Meeting the Client at Their Level

Guest Blog by Charlene Arnold, Ryan White Medical Case Manager (AIDS Care & Education program)

Medical case management is a job I take very seriously. Ensuring access to HIV care and medications is my number one priority with each client. The journey we take with each client to help them understand the importance of these goals, however, can differ greatly. This is the journey I took with Eugene (client name has been changed).

When I met Eugene, he was frail and unhealthy to the point that walking even a few steps was a challenge.  When I began working with him I learned that each month when his medicine arrived in the mail, he immediately threw it all in the dumpster.  When I asked him why, he said that the doctors had told him for years that he needs to take the medicine, but that he didn’t understand why he should take it if he didn’t feel any different afterward.

I sat down with Eugene and drew three pictures for him: first what the HIV virus looked like in his body at this time without taking his medication, and then two progressive drawings of what the virus would look like in his body after taking medication every day for one month and six months.

One month later, I learned how my words had impacted Eugene. He told me that after I explained it to him that day, he finally understood what the medication would do for him and started taking it. After only one week, Eugene was excited about how much better he felt and was resolved to continue taking his medication every day.

Over the next six months, Eugene and I continued to meet and increase his knowledge about his medication along with his medical adherence. As Eugene progressed, we were able to graph his CD4, or white blood cell count, and viral load, or how much of the virus is inside the body, results from the previous year in comparison to his improvement in the past six months. Doing what previous doctors had not and showing Eugene his progress in a picture really meant a lot to him and stood out as the foundation in which he was able to understand the benefits of being involved in his care.

Over the next six months, Eugene had his viral load decrease to become non-detectable, his CD4 raised, he could walk normally again, and said he felt like he had the energy of a teenager. Prior to his death of unrelated causes, he worked hard to keep his medical appointments and maintain his viral suppression.

I truly believe that I was able to make a difference in the way Eugene valued his health and his life by providing him with care and education, at his own level, through case management services.


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