“If you are a caregiver…YOU need to TAKE CARE…of yourself!!!”

From our experience, you can get buried in so many other issues for your loved ones that you yourself could end up potentially depressed and feeling out of control. This won’t help your loved one so make sure to take care of yourself.
Also, for those of you dealing with a new situation with a loved one or if you’re feeling like you’re going nowhere fast, we have a few tips below from our personal experiences.  These aren’t tips from doctors or other sources: only our experiences.  Always seek the help of a professional for yourself and your loved one first.  We hope these can help you to navigate your role as caregiver. 

First and Foremost:  Make sure to take care of the following first if you haven’t already:

1. Ask Youself and a Healthcare Professional:  Are they a “harm to themselves or others?” - This will be asked and it’s the most important first step.  Be honest.  If they’ve said anything about suicide, hurting someone, having weapons or anything similar tell the facility you may have taken them to immediately or dial 911 and explain the situation to get professional help.  There are special teams trained for situations just like this to get them to a hospital where they are evaluated, treated and get help for a period of time depending on their issues to start a treatment plan.  This is NOT “One Flew Over the Cookoo’s Nest”.  This is your neighborhood hospital that has a special area now to treat these issues in most cases.
2. Get the right help - First, if you haven’t already, get your loved one to a psychiatrist and/or a doctor if they are not in a crisis mode as above.  If you feel they are not acting like themselves and its gone beyond anything you can handle or its gone on for a long time, get them professional help.  They may want to just talk to you but if they aren’t getting better, you’re not really helping them in the long run.  Certain types of mental health issues will worsen if not treated and then will take longer and longer to recover!   If neither of you can afford one, we have many clinics listed on the resource page that will help you identify how to get assistance from state or local clinics or how to find a sliding scale doctor.

Tips on how to get help for a loved one, options to consider and what to expect:

1. Hospitals - If they won’t go via ambulance and you can’t wait for a clinic... go with them gently.  Go all the way into the doctor’s areas and let everyone know you are their “advocate”.  Sign papers so you can talk to anyone in touch with your loved one.
2. Doctors in Clinics - If your only choice was to go to a clinic, you will most likely be told it will be a while before treatment,  since funding for hospitals, resources and urgent care facilities are sometimes limited .  If you’re reading this, you probably don’t have a while to wait and watch things get worse.  It’s important to give the social worker or evaluator the full story of all issues going on.  Encourage a faster timeframe strongly and explain the urgency.   They may refer you to the hospital at that point,  and you should go if needed.
3. Sign Release Papers so you can get information for follow-up - Wherever  you go, sign release papers stating you are able to talk to any and all personnel about your loved one.  This is really important so that you can be aware of meds and/or changes they will need and appointments.  The new laws make it so you can’t talk to anyone even if you are a relative unless a release is signed.  It’s very important since many times they may not pay attention to these details and  you will have to help them.
4. Getting them to Appointments - We all calendar our appointments and go to them but most likely your loved one won’t or won’t remember.  Add it to your calendar.  Call them and remind them.  Better yet, take the time to go with them to that appointment and inside the doctor’s office.  Make time for a lunch visit or some other mini event with it to make it pleasant.
5. First meeting with the Dr./Psychiatrist - I highly recommend going into that meeting with them for at least the first half.  Let them know you are giving your observations.  Many patients don’t even realize something’s wrong and can “present” themselves as very together just inside that room.  Go in and explain in detail some incidents.  If your loved one gets mad so be it: it will at least display to the doctor what is really going on.  They only have about a half hour to make a decision on their mental health:  you can help give a clearer picture.  Make sure you understand the results of the appointment.  If there is a medication prescribed, ask what it is…why it is being prescribed…and what possible side effects it might cause. Also, if at all possible, bring along any existing medications, let them know if your loved one has substance abuse issues or any other specific behavior that might be helpful to the Doctor.
6. Disability - If your loved one has been out of work, can’t seem to take care of themselves or has other serious living issues, meet with a social worker to go over the case.  It could be that they will need extra help to manage their lives and you should investigate this option with a social worker. 
7. Housing - Homelessness for a loved one is extremely difficult.  Keep in mind that many feel that it is a way to live without the boundaries we all face in the “regular world”.  There are resources out there and it’s a difficult thing to maneuver but check with your local clinic and ask to have someone work with you.  Depending on the severity there are programs for other items like water, electricity and other bill assistance. 
8. Substance Abuse - Self-medication occurs in such a high percentage of cases it is just good to ask if they are using anything like alcohol or drugs.  Look and ask for special doctors or groups if you don’t have the money where they deal with “co-occurring disorders” meaning they subject is dealing with not just mental illness but substances too.  For those that haven’t been treated, drugs and alcohol are their mental health drug of choice. 
9. Conservatorship - This is an option when you have a doctor that agrees that your loved one is not functioning on their own and you should be making decisions and helping them with other issues as well.  This may be needed when recovery from break-downs or substance abuse are needed, but they refuse and get worse.  It’s not an easy process but it’s been known to help immensely. 

