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Managing Mental Health Declines

Posted on May 31, 2023 by Hal Edghill

Funny how caregiving issues have turned topical. Mental health declines used to be a topic of conversation only in certain circles. Now it is a the topic receiving lots of attention – and rightly so.

The pandemic has added emotional challenges to our repertoire of personal growth events. All of us have confronted lifestyle changes, as well as encountered an incessant rant from the media about conforming to prescribed thoughts and behaviors we did not have before the crisis. With all of this change and hysteria, it is no wonder that psychological grounding has suffered for many.

Expressions

Mental Health declines are common in the aging community. From degenerative changes in brain function to physical aging and drug interactions, older individuals commonly exhibit changes in behavior and judgement. Hence, the necessary changes in living circumstances (i.e., assisted living) and the addition of physical helpers (caregivers!) to keep these affected individuals safe.

What has been unique about recent events is the increase in the expression of mental health issues in the public. As once socially acceptable coping strategies (specific social communities) have fallen out of political favor, younger individuals are exhibiting struggles with their responses to current events.

Egged on by a segment of the media that is happy to promote unhealthy thoughts and actions in a vulnerable population, we have some very public displays of emotional disquiet. The lack of approved treatment measures, as well as attempts to normalize these unstable behaviors by the same groups who created the problem, individuals are alienated from their surrounding communities.

Losing a sense of belonging can have profound effects on how individuals cope with life.

Age is Just a Number

With some high-profile individuals garnering headlines over their age and mental acuity, the unspoken message is that age and declines in mental health are on a spectrum. The politicians in the news demonstrate changes in their health statuses and are not indicators of their chronological age.

Certain ages do not automatically equate with mental feebleness.

Many of my role models have been quite to the contrary.

I once treated an 85-year-old gentleman for some minor back pain. As I took his history, he shared with me in an agitated fashion that he had recently had shoulder surgery and while he continued to participate in robust physical activities, he could no longer waterski.

I can only hope I will have such physical limitation complaints by the time I reach that age.

Implementing Solutions

person in black pants and black shoes sitting on brown wooden chair — Photo by cottonbro studio on Pexels.com

In approaching individuals with mental health issues (which may be us too!), finding and employing sound solutions is essential.

As with any problem, acknowledging that there is a problem is the first step. A parent is not just being forgetful when they cannot remember which house they live in. The same goes for a younger individual experiencing a loss of emotional control. Facing the hard truth is the first task.

When an individual becomes impaired, they are impaired. No amount of wishful thinking changes that.

The second step is to assess the circumstances. Family comes to mind first as sources of support, but as I have shared before, do not get your hopes up. Families’ willingness to respond are variable.

Next, identify professional resources. The person may need qualified evaluation and treatment. Do not make everything about money. Professional care is always costly, but it is also very worth the investment.

Lastly, rinse and repeat.

Mental health situations require the addition of professional help. Your caregiving expertise continues to be a vital part of a person’s care. Sometimes it takes a team to care for the one person.

The important thing is to continue to be there for that person.

“It is naively assumed that the fact that the majority of people share certain ideas and feelings proves the validity of these ideas and feelings. Nothing could be further from the truth. Consensual validation as such has no bearing on reason or mental health.”
― Erich Fromm

When Death Smiled and I Smiled Back

Posted on September 30, 2022 by Hal Edghill

In a caregiving relationship, there is more to the story than just helping another person with their problems. There is an intimacy between people that comes with this sort of relationship and there is something more. There is that ominous something else in the room. Something only glimpsed out of the corner of the eye. Something that feels like the proverbial elephant in the room that bears down on conversation but no one wishes to acknowledge.

There is always death.

There, I said it.

Death makes us squirm. That end-of-life certainty that everyone avoids. Death is far more noticeable when helping someone as they progress through their final journey. It was probably there all the time. We just tumbled to the fact under these unusual circumstances.

Funny thing, though. As the loved one approaches their demise, death becomes a much more familiar entity. It is always underfoot but not obtrusive. Death becomes almost friendly.

woman with white hair and black paint on face — Photo by imustbedead on Pexels.com

Don’t Be Morbid

As we have seen in society in recent years, the intrusiveness of death can really put the whammy on some people’s behavior. Fear does funny things to people.

From officials of society, education and business doing a really good Chicken Little imitation, to a broader incivility problem among the public, the presence of a disease that has a solid track record of killing people (COVID-19) just made things real. Fear on a world wide scale.

