Saturday, July 30, 2011

Planning for the Future With Mental Illness in the Family

Note: This is a guest post from my husband. 

Chaos and unpredictability are not new to the human experience.  In the Old Testament, God's people experienced a series of battles, famines, enslavements and other seemingly insurmountable circumstances.  In each story God came through for his people but only after they had suffered and nearly lost hope.  In the modern world we need look no further than the evening news to see chaos of all forms reported in detail.  Here in modern America we usually have problems of lesser scope than the Old Testament or the Third World. Our typical problems are still substantial enough however to make us lose sleep.  Possibilities of unemployment, under performing 401k retirement plans, health concerns and on and on occupy the minds of a typical family.

Then we take up the case of the family with a mentally ill member or two. Those special family members are more prone than the general population to volatility in their employment, their relationships and their overall health. They often lack motivation or insights sufficient to succeed at the more challenging tasks of adult life.  Mistakes that some others would learn from and move on may be repeated time and time again.  Addiction and substance abuse challenge a high percentage of the mentally ill community.

So how should we as caregivers and stewards of our mentally ill family members manage without either  falling into despair, or, as some have done, over committing ourselves in unhealthy ways? I've found some success with three concepts:  Prayer, Stewardship, and Margin.  You may be thinking Hey wait a minute. This is a Christian blog. I expected to see words like prayer and stewardship but what is this margin business? Sounds like something from an MBA program.

Prayer and faith are staples of the Christian life. God loves you. He loves your mentally ill family member. And as hard as his plan may be to understand some days, we can all count on the fact that he is working things out for our well being in eternity.

Stewardship sounds simple enough.  None of us wants our family member living under a bridge or on the street regardless of what he or she may have done or not done.  Most of us will go to great lengths to see that our mentally ill family member has as good a life as possible.

This is where the margin concept becomes important.  As caregivers, it can be tempting to make bold and generous commitments of our time and resources toset things rightfor our family member.  Where this is likely to fall apart is when all the time and resources have been committed only to have a new problem crop up.  I propose that as responsible caregivers we need to hold in reserve some time and some resources as margin against the next unforeseen event.  Remember I started this article with commentary on chaos and unpredictability and the propensity of our family members to have more than the typical amount of both.

So what does margin look like where the rubber meets the road?  It may be more helpful to pose these ideas as a series of questions to consider since each family is different.

         Have you planned your family budget so you can cover a year or so of doctor and medication costs in the event your loved ones health insurance or government benefits are disrupted?

         For your loved ones transportation needs, would a basic cell phone and a bus or subway pass provide the basics for now?

         Would the use of your spare room or help with basic rent keep them safe without the risk or long-term commitment associated with buying a house or condo?

         Would a group session be sufficient or perhaps even more beneficial than one-on-one counseling?

         Would a couple of semesters at community college make a good low risk way to see how they can perform in a college environment?

         What community or support group resources may be available to my loved one in lieu of fee for service providers.

         Have you talked to an attorney about setting up a trust to ensure the resources you leave behind when you die are managed for your loved one's benefit and according to these same principles?

         What do you need to do to keep yourself well and strong so you are in good shape if your loved one has a crisis?

Remember the idea here is not to be as cheap as possible but rather to provide stewardship of basic needs while retaining some margin in the time and resource budget to account for changing circumstances. If it sounds a little to you like a survival plan that is because it is a lot like a survival plan.  One for you and your loved one.

Prayer, stewardship, and margin. Please let us know if you have ideas or examples of creative ways to cover you loved ones basic needs while still holding a little in reserve for thatrainy day.

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