limits of care

touch drawing card

credit – deborah koff-chapin

I never used to question whether there might be limits to the care one could offer another. It is in my nature to give, or find out how to arrange for, the care that is needed.

The limits that usually materialize are time and money. And personal boundaries.

But what if the care that is needed – demanded, wanted, required – is beyond what exists? I continue to work on the outside with a seriously functionally impaired inmate. Yes – ‘outside’ AND ‘inmate.’ You’ve already met this woman who has learned, in the absence of the care she feels she needs, to work the ‘system’ to its limits. Today she is back inside.

She has created her own bizarre system of care. At night, she does not feel safe. Despite a roommate who shares her apartment for the purpose of helping her feel safe. At night. That’s when she goes into a tailspin by calling crisis numbers, friends, pastors, anyone she has ever known who will still pick up the phone. Her appetites include an endless need for attention and, apparently, for change. When she does not show up for a scheduled meeting with me, I eventually figure out she’s back in jail.

Today she called needing socks, which are not provided inside. In the same breath, she described how she plans to make bail ahead of her court date because there’s an event outside she wants to attend.

It sounds as if she has delusions of manipulating the system at will. In practice, she essentially does. After all, she got herself arrested three times in early March alone for trespass. She refused to leave the ER once they determined she had no acute need for hospitalization. But she knew what she wanted. Who would have thought one wanted to go to jail to be safe?

The sad but real limit to care in her case is this: we no longer have long-term institutional settings staffed and equipped to care for someone like her. So she creates her own system that leads to jail. At least there she’ll get basic care – shelter, food. And if she’s lucky, someone to bring her socks.

2 thoughts on “limits of care

  1. alvaradofrazier says:

    This brings to mind several instances when I’d have young women sabotage their parole dates so they could remain inside. The known was better than the unknown, the routine better than not knowing what was waiting ‘out there.’ For those with dual diagnosis leaving prison was scarier than coming inside. There is a great need for 6-12 month transitional care.


    • sarahwbartlett says:

      Six-to-12 month transitional care – what a dream! Complete with all the services and opportunities to go into the world with baby steps and a strong network at hand. Surely that would be more effective in actually making successful transitions – not to mention the huge overall cost savings. It galls me that for the cost of holding a woman in prison for one year – without needed services or programs, in many instances – she could be getting a college education. Not an even trade; just saying . . . Thanks as always for your thoughtful comments and insights, Ms Frazier!!!


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