Caring for a parent with a mental illness is a special and unique kind of caregiving. Not only are you supporting and managing your parents' emotional and psychological state, but there are other physical changes associated with aging that can add to the strain.
Jump ahead to these sections:
- Things to Remember When Caring for Your Aging Parents With Mental Illness
- How to Discuss Mental Illnesses With Aging Parents
- How to Find Assisted Living or Long-Term Care for Aging Parents With Mental Illness
Mental illness is a term that has some negative connotations. This is why some prefer ‘mental health disorders’ or ‘mental health issues’ as the more politically correct terms. Still, the term ‘mental illness’ describes so many different conditions so it is valuable to know and understand what your parents are going through based on their diagnoses.
More common mental health disorders include depression, anxiety, and bipolar disorder. Others include schizophrenia and personality disorders, like narcissistic personality disorder or BPD. There is much that we don’t know about mental illness, but what we do know can help you support your parent regardless of their diagnosis.
Things to Remember When Caring for Your Aging Parents With Mental Illness
First, there are things to remember when caring for your aging parents with mental illness that keep them stable and stress-free. The nature of mental health problems is that they fluctuate. They’re not always the same every day. For you as a caregiver, this can be highly stressful and time-consuming.
Our tips will help you build a foundation of support, develop a knowledge base, and maintain a flexible and accepting attitude. However, don’t forget to put your needs first when you feel the creeping presence of caregiver burnout.
1. Your parent is not his or her disorder
First, a mental illness is not a behavioral problem. It’s a brain disorder, and your parent can’t help what he or she feels and expresses. If your parent has depression or anxiety, he or she can’t simply ‘try harder’ or ‘pull themselves up by their bootstraps.’
It is heartbreaking to observe a parent suffering from a mental illness and not know how to respond, but do your best to show compassion. Remember that who your parent is not defined by their diagnosis.
2. You need to be your parent’s advocate
Everyone should discuss advance directives, go through the aging parent checklist, and assign powers of attorney for healthcare. It’s especially critical when you have a parent with a mental illness.
Some mental health disorders wax and wane or worsen through time. You need to have the legal authority to help manage their healthcare and finances when they can’t. It’s better to prepare today than to be underprepared tomorrow.
3. Understand their treatment options
Next, the more you know about your parent’s disease and treatment options, the better. You can better support your parent by recognizing symptoms, realizing when there might be an exacerbation of his or her illness, and knowing the treatment options.
As the saying goes, knowledge is power. Talk to their mental health provider, doctor, and online communities to find the right information.
4. Be there to provide support
Support can take many forms. You might help them find a therapist, a psychiatrist, or a support group, or simply be there for them. People with a mental illness often feel stigmatized and respond by becoming isolated and lonely.
Do what you can to facilitate social engagement, starting with immediate family and then putting together a health team that your parent can trust. Even consider a private caregiver who can offer companionship and monitor your parent’s health and well-being.
5. Ensure treatment compliance
Ensuring treatment compliance is easier said than done. Many medications used to treat mental illness can have unpleasant side effects, discouraging compliance. The other problem could be remembering to take medications.
By identifying what the challenge is, you can solve it. For side effects, ask the doctor for some alternatives. If your parent forgets to take medications, consider an automated system. The right treatment plan makes all the difference.
6. Accept instability
Some mental health disorders like depression and anxiety may respond better to treatment than psychotic disorders like schizophrenia. Similarly, psychotic disorders can result in hallucinations, delusions, and behavioral problems that are difficult to manage.
Your parent’s mental state may go through periods of stability and instability. If you accept that this is likely, you can stay calm and make better decisions about what they need when they are suffering. This is a reality of living with someone who has a mental illness, and it doesn’t have to disrupt your life.
7. There may be no ‘recovery’
For some mental health conditions, complete and long-lasting recovery may not be possible. As hard as this is to accept, it will take the pressure off of you and your parent to achieve something that may not happen.
Instead, think about managing the symptoms of mental illness and realize that there will be periods of remission and exacerbation of their condition. Strive for achievable short-term and long-term goals that set you both up for success.
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8. Take care of yourself
Lastly, the stress of taking care of a parent with mental illness can be overwhelming, frustrating, and exhausting. Caregiving can take an enormous toll on you that can cause caregiver burnout and mental health problems for you as well.