Our views on death and the dying process are as varied as we are as people. Religion obviously has a profound effect as funerals and burials are a regular part of religious practice.

As a preacher’s kid, I was around a lot of older individuals in the church. They had a habit of dying naturally over the years, prompting the need to attend ceremonies that are ostensibly designed to send off the dead but in reality are only for the living. All that ritual and flowery language failed to inform me.

woman s face — Photo by Elīna Arāja on Pexels.com

Close but Not Quite

As a teen, when people who were close to me began to die, I responded in a fashion like what we have seen in society in recent years. I just lost it.

Dr. Eli s abeth Kubler-Ross had it right. The first response to grief is denial. I could find no reason to connect the death of a friend with any sense of normalcy or natural process. (Besides, as a teenager, I was going to beat the odds and live forever.)

It is from these experiences of adolescence that I recognize so much of the weird behavior around us today. Having once gone crazy over death, I know that neighborhood. Am I ever glad I moved out.

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Death Upon Arrival

With the start of my caregiver adventures, I was older and felt a difference that I ascribed to finally being more of a grown-up. I made sure to distract myself with the business affairs at hand. As I had done as a grad student, I just kept my head down and feet moving.

Eventually I had to pause to catch my breath and I realized things had changed. I had changed. Dad and his situation had not changed but I was finally seeing a something that I had spent loads of energy and years trying to ignore.

This was not something I had sought out but there it was, staring me in the face. It felt like those dreams or movie scenes where you see the charging demon descending upon you. You close you eyes to wait for the inevitable contact – but it doesn’t come. When you open your eyes, the vicious creature that you thought was going to devour you is calmly sitting next to you on the sofa.

That was my adult introduction to death.

I recognized death for the first time and blinked. When I opened my eyes and my heart to the experience, I began to understand the world and my self without the menace we place on our view of a final passing.

The truth, well my truth, is that I am developing an understanding of death. I have seen it in others, and I have found a connection to it in me. Don’t get me wrong – I have absolutely no interest in becoming more intimately acquainted with dying in the immediate future, but I have a fundamental understanding what I will someday be up against.

You too.

Death is that quiet passenger in the back seat of the car. Full of potential changes but choosing to quietly go along as I journey through my life. The uncertainty of what lies beyond will always be there but having seen others make the transition with this same passenger in tow (and the peace and acceptance that many of them demonstrated at the end), I may be arriving in Dr. Kubler-Ross’ final stage of Acceptance.

I like to think so, anyway.

“Just as when we come into the world, when we die we are afraid of the unknown. But the fear is something from within us that has nothing to do with reality. Dying is like being born: just a change”
― Isabel Allende

Grief Management 101

Posted on February 28, 2022 by Hal Edghill

When I lost my dad, I had plenty of warning.

His decline over the preceding years. The hospitalizations, Assisted Living, his mental decline, and family dramas all clearly pointed to his exit. Yet when the time came, I felt hollow and bereft. The grieving process had begun, and I was starting at square one once again.

As emotional reactions go, grief is likely one of the strongest we are ever going to experience. Debilitating and liberating at the same time, grief takes us through several emotional responses but there is a certain amount of repetition of the experience with each loss. This doesn’t make things any easier, but it does make them familiar.

Familiarity helps.

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Grief is a Natural Experience

Since we revisit grief on a regular basis throughout Life, learning to manage our grief is a good skill to develop. Management begins with understanding the experience.

Immersion in the grieving process is a natural experience. Learning to accept the feelings of loss and their aftermath gets us emotionally farther down the road and healing. Life does go on but while in the grieving process, give yourself a vacation. Life will be right where you left it when you return.

Talking with others helps a whole lot too. Grief is a common experience of being human that all share in. No one who lives a lifetime escapes loss. It equalizes all of us and it connects all of us no matter what dividing lines society or politics overlays on us.

The best connections I have had with other during the grieving process, whether theirs or mine, have been to just be present with the other person. This is not a time for platitudes of how the loved one is “now in a better place”, or advice as to how to “get back to living”, but to just be with the person and allow them to lead to time. Their talking about their loss or complete silence are both acceptable. The important thing is the nonverbal and nonjudgmental presence with the person.

Communication between people is more than just words.

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Letting Go is Difficult

Denial of loss is a common response. Hoping against an unpleasant reality is a common human trait (look at many of our responses to the current pandemic) but the harsh truth is that reality wins out in the end. Always. Acceptance of loss means letting go of what we wanted – not an easy choice for any of us.

