Kerri Ast, MA, LPCC, NCC By Life Care Counseling October 28: 2018 Loving someone who lives with a mental illness, addiction, and/or Alzheimer’s/dementia Kerri Ast, MA, LPCC, NCC By Life Care Counseling October 28: 2018

This affects all of us, especially the family: time to start talking! Statistics: Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from mild, moderate, and even severe impairment. In 2016, there were an estimated 44.7 million adults aged 18 or older in the United States with AMI. This number represented 18.3% of all U.S. adults. This affects all of us, especially the family: time to start talking! Taken from www.nimh.nih.gov National Institute of Mental Health

Common emotions you may experience: Anger/resentment: doctors, family, loved one, system Guilt: especially as a parent Fear: of unknown, future, suicide, finances Embarrassment/Shame/Stigma Grief: relationship changes, unmet expectations Despair/Hopelessness Anxiety/Worry Exhaustion/Stress Goal: Acceptance

Practical things you can do: Get a diagnosis; educate yourself; treatment options Help facilitate and procure services: intervention, disability, Medicaid, case management, housing, food, transportation. There are good people available to help. You can be allowed to communicate with care team with permission. Medical power of attorney, guardianship? Be prepared with a list of phone numbers, medication list, diagnosis, history

Boundaries: Guidelines, rules, or limits that a person creates to identify reasonable, safe and permissible ways for other people to behave towards them and how they will respond when someone passes those limits. Requires wisdom, seldom black and white, nor always right or wrong. Sometimes a decision is the best “bad” option out of several bad choices. Boundaries are individual choices based on values, situation. Different for every one. Boundaries are loving. We let the good in, the bad out. It is hard, guilt is strong, get support.

Boundaries: Decide what you will and will not do; communicate that to your loved one, and family. An illness does not excuse behavior, but it can help us to understand it. Do not tolerate harmful behavior; do not take it personally. Speak the truth gently; accept their free will to choose. This is hard! Behavior may get worse, expect resistance. Call 911 if suicidal (see handout). Accept changes in the relationship once boundaries are put in place.

Self-Care: Don’t forget about the other people in your life. Live your life! Offer grace to loved one, self-empathy Count your blessings: focus on loved ones strengths, not illness. Use your faith as your strength

Self-Care: Resources: knowledge is power, knowing resources available in your community can relieve anxiety Be prepared for a crisis (see handout) Get emotional support from others (groups, friends, family, counselor) Be honest about your situation, while respecting loved one’s privacy Deal with your own emotions, seek counseling if necessary.

Communication: Listen and Validate “I can see that you are very sad today” Do not argue with their reality Communicate your love and concern for them Ask: “how can I help you right now?” “what might help you remember to take your medication?” Do not be afraid to ask about suicidal thoughts Encourage them to find own solutions; take ownership of mental health (if they are able); you may need to be more active in a acute crisis.

Resources that can help: www.lifecarecounseling.life Alanon, Celebrate Recovery SAMSHA: substance abuse support Alzheimer’s support National Alliance of Mentally Ill (NAMI) Caregiver.org Colorado Crisis Services: free local support NIMH: National Institute of Mental Health

Serenity prayer: “Lord grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”