Caregiver Tips for the Caregiver:

1. Take care of yourself - Ok, you’ve heard this no matter what kind of situation you’re in, but caregivers usually throw these out the window first to make room for what they need to do to take care of their loved ones:
   Eat right, get a lot of rest and exercise..... schedule it in your calendar.  Don’t put it off because it will catch up on you fast with the extra stress you will be under in managing another’s life details whether short or long-term.  Many of us see the loved ones start to look better and better while the caregiver starts to look worse and worse!!
2. Get help for yourself if needed - Watching a loved one go through crisis can sometimes bring up a lot of past conflict and amplify current issues.  It’s important to take a strong look at yourself and see if you need to talk to someone yourself.  Don’t wait until you feel like everything is out of control.  Go talk casually to someone and see what comes up.  People in our group were shocked at things that brought up past anger and frustrations.  Take care of them and get help to feel at your best mentally too.
3. Join a Support Group - There are many groups that can tell you more about what is really happening behind your loved one’s issues.  It can be very frustrating and you may want to say things like “snap out of it”, “you can get through this” or “no I don’t think the tree is talking to you!”.... but to the loved one these things are real.  Understanding more about their plight is healthy for you.  There are many support groups and NAMI (www.nami.org ) has a course that can give you very in-depth information.
4. “You Time” - This is the little bit of time we all have that once there’s a crisis it’s usually the first thing to go.  Schedule it and commit to it whatever it is.  It will help you keep balance which is a real issue.  Psychologically if your only experience with the world is conflict and caretaking and work your perception will change to a life of drudgery and not one where you are living a healthy life.  Scheduling a special “me time” even if it’s sitting alone, reading or whatever is important.
5. Set Realistic Expectations - Sure this sounds simple enough right?  We may know how to do this in our own lives for the most part but add in the chaos of caring for someone with a mental illness and it just doesn’t work the same. 
6. Try to enjoy the little victories - This sounds like another simple one, but it is important.  The reason it’s important is that most of these mental health issues don’t just get “cured”.  They have many ups and downs.  It’s important to enjoy the moments when things are peaceful and in a good place.  Because it may not last and you will at least have those good moments to think back to AND to express to your loved one.  We have found that reminding your loved one of how peaceful or happy they were when perhaps they were taking their medications can help encourage them to get back on them.
7. Communication -This is one that needs some work many times.  You may be used to communicating with your loved one in a way that is condescending since you may not have understood what they were really going through.  Learning more about what they are going through can help you to communicate in ways that are productive.  An angry bipolar that is in a manic stage can sometimes say very mean things which may make you want to engage in an angry way.  It’s natural and no one should be abused.  You just have to find that balance that works for both of you and helps you stay productive.  Sometimes a sense of humor can also help to diffuse situations, but exit and try to get someone else involved if it escalates.  If you have a particularly volatile loved one, go and speak to a professional for advice.  Oftentimes loved ones can end up being targets of attacks so take it seriously and get help, or speak to their doctors.
8. Get in touch with your sense of humor - As mentioned above, sometimes humor can help both you and your loved one.  It can also take away the pain and frustration associated with the loved one.  Often we start to look at them as the “problem” in your life and not the mother, brother, sister or whomever.  Reminising about past fun times, or something funny they said or a funny story can soften the blows of the issues surrounding both of you.

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