Taking care of yourself may involve having your own mental health therapist to help you navigate care for your parent. A good place to get information is the National Alliance on Mental Illness (NAMI). Also, make sure you get enough sleep, eat well and engage in activities that bring you joy. Reach out to friends and stay connected with people who can support you. Caregiver burnout is real, and you need to protect your own wellness.
How to Discuss Mental Illnesses With Aging Parents
People can be sensitive and resistant when discussing mental illness. Your parents might be defensive or deny that they have a problem. If you anticipate either of these could happen, it will help you not to overreact. Here are some suggestions for discussing mental illness with your aging parents.
9. Pick a good time to talk
It might be a good idea to pick a time when you expect everyone to remain calm. Your parents might be more receptive in the morning or later in the day. Pre-schedule a time to discuss mental illness with your parent at a time you think they will be at their best.
10. Use respectful language
Additionally, your parents might be sensitive to certain terms like ‘mental illness,’ so consider using respectful and compassionate language. For example, you could begin by talking about behaviors and emotions that you observe that are causing discomfort or suffering.
Remember to focus on how these things affect you and your concern for them, not what they’re doing wrong. This is not the time to assign blame.
11. Have solutions and resources ready
If your parents are receptive to talking about mental illness, have some solutions ready to discuss. Some ideas include scheduling time to speak with a psychiatrist or therapist. Let your parents know you are there to support them and take whatever time is necessary to get treatment and help them feel better. Have some online or written resources available that talk about mental illness and treatment options.
12. Set healthy boundaries
In cases where you have tried to help your parents and haven’t had success, you may have to set boundaries. Angry or abusive behavior is not helpful, it’s harmful. Let your parents know that you won’t tolerate inappropriate behavior. If you don't feel comfortable, let them know you will come back another day to talk with them about mental illness.
13. Get support through this process
Consider bringing a sibling with you or a trusted friend like a chaplain to discuss mental illness with your parents. You will want to be sensitive to confidentiality issues, so plan the discussion taking into account your parent's privacy.
How to Find Assisted Living or Long-Term Care for Aging Parents With Mental Illness
Finally, when the time comes to find assisted living or some other long-term care for a parent with mental illness, the decision depends on several factors. Before looking for any senior living option, including assisted living for someone with mental illness, these are some questions and suggestions on finding the best option.
How ill is your parent?
There is a difference between someone struggling with depression or anxiety and someone with a psychotic disorder. If your parent has angry outbursts, paranoia, or delusions, these behaviors could be upsetting and disruptive in a congregate senior living community. Before looking for assisted living, you may want to try and stabilize your parent first.
Is your parent compliant with treatment?
If your parent has difficulty with keeping appointments or taking their psychiatric medications, this could cause problems in assisted living. Even though assisted living communities dispense medications, anyone can refuse to take them.
Is your parent suicidal?
When someone voices that they no longer want to live, this situation needs immediate attention. Moving a parent under these circumstances could be risky. The change of a move could make things worse. With your parent’s permission, talk with your parent’s mental health provider about this issue.
Be honest about your parents’ struggles
Any assisted living community will have residents with mental health problems. Acknowledging that your parent struggles with mental illness is not necessarily a bad thing, but you will have to use your judgment as to how much information you are comfortable divulging.
On the one hand, it can help staff to be more supportive. On the other hand, it may create a stigma. If you can, talk with your parent about how they would like to handle communication with assisted living staff.
Consider all options
Try not to confine yourself to one idea of senior living for a parent with a mental illness. You could consider living with your aging parent but think through this option carefully and take an honest look at what you are taking on.
Would your parent prefer a larger community or something more intimate like a homier board and care situation with fewer residents? Perhaps a home share situation is a possibility where your parent shares housing with someone else. Or, the possibility of bringing home care caregivers to your parent’s home for additional support. Talk with your parent about what situation they feel most comfortable with.
Consider using a senior placement specialist
A senior living placement specialist is someone who knows the local senior living resources. You can be honest with a placement specialist about your parent’s situation and they may have experience working with communities that are accepting of residents with mental health issues. Ask your parent’s doctor for a referral or search online for one of these professionals.
Caring for Parents with Mental Illness
Caring for parents with mental illness can be a heartbreaking experience, but it can also bring a sense of responsibility and compassion for their suffering. If you can be prepared and informed, you can help your parent have a stable and worthwhile life.
Helping a family member navigate these end-of-life challenges as they age is also a reminder of your own future. Your health is the most important thing you have. Not only should you protect it today, but you should create a shareable plan for tomorrow.