Area 1 - Functioning in Living Arrangements

 

John lived with his mother and father until their divorce, then briefly with his aunt, and later his mother, with whom he continues to reside.  Due to avolition and lack of motivation, John has lived with family members all his life and has not acquired the life experience necessary to live independently.  This is a problem because John is now 43 years old and expresses the desire to have a place of his own, but has no idea how to do so. (John was diagnosed with residual-type schizophrenia.)

Due to irritability and low tolerance for frustration, Carl gets into heated arguments with his housemates over minor issues such as the volume of their music (even when they’re wearing headphones) or taking too long in the shower. Last month, Carl threatened to kill one of his housemates because he failed to takes his clothes out of the washing machine and put them in the dryer quickly enough. Carl’s R&B manager reports that Carl will have to move out if this continues.

Due mood lability and paranoia, Damon has loud arguments with people in and around his apartment complex. Police have been called by neighbors on three occasions. Now that Damon’s lease is nearing expiration, his landlord has informed him that he is no longer welcome in the apartment complex and needs to move out.

Due to paranoia, delusional thoughts, and impulsivity, Rebecca asks men she does not know well to move into her apartment with her and protect her from "government spies that want to kill me." These men are often strangers that Rebecca has only known for a few hours or days. This is a problem because Rebecca is jeopardizing her personal safety by having strangers live with her, and is also putting her housing certificate at risk by violating Shelter + Care rules.

Due to paranoia and delusional thinking, Peter frequently becomes convinced that something terrible is going to happen to him unless he moves to another city. As a result, he gives 30-day notice to his R&B owner and informs her that he’ll be moving out. When the day comes that Peter is supposed to move, he tells his R&B owner that he’s changed his mind and will be staying. This creates a great deal of confusion for Peter’s R&B manager, who must interview prospective residents and plan for Peter’s departure every time he gives notice. If this continues, Peter’s R&B manager reports that she will no longer allow him to rescind his 30-day notices and will evict him from her R&B.

Due to delusions, command-type hallucinations, and his belief that he can “hear” the thoughts of others, Richard has engaged in several unprovoked assaults on other residents at his R&B whom he believed where having "evil thoughts" about him. On one occasion he set a housemate's bed on fire, and on another occasion he punched a sleeping roommate in the face. This type of behavior has resulted in Richard being arrested once and exited from four R&Bs over the last 2 years.

Due to auditory hallucinations, paranoid delusions, and poor impulse control, Steven becomes convinced that persons around him are plotting against him or trying to harm him in some way. He then becomes aggressive and confrontational, and gets into verbal and physical altercations with his R&B manager and housemates. This leads to his being exited from the home. Over the last 6 months, Steven has lived in 2 different R&Bs and has been homeless twice. His longest stay at either of the R&Bs was 7 weeks.

Due to symptoms of OCD, Keith becomes anxious and irritable if things around him are not in order. He gets into frequent arguments with his housemates over the cleanliness and orderliness of shared areas of the house. When Keith has a manic episode, he becomes hyperverbal, grandiose, and demanding. His housemates object to being ordered around, and fights often occur. Keith has been exited from two R&Bs over the last 6 months, and arguing with housemates or managers was a major factor in both evictions.

Due to symptoms of anxiety and OCD, Amanda has a persistent impulse to collect and store objects with little to no value. As a result, she quickly fills any living space she has with items she has picked up on the streets or taken from trash dumpsters. This is a problem because it creates a fire hazard and is not permitted by most R&Bs, apartments, or housing programs. As a result of her hoarding, Amanda has been kicked out of three R&Bs over the past year and is not a good candidate for Shelter + Care. She is currently living on the street, which puts her at risk of being assaulted or robbed.

Darren lives in an apartment subsidized by Shelter + Care. Due to paranoia, delusions, and disorganized thinking, Darren has difficulty managing the responsibilities of living alone. He recently failed a Shelter + Care inspection because his apartment was unkempt and infested with roaches, and because he had no working electricity or gas. These were shut off because Darren had not made arrangements to have his utility bills paid. Darren has no telephone and says he’s afraid to tell his apartment manager about problems he’s having with his plumbing for fear that something bad might happen to him.

Robert has Shelter+Care and lives in an apartment in Garden Grove. He gets along well with his neighbors, although his interaction with them is limited. Impairment in this area is related to Robert’s dependence on others. Due to paranoia, excessive worry, and fear of making a mistake, Robert does not attempt to resolve housing issues himself, even when they are routine and well within his ability to manage. For example, instead of telling the manager his kitchen sink was stopped up, Robert simply quit washing dishes and threw many plates and eating utensils in the trash.

Ben is currently homeless. He has lived in 2 different R&Bs over the last 6 months, but due to paranoia and irritability, he frequently accused roommates of stealing from him, plotting against him, and trying to sabotage his recovery. As a result, he got into heated arguments on a regular basis and was eventually asked to leave. This is a problem because living on the streets exposes Ben to the risk of being assaulted and victimized.

Due to irritability and difficulty regulating her emotions, Pauline has frequent arguments with her roommate/boyfriend. She has received several warnings about the noise and fighting. This is a problem because it puts her at risk of being evicted and becoming homeless.

Solomon has resided in a S+C apartment for the past year. Due to anxiety, hypervigilance, and heightened sensitivity to sound, Solomon reports feeling uncomfortable at his apartment complex and dissatisfied with the manager’s lack of responsiveness in reducing “excessive noise” created by other residents. This is an issue because Solomon feels he may need to relocate, but finds the change associated with moving very anxiety-provoking.

 

 

All PHI has been de-identified per HIPAA Privacy Rule