Tag: dementia

Photo by lunamom58 (Creative Commons License)

A commonly heard phrase is that you have to let someone hit “rock bottom” before they will be willing to accept help, seek help for themselves, or make positive life changes.

The problem with “rock bottom” is that for many people, “rock bottom” is death (or in some cases, irreparable harm to health, relationships, and career). Substance abuse, remaining in abusive relationships, mental illness, dementia, gambling addiction, untreated chronic health conditions, and many other life circumstances can lead to a grisly end and premature death. In many cases, an early intervention by family, friends, and/or the state can preserve and improve quality of life for a person for many years.

The “rock bottom” trope is a convenient rationalization for friends and family members who (for many valid reasons) do not want to jump headfirst into the messy, unpredictable, time-consuming, expensive, grueling, no-results-guaranteed process of trying to help someone whose life is going off the rails. I have personally made good use of this rationalization at several points in my life.

I’m in the process of helping out someone I’m close to, who is not in a good way. I’m part of a team helping this person. It’s not the first time. It’s stressful, it takes up time, there are serious opportunity costs, but it’s worth it.

It’s almost always worth it. When you don’t help, when you turn away and cut someone off entirely, you’re killing part of yourself (and not always a small part). This post is about how you can help effectively, and protect (and possibly even enhance) your sanity in the process.

Summary: For friends and family suffering from illness or addiction issues, “rock bottom” can mean death or irreparable harm. It’s better to do something to help, rather than taking a “hands off” approach.

Some General Observations

After struggling for many years with the question of “when, and how much, should I help?”, I’ve come to some of the following conclusions:

• Some (but not all) forms of “helping” are counterproductive. While it can be an act of kindness to bail out a friend or family member and protect them from harsh consequences, doing so over and over again enables the behavior that is getting them into trouble. This cycle is called codependence. The other extreme is total disengagement: cutting someone off entirely. Some “in-between” alternative are offering support, being part of a support team, and in some cases being part of an intervention.
• You can’t control other people, and trying to do so leads to anxiety and despair, or abuse/coercion. What you can do is try to persuade them to get help and/or change their behavior, using both soft and hard tactics (intervention).
• Helping someone has real, tangible costs (time, money, emotional strain), and if you overextend yourself you risk losing your own health, sanity, means of supporting yourself, and important relationships.
• You may put in a great deal of effort, at great personal cost, and still not succeed in helping someone.
• Helping someone also has real, tangible benefits (the person might get better, you may feel like you are doing the right/moral thing, other people may consider you to be a good person, or even heroic).
• You might feel resentful if you overextend yourself. You might feel guilty if you don’t help enough. You might feel both emotions; regardless of how much you help you offer.
• You have to decide for yourself if you want to get involved, and how much. You may be negatively judged (and even suffer tangible consequences) for your decision to help or not help, depending on the social norms and values of your peers and family. There is no “right” decision; you have to figure it out for yourself.

Nobody is exempt from these decisions. At some point every person will have to make a decision about helping a family member or close friend who is in very poor shape. This is a choice 100% of us face, at some point in our lives.

Summary: There are benefits and costs to helping someone. There is no “right” decision in terms of how much you should help.

Do Something!

There is almost always something you can do to help a person in trouble. Some of the items below may seem “small,” but never underestimate the possible impact of making a “small” gesture to help someone. They may remember the act of kindness for the rest of their lives, and what seems “small” to you might actually be a huge turning point for the person you are helping.

• Learn about the condition, so you’re not flying blind.
• Tell the person that you love them and care about them (frequently).
• Acknowledge that the problem they are facing is difficult, and commend them on any positive steps they take (no matter how small).
• Research social services and programs that might be available to help the person in question.
• Let the person know about social services that are available to help them (support groups, treatment programs, healthcare, assisted living, etc.)
• Encourage the person to take advantage of any support resources that are available.
• If the person is resistant to accepting help or seeking treatment, keep suggesting it (but don’t threaten or cajole or bully; it needs to be their decision). You might get stonewalled at the first suggestion, and by the fifth they are happy to go along with whatever you suggest.
• Offer temporary assistance in the form of basic necessities (food, paying utilities, rides, etc.). This kind of helping is not necessarily codependent, especially if the person is in the process of trying to get better. Don’t offer more than you can afford (see below).

Summary: There is always something you can do to help that is within your means and abilities.

Stay Sane

When someone you love is in bad shape, you’re going to have a bad time. There’s no way around it. But there are ways to mitigate the bad feelings, to manage your stress, to preserve your sanity, and to protect your life and well-being. Here are some suggestions:

• Don’t go it alone. Build (or join) a support team, focused on help the person in trouble. If the people you ask first aren’t willing or able to provide much help, keep expanding the circle until you feel like “we’re in it together.”
• Don’t put your life on hold. Keep doing the things you love, keep meeting your responsibilities. Never go “all in” trying to help someone; you’ll just quickly deplete yourself and end up needing help yourself.
• Don’t put yourself in physical danger. Leave dangerous and highly volatile situations to the police. If you feel physically threatened, get out.
• Don’t expect a quick fix or resolution. The healing (or dying) process can take years. Provide support at a level that you can sustain, and think long-term.
• Experience and constructively express your own emotions. Don’t bottle it up; talk about it. At the same time, don’t fixate on emotions, or endlessly process your feelings with everyone you encounter to the extent that you become tedious and a downer.
• Understand and use your stress. Stress is a physical response to 1) provide energy to deal with a situation (adrenaline) and 2) seek emotional support (oxytocin). Acute stress does not have negative health consequences, especially when that stress leads to constructive action. Watch the video below for more information (there are some “association vs. causation” issues, but valuable information nonetheless).

Summary: You’re no use to anyone unless you maintain your own sanity and well-being. It’s not selfish to continue living and enjoying your own life; it’s common sense. Also — stress isn’t necessarily bad for your health.

A Final Thought

Helping someone is not an all-or-nothing question. There is always something you can do to be helpful, something that is within your means and abilities. When someone you love is in trouble, figure out what that thing is, and do it (and keep doing it).

Please feel free to share your own perspectives and experiences below.