Tag Archives: Mental Illness

Video: Who Cares — A Film for Carers

Who Cares — A Film for Carers is a short film highlighting how mental illness can effect family members who often become carers themselves. It can be overwhelming and these films want to spread the word that carers are not alone in their struggles. Each section is about half a dozen minutes.

  • Part One — The film begins with a mother whose son is at university and begins to have signs of a mental disorder. From then on, Fiona enters the world of the family caregiver for the mentally ill.
  • Part Two — Adam, 26, finds his wife becoming different woman. At first he thinks Sandra has the ‘flu.
  • Part Three — Seventeen year old Rachel observes that her mother’s depression was a long time in the making.
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The Friday File — Advice for Newcomers to Bi-Polar Caregiving

The caregivers of bi-polar parents that I know, and with whom I correspond, are generally helpful people. You wouldn’t know it from this blog but I do try to be helpful, considerate and enthusiastic and generous. Like any other feature of  your personality, it can be made to work against you.

This is a critical tip for newcomers which is why I am making it a stand-alone item despite being very short. I don’t want this to get lost in one of my lengthier articles.

Let us say that your bi-polar parent has been in the hospital for some reason, either for an episode, or because of a medical procedure. If the hospital calls on Friday afternoon, and says your bi-polar parent is ready to be released but you need to stay with her or him for the next 48-72 hours. Well, you have your own family, your own life and work situation.

  • The call will come from a blocked number after lunch
  • You will be presented with a statement implying your consent: ‘Your parent is ready for discharge. You’ll need to stay with your parent for 48 to 72 hours ….’

I understand if readers of this web site think I am hard-hearted but believe it or not, I do try to be a helpful soul but being the giving people we caregivers tend to be, you’ll say yes before realizing it. Look, I realize that governments need to cut back these days because times are hard and that I’m writing from the comparative luxury of a country with national medicine (sorry to our American friends) but ethically, given everything else you do, you’re allowed to use the ‘no’ word.

Practical advice:

If your bi-polar parent is in the hospital for a comparatively minor procedure, and it is Friday, expect a call from a blocked number from someone very, very, very, very well-practiced at getting you to agree to having you take your bi-polar parent into your home for observation. If you say ‘no’ the social agency officers will find a place for your parent. It may be in an irregular ward, but they’ll find a spot, don’t worry.

What are the ethics of this? Look, you are under no obligation to say yes to something astonishingly disruptive just because someone asks. Given everything else that I do, the ‘no’ word is probably one I should use more often.  I remember once I was giving a speech one evening and I got the call. They wanted to know what the speech was about and where I was giving it.

Prepare for the call on Friday afternoon. I am not you and you are not me so we’ll each handle it differently.

  1. If it’s not possible, use the ‘No’ word but be prepared to be on the phone with someone who has a lot of experience in getting you to agree. Have your answers ready. A white lie may be needed here (kids with the gastro, you’re on a trip and are already 400 km away, tell them you’re in the hospital yourself with the Lurgi, or you live in a tree.) Be warned, they’ve heard them all so have your explanation ready. Note that I say explanation and not lie. A legitimate reason to say no is exactly that.
  2. If you cannot say no, you just don’t have the personality for it, on Friday afternoon, do not answer the telephone if an unfamiliar or blocked number rings.
  3. Visit the hospital late at night after the discharge office is closed, after 8:30 p.m. is usually safe.
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Article: The burden on informal caregivers of people with bi-polar disorder

This article, from Bipolar Disorders, reviews the burden on informal caregivers of people with bi-polar disorder.

Abstract:

Caregivers of people with bipolar disorder may experience a different quality of burden than is seen with other illnesses. A better understanding of their concerns is necessary to improve the training of professionals working with this population. Conceptualizing caregiver burden in a conventional medical framework may not focus enough on issues important to caregivers, or on cultural and social issues. Perceptions of caregivers about bipolar disorder have important effects on levels of burden experienced. It is important to distinguish between caregiversÕ experience of this subjective burden and objective burden as externally appraised. CaregiversÕ previous experiences of health services may influence their beliefs about the illness.

Caregiver burden is associated with depression, which affects patient recovery by adding stress to the living environment. The objective burden on caregivers of patients with bipolar disorder is significantly higher than for those with unipolar depression. Caregivers of bipolar patients have high levels of expressed emotion, including critical, hostile, or over-involved attitudes. Several measures have been developed to assess the care burden of patients with depressive disorders, but may be inappropriate for patients with bipolar disorder because of its cyclical nature and the stresses arising from manic and hypomanic episodes. Inter-episode symptoms pose another potential of burden in patients with bipolar disorder. Subsyndromal depressive symptoms are common in this phase of the illness, resulting in severe and widespread impairment of function. Despite the importance of assessing caregiver burden in bipolar disorder, relevant literature is scarce. The specific effects of mania and inter- episode symptoms have not been adequately addressed, and there is a lack of existing measures to assess burden adequately, causing uncertainty regarding how best to structure family interventions to optimally alleviate burden.

The relatively few studies into caregiver burden in bipolar disorder may largely reflect experiences in the US Veterans Affairs health service, but the findings may be limited in their generalizability. Nevertheless, available data suggest that caregiver burden is high and largely neglected in bipolar disorder. Clinically effective, well-targeted and practically viable interventions are needed. However, services cannot be enhanced on a rational basis without an improved understanding and capacity to measure and target caregiver burden the impact of any change in services be evaluated.

Authors

Ogilvie AD, Morant N, Goodwin GM.
Bipolar Disord 2005: 7 (Suppl. 1): 25–32. a Blackwell Munksgaard, 2005

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Article: Caregiving for the mentally ill starts in adolescence

A national survey of 1000 Australians has revealed the vast majority of relatives of people with a mental illness are suffering physically and mentally.  The report by the Wesley Mission has found many carers, especially young carers, are reluctant to ask for help because of the stigma associated with both caregiving and mental illness. The report is called Keeping Minds Well: Caring Until It Hurts.

You can also hear a quick interview from the Australian Broadcasting Corporation’s AM with Tony Eastley about this survey. According to their web site, the Wesley Mission  provides ministry to  ‘the vulnerable and marginalised. It includes the lonely, hurt and fragile, the homeless, mentally ill, aged, disabled, unemployed.’

Australian Broadcasting Corporation AM with Tony Eastley

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