When Clients Make Bad Choices

I learned this truism early on in my social work career-clients have the right to make poor choices. You can try to encourage them to make better choices, you can show them examples of healthy choices, but in the end, they are going to do what they want to do.

I had a client who was obsessed with drinking root beer. He bought so many two liter bottles of root beer that his local Safeway had to carve out extra shelf space just to hold his bottles of root beer. He lived on disability, and once his money was gone at the end of the month, that was it, there was no more. He spent his entire check on root beer, there was no money left for food.

I knew this was not going to end well. I tried desperately to intervene. Most people are surprised to learn how hard it is to put a person in a more restrictive but safer environment. You are basically in a position of trying to take away a person’s civil rights. The rule of thumb is this: is a person an imminent danger to themselves or others? The key word is “imminent”. I knew my client was slowly killing himself. But because it was happening slowly, there was nothing I could do.

It wasn’t until he ended up in the hospital that we were able to place him in a supervised group home. Sadly it was too late, his kidneys were failing. He died shortly after moving.

I had another client who was a lover of coffee. “Dan” lived in a group home, so they were able to restrict his coffee intake to one carafe a day, or four cups. If Dan wanted more coffee, he would have to find it in the community. But, Dan was broke. He tried to find churches with open doors and free flowing coffee. That worked ok for awhile, but he was wearing out his welcome. Finally, he discovered that his local grocery store, Winco, offered small cups of free coffee each morning, between 9:00 and 11:00am. Dan parked himself in front of the coffee pot, and poured himself one small cup after another. He learned to bring his own mug in order to get bigger portions. But, Winco wasn’t going to allow Dan to drink up the entire coffee budget. After several warnings, Dan was banned from Winco. As the manager was escorting Dan from the premises, Dan began to panic. Where would he go for coffee? He was in a helpless solution. He fell to the ground sobbing. He laid on the ground writhing in pain. The store manager had no choice but to call 911. When the EMT’s arrived, they were incredibly kind to Dan. On the ride to the hospital, one of them even offered Dan a cup of coffee from his personal thermos. Of course Dan said yes. In the hospital emergency room he was offered even more coffee. A light bulb went off in Dan’s head. He had found a solution to obtaining more coffee. The next day Dan was on the phone calling 911 for his new coffee connection. Of course the 911 operators are trained to see through people like Dan. The only choice left for Dan was panhandling for coffee money. The last time I saw Dan, I told him I was transitioning into a different job and would no longer be his case manager. He asked me if I would take him out for coffee for our final good bye. I told him no.

Cindy had the belief that her neighbor was making noise through their adjoining pipes to torment her. These noises never happened when I was in the apartment, so I brought her a tape recorder to record the sounds. Cindy refused to do it. Unfortunately Cindy took matters into her own hands. She started banging on her neighbor’s door when she heard his noises. His response was to call the police. Cindy’s banging weakened the integrity of the door so much that finally one day her fist went through the door. That was the last straw. Her landlord evicted her. Once someone has an eviction on their record, it’s almost impossible to find another apartment to move into. I convinced the landlord that Cindy would leave voluntarily, but even so, we could not find an apartment that accepted her small disability check. Cindy was homeless. Fortunately her mother said Cindy could move into her house. The last time I saw Cindy she and her mother were squabbling with each other. Cindy’s mother begged me to find her a new residence. Cindy’s mom lived in another state and we had to transfer her services to another mental health organization. Sadly, I never saw her again.