By Dorian Morello, HAC Managing Attorney
Back in the spring of 2018, I was almost three years into my tenure at HAC. Though still relatively new to the work, I had become proficient at the basics and was starting to feel like I was hitting my stride. It was a typically busy afternoon in the office, with the sounds of our drop-in clinic filtering down the hallway to my office in the back.
My co-worker, Kyle, who was on duty at the front desk, poked his head around the corner of my office door with a gentle, “Hey! Karl is up front and wants to speak to you. He’s in pretty bad shape. Do you have some time to talk to him?” With a pang of anxiety, I glanced at the clock. I didn’t really have time for this today, but this client (to preserve his confidentiality, let’s call him “Karl”) was a special case. I could hear his deep, loud voice (with just a hint of an east coast accent), before I saw him: a middle-aged man in his fifties, with a bald head and slightly sunburned skin after too many hours in the California sun.
Today, Karl had a gash on his head that was bleeding a little and I could smell the alcohol from several feet away. He’d had a seizure earlier that morning and hit his head on the concrete. He was expected at his doctor’s office for an appointment around the corner, but did not think he could walk there alone. Kyle and I exchanged glances – what to do? Call an ambulance?
After some back and forth with Karl – who absolutely did not want to call an ambulance – we arrived at a plan and Kyle and I began the slow two-block walk with Karl to his doctor’s office, flanking him on either side just in case he fell. I helped him check in and sat with him in the waiting room, but he tripped and fell when he got up to walk into the exam room. As the medical staff swarmed around him on the floor to triage his head laceration and assess for further injury, I wondered (not for the first or last time) how Karl was going to get through this and how on earth I was going to help him.
Supporting Our Clients Unique Communication Styles and Decision Making
I first met Karl in January 2018, when his case was transferred to me. He had been a client of HAC’s since 2012 and was on his third application for Supplemental Security Income (“SSI”) disability benefits. His past applications had been unsuccessful, but not because he did not have a legitimate claim for disability. Rather, Karl – who had been chronically homeless for more than a decade – would lose touch with us for long periods of time, making it challenging to keep him engaged with health care providers and document his disabilities.
Reviewing Karl’s file prior to our first meeting, I knew we were going to have to try to do things differently this time if we were to have any hope of achieving a positive result. Since he was over 50, I knew he had a higher likelihood of being approved for benefits, but only if we could get him into treatment and help him stay connected to his medical providers.
So, when I sat down to our first meeting together, I had hoped to discuss the need for consistent medical care and our strategy for how to get Karl approved. The meeting did not go how I expected. In response to my questions about his medical history, Karl would reply with a meandering, convoluted answer that was only tangentially responsive to the question. All of my attempts to redirect him were unsuccessful. After a solid 15 or 20 minutes of this, I gave up trying to control the interaction and just let Karl take the conversation where he wanted it to go.
We talked about Karl’s childhood, family relationships, and his experiences living on the streets. We talked about his history of alcoholism and why it had been so hard for him to stop drinking. He told me about the community he had built on the streets – the friends he camped with, cooked with, and looked out for. While there were hardships to be sure, he also spoke of the unexpected kindnesses he had experienced from total strangers. “I have nothing,” Karl told me, “…but I have everything.”
I gave up trying to control the interaction and just let my client take the conversation where he wanted it to go.
In that moment, I realized the importance of talking less and listening more. As an attorney, it is easy to take charge of client meetings and drive the agenda. However, in our two-hour discussion, Karl and I got to know each other far better than if I had directed the conversation to cover the practical questions and issues I had initially wanted to address.
Perhaps more than anything else, Karl wanted to feel heard and seen. The practical issues would be dealt with later; today was about building rapport. As our conversation began to wind down, Karl looked at me as he asked: “So, do we have a chance at winning this thing?” “Absolutely, Karl,” I said, “but I need you to keep showing up and stay engaged with me if we’re going to make it happen.”
Since Karl did not have a working phone, he agreed to stop by regularly to check in. True to his word, he started dropping by at least once per week. Sometimes we had business to discuss or forms to complete, but most of the time we spent our meetings talking about whatever he needed to talk about. A few months into this routine, he started showing up with little gifts – framed art he found on the street and fixed up, a funky beaded bracelet he had hand strung himself, or little trinkets he found and repaired or repainted to look like new.
As a non-profit delivering free legal assistance, HAC is funded to do our work primarily through contracts with Alameda County. We never accept payments from our clients or encourage them to feel that they owe us anything for our services. But, to reject these gifts – so painstakingly restored and presented with pride and gratitude – would be hurtful. So, I hung them on my wall and displayed them on my desk, a testament to the working relationship that Karl and I were building.
The Importance of Boundary Setting
As the duration and frequency of these meetings increased, my supervisor and I started to discuss the need for boundary setting. Creating and maintaining boundaries in our work is healthy and an important way to protect our time and prevent burnout. If one client is allowed to take up too much of your time and mental bandwidth, it takes away from your ability to be available to other clients who also need you.
Meeting with Karl multiple times per week was not sustainable for me. Even devoting a full hour per week to our discussions was more than I would be able to offer any of my other clients on a sustained basis. Still, I knew our frequent meetings were what had helped Karl to stay connected to us and if spending more time with him was what it took to keep him engaged, it was worth it. So, I limited our meetings to once per week and if he came by at a time that was not convenient, I would greet him warmly and ask him to come back another time.
There were also weeks when I would not see Karl at all, and I would worry. If he missed two weeks in a row, I would start calling around to the nearby hospitals or check the county jail inmate locator just in case. Once, when he had been out of touch for nearly a month, I called the county coroner and audibly sighed with relief when they confirmed that they did not have a record of anyone by his name. Karl always resurfaced from these periods of absence, and I came to trust that he would reach out one way or another when he was ready.
Though it took time, Karl and I made progress on his case. We got him connected to medical care. He consistently made it to his appointments. He did not stop drinking, but he did significantly reduce his consumption. He kept showing up and together we built the case that we needed to document his disability. He was approved for benefits in October 2018, ten months after we started working together.
At HAC, the work is more than just providing legal advice. It is a partnership, in which advocate and client must collaborate and problem solve together to reach the desired outcome.
Though initially hesitant to leave his community behind, Karl eventually allowed us to help him look for housing and after more than a decade on the street, he moved into his own apartment. When he was ready – and on his own terms – he stopped drinking. Later, he confessed to me how many times he had wanted to throw in the towel: “But, you never gave up on me. How could I let you down by giving up on myself?”
Working with Karl forever changed the way that I practice law and how I approach my work. At HAC, the work is more than just providing legal advice and representing a client’s interest in a legal matter. It is a partnership, in which advocate and client must collaborate and problem solve together to reach the desired outcome.
A one-size-fits-all approach to representing Karl would have failed. To serve him well, I had to listen to his concerns with patience, and be open and responsive to his needs without judgment. Karl’s case was unique, because he and his story are unique. The path to success in his case was different because his needs and challenges were different. Ten years into my time at HAC, I have learned that tailoring my representation to the specific needs of my client is the cornerstone of client-centered, barrier free service: you have to meet the client where they are.