Caring for the mentally unwell

[white knight]

The vast majority of carers do not have any training to be a carer. Most times they are simply partners that fall into that role. So how do they cope?

Unfortunately when the mentally ill are unwell we tend to drift into the "it's all about me" syndrome. This is natural as our minds fund the basic tasks daunting. Symptoms like insecurity, headaches, feelings of low self esteem and exhaustion find us with little patien f2f e even towards those reaching out to us.

Regardless of our depression and it's associated difficulties we still have an obligation towards our carer. For example: if you feel bedridden but you are capable in attending the bathroom or answering your phone or watching TV then when your carer returns home from their job, you are capable of making him/her a cuppa. A simple form if expressing gratitude. That basic task is symbolic in expression of respect.

Many carers end up with stress related issues over time. They run a household, often work, listen to our struggles and don't have anyone to listen to theirs. This can wear a carer down to the point of wanting to escape. Carers need care and appreciation, the least we can do is show it when we have the capacity to do so.

Consider respite for your carer. Encourage them to socialise even if you cannot join them and a hobby. Their contentment in those areas will create a good balance rather than a life of work and caring with no end in sight of any substantial improvement in our depressed state.

Carers need us too.

Are you a carer? Do you have ideas on how your "patient could help you?

TonyWK

[romantic_thi3f]

Hi TonyWK,

Some interesting thoughts here, as always! I'm grateful for the way you contribute to the forums and start so many sorts of conversations here.

For me, I fit into both of these boxes, as 'carer' and 'patient' although I've never seen myself as these labels.

The thing I've found that matters the most, from both sides - is communication. Sometimes I feel genuinely too drained and too tired to think that making a cuppa might be helpful, so while I agree it's respectful, this isn't within my capability at that time. What I can do though, is say 'thanks' since gratitude is an easier one for me.

As a 'carer' the biggest thing that I think I'd need is knowing what's going to be helpful - does my 'patient' want my company? To sit and talk? For advice? To be pulled outside to go for a walk? The reality is that these answers changes everyday, but hearing that can help me know I'm doing the right things.

Respite is such an important one, and I don't think we really talk about this enough. I've seen so many posts where people can feel 'selfish' and 'rude' for wanting to go out and have a nice time, but yet this is so so important.

I think it's a really tricky balance. Everyone is so different with their own experiences, and I'm looking forward to hearing back from you and reading some of the other posts here.

rt

[Elizabeth CP]

Very good points Tony.

I'm in both camps. I care for my husband who has a degenerative condition (neuro muscular) not mental illness but the principle remains the same. Sometimes it is hard to know what it due to limitations of his condition & when he just gets into the habit of expecting me to do most things because it is hard to do many things. My son has MI &I cared for him for years until he recovered enough to live a more normal life.

I'm also suffering MI myself & the stress of being a carer particularly i n the current situation in Melbourne where normal supports & opportunities are not available.

What helps the carer?

• Encourage them to have respite (Difficult at the moment in Melbourne) This as Tony mentioned means spending time going out doing something which takes your mind off your role as a carer. I'm desparately missing this!!!! Just going for a walk or similar on my own while helpful is not giving me the distration needed to take my mind off my situation.
• When encouraging them to take time for themselves give real encouragement which helps alleviate the guilt associated with taking time for themselves. Saying things like 'I really appreciate all the support you have given me (perhaps mention specific things you like) ... so I'd like to see you doing something you really enjoy. or similar
• Be honest.... Sometimes my husband will say things to avoid upsetting me or to 'make it easier for me. Un fortunately this doesn't work because I then don't know what he needs or what will help. His idea of what he thinks will help me isn't always accurate and causes problems.
• Showing appreciation & offering to help when you can is helpful

[tranzcrybe]

Hi Tony,

Thank you for this thread as it has been tossing around in my mind for some time.

Of course, there are two types of care giver:

1. Personal care attendants (PCA)
2. Partners and family members

The first, being trained and paid for service, are well versed in letting things slide whilst maintaining controlled responses (although I believe there are some undesirable exceptions...).

In the second case, the emotional connection (the very reason for being carers) can work against our objective...

In happier times, the simple 'please' and 'thank you' were standard fare, and conversations that would once have covered the gamut of events and emotions suddenly find themselves being reduced to immediate needs and self interest (not in all cases, but mine).

This really takes a toll on mood and reduces the carer to a 'service provision'. It some respects, it would be more practical to care for other's family members to negate this personal impact!

So I find the best way to navigate is to operate on two planes - when assistance is required, it is provided with objective precision to the task (not the person). This releases the expectation of any acknowledgment and minimises negative feelings; and, at other times, it is possible to enjoy the moments in between (as few as they can be) and reflect on what is.

I don't think caring can be 24/7, and securing some dedicated 'away time' every day (an hour or two) is essential for restoring perspective and balance to the demands and sacrifices made.

Regards,

t.

[white knight]

Thank you for your replies

RT- admittedly I don't have the sort of depression that dibilitate me to the point whereby I can't even make coffee. My bipolar has depression but not the same symptoms. My dysthymia abbreviated is deep sadness, again it doesn't result in mental collapse so your comments reminded me that even such a minor chore is not possible for some people some of the time.

Elizabeth- yes you are in a unique situation with your husbands limitations. Respite, I assume you've tried relevant authorities for this?

Tranzcrybe- 24/7 Caring is not sustainable long term. That "balance" is mandatory. But it's just as important the "patient" appreciate the carers need for this and doesn't take it personally. In fact the patient would be considerate encouraging regular breaks I'd suggest.

TonyWK

[tranzcrybe]

Hi Tony,

... and what would you suggest for patients who are neither appreciative nor considerate due to cognitive impairment?

t.

[white knight]

Hi t

They say "those with insight to their mental illness are the lucky ones".

I'm focussing on those people that have the capacity to appreciate their carers efforts and commitment.

Often carers work full time. Add to that commuting to and from work, sometimes shopping on the way home, Bill paying and other daily chores. What I'm suggesting here (more than anything else) is that if the patient has the ability to attend the bathroom or prepare a meal or talk in the phone etc then likely they have the ability to boil the kettle as their carer arrives home.

I'd suggest in such situations where such capacity is present, some patients choose not to make that effort and therefore place added unnecessary strain on the relationship.

TonyWK

[geoff]

Hi Tony, a good thread because some times the person who is being cared for doesn't actually know or want to know the extra pressure our carer is struggling with or not prepared to discuss their concerns because for them it can be exhausting, demanding and overwhelming.

I've been a carer a couple of times when the requests or perhaps you could call it, 'demands' that weren't urgent but still had to be done never the less straight away.

Now I have a carer and am mindful of how he is feeling and act accordingly.

Take care.

Geoff.