuals, research and planning documents for non-profit organizations and government agencies..... mostly native health, education, arts and social services related interests. I had to leave my job as a college administrator because of my illness. Now I market the skills I'd developed to help other administrators shuffle paperwork to and frow.

I want to write my mother's story someday but the time hasn't come for that yet. I write short stories and what I call poetry but probably isn't technically correct enough to really qualify as poetry but it expresses things my other writing doesn't so it speaks for me just the same.

I do enjoy writing and feel blessed that my free-flowing ramblings on the boards sometimes says something useful and inspiring for people. I feel blessed. Thank you for reminding me today.

Hope to see you drop around the native spirituality thread someday where we can talk more about your native ancestry. Cool.

Keep smiling..... it brings healing to all who see the love you share.

I'm glad you are in this world.

wickedwings You and I must have been typing at about the same time before, because I didn't see your response when I was writing mine!
I also had similar experiences to yours in the care center. My mom is a nurse and I've gone to see her at her work. I've heard people crying and smelled the smell of urine. I can't handle those places, they make me so sick. One time I was really haunted by this woman with schizophrenia. She was in bed, and it was late at night, but she was having some really scary hallucinations. I don't know what she was seeing, but she was terrified, I could tell from her voice. I felt sick inside
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wow. and i see the dark side everywhere i go - so much pain, so much suffering

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I know what you mean. I think for me, I see way too much dark everywhere I go. It makes me sometimes shrink back from my emotions and my experiences... because when I open myself up, I just seem so much more able to absorb the dark and the pain. If I could just become better at absorbing light and comfort... maybe I could feel alive more. I could definitely offer more compassion to the world if I could learn to take in more than just the darkness. Know what I mean?

ty for sharing some of your compassionate soul with me.

Chocolatelover ty for your continued support and encouragement, and ty for helping me feel more positive and peaceful this morning. & I will visit your Native thread I think it's awesome that you're a writer. When I was growing up, everyone told me that I should become a writer, but something about sharing my writings, which always contained such a big and personal part of me... really freaked me out. So I always told people that I didn't write because I wanted to publish. I said I wrote "for me." But really, it's always just been a cop-out. Though it is true I write for me, and my own healing... I would love to write more often, and share it. And I would be happy as a clam if I could write for a living!

doh ty! what a wonderful, kind thing to say!