Responsibilities of the Patient

Over the months, K and I have had a number of discussions regarding the responsibility of someone, who is ill. During the throes of illness, it becomes difficult to know when a caretaker should give up and when they should continue to fight. All activities become overwhelming and difficult instead of being able to easily move from one thing to another. One of the most prominent memories that I retain from K's illness is a feeling of complete exhaustion. Much of that time is in a memory haze or fog. I believe that the fog is my body and mind protecting itself from the pain that the memories bring.

But let me return to my topic. At what point does a caretaker have the responsibility to say, "I can no longer do this."?

I strongly believe that the patient has the responsibility to do as much as they can to get better. Some days that may mean that they are only able to swallow their medication when it is handed to them. Other days, it may mean going to a therapist or calling the doctor. The responsibilities should be determined by the patient's illness and limitations. However, my key message is that the patient has a responsibility to try and get better.

If there is no effort on the part of the patient, how can the caretaker keep going? Mental illness is not a disease that can be cured by outside forces. It is necessary to have external involvement to make it possible for the patient to address their problems. For example, someone needs to be on medication before they can begin to change their habits to reduce the likelihood of another episode. But, in the end, the changes have to come from the patient.

I believe that there are firm guidelines as well regarding the role of caretaker. I'm not willing to remain in any situation when my safety may be compromised or I am subject to either emotional or physical abuse. There was also a point when I had to admit that it was time for me to get help. K's illness was having a profound effect on my ability to function and I was not longer able to go it alone. The third thing is really the idea that the patient has to continue to help themselves.

L's Caretaker Tenants

1. Never accept any type of threat to personal safety from the patient.
2. Never accept physical or emotional abuse from the patient.
3. Realize that you cannot do it all and accept help, either personal or professional.
4. The patient must be willing to help his- or herself.

These are tenants that K agrees with. She feels that I have no obligation to remain if she's unwilling to do anything for herself. We are fortunate in that we didn't have children in the house or other obligations throughout the period of K's episode. Instead, we were able to focus on her health. Other obligations change the mix and make it more difficult to focus on the one, who is mentally ill.

These are really some thoughts that have been swirling in my head over the past few months and it seemed to be the time to put them out here.


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