Anna Suswillo, one of our Asset Coaches discusses how people like Martin struggle to navigate through a complex system of homelessness, care and health.
Whenever I pass the high street early on a weekday, I always half-expect to see Martin sitting there, waiting to meet me. Usually complaining that he had been there half an hour already – he was always early. Always so early, in fact, that I often had to warn him not to be when it was raining or very cold. He could be conscientious to a fault.
Our meetings would always be short, in line with his attention span. We would laugh about different DVDs or the TV shows he watched religiously. He would tell me which superhero comic he had taken out at the library that week (and which he would be sure to return on time). Sometimes, he would tell me proudly of an achievement, such as putting on weight – one of his regular goals from the doctor.
Over the time we worked together, I gathered the snippets he would offer me. I knew his jokes, what he found funny, what enraged him, and that he put on a suit and visited his parents at the cemetery every week. He took no sugar in his coffee because he was, always, “sweet enough” and he loved fish and chips on a Thursday. I knew he liked to walk his friend’s dog. I knew he had a sister, with whom he had fallen out of touch, but who he always recalled warmly and wished they spent time together.
We focused on the things that he liked. He enjoyed making models out of matchsticks. We provided a personal budget for the necessary supplies, and we went to buy splints, baselwood, and glue. I remember the confidence with which Martin talked with the shopkeeper about his plans and techniques; I had not seen him do so anywhere else. He confided he hoped that modelling would mean he would feel less inclined to go out drinking. He attended cooking lessons, which he loved, and he would enthusiastically call me to tell me what they had made.
Did Martin have complex needs, or was he stuck in a complex system?
Life has not been kind to Martin. He had suffered several losses – from his mother’s death which had made him homeless; to his fiancée; and then his best friend.
Martin was struggling to navigate his way through homelessness, care and health systems and was also physically unwell. It was suspected that he had a learning disability – by both ourselves, his doctor and previous workers – but as he was in his fifties, and had never been officially documented as having one, he was not entitled to support.
Martin lived with his mother until his late forties. He had never paid rent, never managed bills and never cooked for himself. He did, however, pride himself on his cleaning and regular laundry. He struggled with reading and writing and comprehension of complicated matters. He had no concept of the value of money. He wanted to be in a supported living scheme, because he didn’t feel safe on his own. But he was not eligible for the support he wanted, and in his distress and confusion, he was self-medicating.
We approached the social care services, but the reply we received depicted a very different man to the one I knew. He was identified as “an alcoholic, who did not want to engage with abstinence services”. The tone painted the picture of a contrary man who refused to make things easy, even though he was one of the most engaged and reliable people I worked with. Everything hinged on his alcohol use, and his ‘choice’ to continue drinking. Any chance of a learning disability was disregarded in the face of his drinking. The reasoning was that so long as he stopped drinking, he would be able to receive help – “stop drinking; then we can talk”. There was no consideration of the fact that Martin was drinking to cope with an unstable situation that he could not understand.
Pieces came together, only too late
Martin died in the ICU, following an ongoing and complicated lung problem. He did not want to go to hospital. He did not want to give up smoking and he had remained drinking down by the river. In his mind, if drinking and smoking made him feel good, while everything else made him feel bad, why on earth would he stop? For Martin, drinking was not a ‘choice’, but a survival tool. Alcohol and cigarettes were steadfast companions that brought him drinking buddies, warmth and moments of positive feelings. Although our work together had begun to offer feelings of friendship, warmth and well-being from a source besides alcohol, I was just too late.
While he was in the ICU his sister was found. It was a bittersweet moment that she was, finally, there – but he was unconscious and would not wake up. I was grateful then, that I was a person who had vivid, human memories of the time I had worked with him. I knew his jokes, what he found funny, what enraged him and that he put on a suit and visited his parents at the cemetery every week.
As a worker, the death of someone you work with is devastating, and it is hard not to question yourself and to feel blame.
Martin was let down by a broken system: a system that slammed doors shut tohim, because he did not meet the desired criteria of ‘sick enough’ or ‘well enough’; a system that could not see him as an individual rather than a shopping list of problems.