The Changing Needs of Clients – Yes, We Make Housecalls

Ayan, Lana, and Sam show samples for the upcoming art project.

The changing needs of clients mean more work outside the office for Bruce House staff.

We often speak of the changing needs of people impacted by HIV.  Most of the time we are speaking of slow, gradual changes over years.  Sometimes, however, we see a rapid shift in the requests we receive. Bruce House has always worked to adapt to these changes but doing so comes with challenges.

We asked Ayan Jama (Client Health Management Coordinator), Lana Duss (Supported Independent Living Program Coordinator) and Sam Taylor (Rehabilitation and Episodic Supportive Transition Program Coordinator) what has changed in their daily work. 

What has changed?

Lana:  In the past 18 months, we are seeing more and more people aging with HIV.  This can come with more health concerns and reduced mobility.  This makes it hard for people to get out or navigate public transit, particularly in winter.

Sam: Without a Transition House Program at Bruce House, we have more clients in supported living facilities, from respite to palliative care.

Ayan: The government’s “housing first” approach sometimes misses the supports needed to keep the individual housed or allow them to have a good quality of life. We need more appropriate options for long-term care.

Lana: For some people with mental health issues, the system simply does not provide enough trained staff.

Ayan: Due to issues such as HIV stigma and past trauma, some clients do not feel safe entering an AIDS service organization—they may avoid coming to our office. Seeing them at home may be the only means to help them.

What are the needs?

Sam:  I do a lot of shopping, mostly groceries, for people who have neither the means nor skills to order online and have no one to help them.   Even for clients who live somewhere with meals provided, they still require basic personal items, snacks, etc.

Lana: Taking clients to doctors’ appointments, medical tests, and procedures is increasingly common. Sometimes this is due to mobility issues or the cost of travel—and transit is not always an option depending on the type of procedure. Clients may also need someone with them for support, to help them interpret medical information, or advocate for them. People are now often released from hospital with little support, from setting up after-care to assistance with personal shopping for basic necessities during recovery.  Often other social services are unable to meet these needs.    

Ayan: Social support and wellness checks are also very important, and while they can sometimes be done by phone, seeing someone in person is better.  Long forms like the intake for a new client also need to be done in person, so if the client cannot come to us, we go to them.

Sam: Many clients face significant financial barriers—some have as little as $400/month to meet all their needs once rent is paid.   This means that the cost of cabs and transit may be prohibitive.  Bruce House helps with taxi chits and bus vouchers when those are available [our client assistance fund is largely dependent on donations].

What does this mean for you, as program staff?

Sam: Busy, busy, busy!  It’s trying to free up the time… there are clients on my list that I feel guilty for not checking in on in a long time.  I wish I had the ability to call them more often, I may have to take the time from home.  My schedule is filled with work for clients who have constant, urgent need.  Travel times in this weather have been a huge problem.  I just hate saying “no” but can’t always meet all requests.

Ayan: I sometimes feel guilty doing work that is not directly helping clients, but that work is also important and part of my time, such as program development and supporting community initiatives. I may have to use the phone more, rather than visit in person, to open up some time.

Lana:  I also need time to interact with the housing and service providers we work with.  I need to be in the office more to help clients here too.  Finding and training more volunteers in the Buddy Program will help, but that takes time and resourced: those volunteers need to be trained, matched with clients, and introduced to them.

As part of our 2018-2021 Strategic Plan Bruce House has committed to review our existing programs, assessing the needs of clients, and finding the best ways forward to meeting these changing and growing needs. 

If you would like to help, please consider making a donation or volunteering for our Buddy Program.