A Mental Health Resource: Psychiatric Advance Directive

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A Mental Health Resource: Psychiatric Advance Directive

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Sign_icon.svg.medThis afternoon on Your Caregiving Journey, Támara Hill, MS, an integrative therapist, joined me for a discussion on how to help your caree with a mental illness. You can listen to our show via the player below.

Tamara described how difficult it can be to get the appropriate treatment for a caree when mental illness is involved. In some states, an individual can make decisions about treatment at 14 years of age--which means many teen-agers don't receive the help they need.

Tamara also suggested creating a psychiatric advance directive with your caree which details your caree's treatment decisions in case he or she cannot make decisions in the future. You can learn more about psychiatric advance directives at National Resource Center on Psychiatric Advance Directives. She also talked about the importance of knowing which medications your caree takes; you can learn more about the medications at drugs.com or rxlist.com.

I'd love to have Tamara on again. What questions do you have about caring for a family member or friend with a mental illness? Please share them in our comments section, below, and we'll answer them during a future show.

(You can reach Tamara at her website, Anchored in Knowledge, or via Twitter, www.twitter.com/TherapistTee.)


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ejourneys

Oh, my -- My first reaction was, what questions <i>don't</i> I have? Followed by, are any of them answerable?\r\n\r\nMy partner has told me flat out that she doesn't want to be hospitalized, since she believes that her 1982 hospitalization had resulted in the CT scan \"brain surgery\" that she says gave her MS. A cognitive neurologist has told us that her MS acts like traumatic brain injury, with major damage in her prefrontal cortex. Her regular neurologist says there's no telling where her MS ends and her mental illness (a.k.a. \"schizoaffective features\") begins. A PAD is the last thing she'd want to fill out because she doesn't believe it applies to her, and she doesn't trust it.\r\n\r\nFortunately I have POA, which I have successfully used to get her some help in the past.\r\n\r\nI have a hard time articulating my questions (although I can articulate the challenges), mainly because I've had to choose my battles and have gotten habituated to compromise. My partner takes no psychoactive or MS drugs and doesn't always take her prescriptions according to directions, instead arguing why she needs to take them <i>her</i> way. (She is still considered competent enough so that I cannot become her legal guardian. Frankly, given all that's involved, I'm not sure I want to.)\r\n\r\nAs the homeowner I am responsible for upkeep, but my partner has a hoarding problem; OCD was one of her interim diagnoses. This created considerable stress when our house was in danger of being condemned, according to a DCF inspector whom my GP had contacted on my behalf. More recently, I was able to enlist the help of our local MS support group in convincing my partner not to use her \"fifth burner\" cooking coil as a space heater. Prior, I had sought the help of our county health office, which could do nothing; I also informed our local fire department. I have been told by local police that obtaining an Ex Parte (which the DCF inspector had suggested) and/or Baker Acting (which friends have suggested) would \"do no good.\" The battles I choose to fight are those that directly involve safety issues. \r\n\r\nOver the past four years my partner has seen three therapists (for 1.5, .5, and 1 year) and one psychiatrist (briefly; it was a disaster) and currently does not see a mental health practitioner. She has also had three days and a full battery of neuropsych testing. She has been referred to our local ICCD Clubhouse, to which she does not want to and cannot be forced to go. I have been using Dr. Xavier Amador's LEAP principles to aid our communication and highly recommend his methods. http://www.leapinstitute.org/\r\n\r\nI have supported my partner fulltime since 2001. My lawyer's office has told me that I'm \"not responsible\" for her, but I don't see that I have a choice in the matter, given the consequences of not paying her bills. She does not qualify for public assistance because she (a) has her own savings, much of which I had given her (to access easily, in case anything happened to me) and that she doesn't want to touch; and (b) her MS, now believed to have started in 1982, was recently diagnosed; she has no medical records within the time frame that would have qualified her for Social Security disability. (We have now spoken with four disability lawyers on this matter.) Plus, she kept insisting she was \"fine,\" even though that lack of insight (anosognosia) is part of her disorder. I have looked into special needs trusts, which do not seem a good solution at this time, given how they work in the state of Florida.\r\n\r\nContact with my partner's family is minimal to nonexistent, due in part to abuse issues. My partner accused me of betraying her when I had contacted her family without her consent several years ago. I need to maintain a relationship of trust in order to get whatever compromises I can.\r\n\r\nSo I guess my question is: Given all of the above, what would you suggest that I haven't already tried? Do you have any questions for me that I haven't answered above? Many thanks!