Tag Archives: coping

The Death of a Service User

When a homeless person dies, not only do friends and family members of that person become affected, but so can front line workers. Richard Lakeman, Mim Fox, and R. Dean Wright and colleagues conducted separate research on how service workers are affected by deaths of people who are homeless. Lakeman tells us that service workers can encounter deaths frequently (2011:928). Wright et al., suggest that service workers may feel self-doubt and might ask questions such as “Did I do enough?” or “Was there something that I could have done differently?” (1999:245). Fox explains how social workers see the deaths and continually feel powerless (2005:196).

I volunteered with two different agencies a while back, doing street outreach for homeless youth. Luckily, I never did experience the death of someone I knew directly, probably because I had only volunteered for a few months. However, I did counsel some youths who had friends pass away on the streets. At this point, I was out of school from Child and Youth Work, so that support system was no longer available. There were people that I volunteered with and the service providers who understood, but many of them were dealing with their own problems. This was a tough time for me personally, as I was finding myself burning out and nowhere to turn for help.

stress

 

Maslach et al., define burnout as “…emotional exhaustion, depersonalisation, and reduced personal accomplishment” (1997:192). I know this feeling all too well. You simply feel as though you no longer have the mental capacity to handle day to day situations, let alone help anyone else.  There is a sense that things will never change and you can even start doubting yourself and your abilities.

Research shows that depersonalisation can happen when a service provider loses someone. Even the terminology we use at times is depersonalising. “Service user” and “Client” are ways to distance our professional selves from those we serve. Wright et al., found that “[a] common, although dysfunctional, response among staff to the multiple losses they experience is professional distancing. They may deny any feelings for the deceased and detach from other guests so as not to be ‘affected’ or place themselves in jeopardy of suffering more loss” (1999:244). Lakeman says workers may expect more deaths in the future and that a feeling of uselessness may occur (2011:933).

When front line workers don’t get the services they need after dealing with many deaths in the community they may suffer from intrusive memories or experience anxiety, wondering who will be next (Lakeman 2011:942).

burnout

 

What can be done?

Few organizations have the capacity or resources to fully attend to the needs of service workers (Wright et al., 1999:247). Lakeman suggests that a positive response to the death of a service user includes the ability to preserve the memory of that person, like a picture on a wall (2011:942).

Some organizations have their own ways of dealing with the loss of people they work with. Lakeman learned that some service providers would do things like “…convening a special group, planting a tree, or having a sing-along…lighting a candle or spending a few moments in quiet reflection at some point during the working day” (2011:937). Wright et al., made a similar finding that staff may hold a moment of silence, or have an annual service to recognize those homeless people who have died throughout the year (1999:241).

candles

 

An organization here in Toronto has a Reflections Memorial Project that helps everyone grieve and remember those who have passed away. The project was inspired by the need for people to process loss and encourage healing through art, expression and memorial.

Firstly, they have an ongoing scrapbook, where photos, artwork and writings are added when someone dies. The book can be looked at by service providers whenever they want to remember. Secondly, they have a wall mounted display which is magnetic.  Small circular buttons are placed on the wall that contain initials, artwork, photos or writings that each represent someone who has passed away. The display is hanging on the wall in a visible space in the organization. Lastly, they hold a Reflections Memorial Event in the fall every year, symbolic of change, transition and reflection. Poems are read, candles are lit and the memory book is available for others to read.

These are just some great suggestions for how other organizations may approach remembering people who have died while homeless.  These rituals are a way for service providers to mark death, which “…serves a therapeutic function in that it helps people to experience emotions and is part of properly framing death. Marking death is undertaken in highly personal and private ways as well as collectively through formal mechanisms such as memorial services and funerals” (Lakeman 2011:936).

Working with socially excluded people is a tough job. It requires resiliency, stamina, support, compassion and coping strategies in order to keep going. Much respect goes out to those who continue to serve others despite the hardships, your efforts are greatly appreciated.

 

References

Fox, M. (2005). To die destitute today: What are the implications for social work?. Australian Social Work, 58(2), 188-198.

Lakeman, R. (2011). How homeless sector workers deal with the death of service users: a grounded theory study. Death studies, 35(10), 925-948.

Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach burnout inventory. Evaluating stress: A book of resources, 3, 191-218.

Wright, R. D., Wright, S. E., & Jones, A. (1999). Dying homeless but not alone: Social support roles of staff members in homeless shelters. Illness, Crisis & Loss, 7(3), 233-251.