I had the luxury and the curse of losing Dad to dementia over time. We had some terrific heart-to-heart conversations at the beginning of the end. I got to say the things that I am grateful I did.

“No regrets” is the way to go.

By the end of his life, he had lost much of those conversations but that was okay. I was the caretaker now and those conversations were safe.

Family members who tried so hard to make the reality of those days conform to what they thought they should be, had a harder road to travel. Whether is was cultural machismo that was going to somehow save the day because they said so, or the one who had always been “Daddy’s Darling” wanting what she wanted, all were disappointed in their denial of the reality at hand.

Grief is expressed in any number of ways, but I have not yet seen denial as a healthy response that leads to healing and growing.

Then again, the comfort that denial brings may provide respite from the hurt and can be used as a step in a process of healing. Just don’t forget to move on.

Expect to Grow

Loss has given me so much.

Sounds strange, eh?

Coming out the back end of grief is a different person than went in the front. If you put in the work needed to process loss, profound and subtle changes occur. I like to think of it as growing up.

After such a gloomy time as grief, discovering and embracing joy becomes a new talent. I suspect that things that can provide such joy, from enjoying moments in Nature to interactions with other people, have always been available. We just needed to develop the ability to recognize the joy.

Seeing life through a more pragmatic lens provides greater satisfaction with our lives. Acknowledging that we can’t get everything we want, takes a burden off efforts to keep flying in the face of reality and trying to accomplish the truly impossible.

After seeing others make their way through life and transition to the other side (whatever that means to you), provides a great set of examples to learn from. I have seen those who railed against the inevitable and spared no expense in fighting the inevitable before the inevitable occurred. I have also seen those who accepted the circumstances and moved on in a much gentler fashion.

The grieving process was the same in both instances, but they have cued me into ways in which I would like leave. That preparation begins now. How I choose to live my life has been instructed by the way I have said goodbye to others who have left.

Growing up isn’t what I expected but I think this is better than I had imagined. Funny how that works out.

“Grief can destroy you –or focus you. You can decide a relationship was all for nothing if it had to end in death, and you alone. OR you can realize that every moment of it had more meaning than you dared to recognize at the time, so much meaning it scared you, so you just lived, just took for granted the love and laughter of each day, and didn’t allow yourself to consider the sacredness of it. But when it’s over and you’re alone, you begin to see that it wasn’t just a movie and a dinner together, not just watching sunsets together, not just scrubbing a floor or washing dishes together or worrying over a high electric bill. It was everything, it was the why of life, every event and precious moment of it. The answer to the mystery of existence is the love you shared sometimes so imperfectly, and when the loss wakes you to the deeper beauty of it, to the sanctity of it, you can’t get off your knees for a long time, you’re driven to your knees not by the weight of the loss but by gratitude for what preceded the loss. And the ache is always there, but one day not the emptiness, because to nurture the emptiness, to take solace in it, is to disrespect the gift of life.”

― Dean Koontz

Pass It On

Posted on March 31, 2021 by Hal Edghill

positive senior man in eyeglasses showing thumbs up and looking at camera

Sometimes personal growth comes from caregiving. Sometimes this growth is from the effects of loss.
And sometimes it is just all of the above.

We’ve all had our heroes. Attitudes and personality traits that I once admired in my childhood mentors have been coming back to me in funny ways. Those role models all had a strength of conviction that appeared to be born of innate wisdom. Confident, knowledgeable, and comfortable in their skin.

As my path continues to stretch out in front of (and behind!) me, I am discovering that such wisdom might not have been so innate after all. Maybe, sometimes, heroes were just the product of weathering personal storms.

Grieving Friend

This is a story about responding to a problem in a way that is not right or wrong. It is about power but especially not about power over others. It is about healing.

A friend recently suffered a great personal loss and has been struggling, as we all do in such circumstances. He began to act out some very uncharacteristic anger that I recognized. (A “been there, done that” moment.)

Folks nearby seemed to be waiting for the retaliation in kind from me but I just moved on with the conversation. (Responding to anger with anger is a true zero-sum event.) Judging from their reactions, I guess I disappointed the spectators in the group.

A day or two later, I had the opportunity to talk privately with the same person. When I said I wanted to discuss something personal, his face fell and he looked like he was expecting a major dressing-down.

All I did was offer support in this time of troubling adjustment to his loss. No judgements or even comments about what had happened earlier. I understood his anger but how do you tell someone you understand what they are going through when you know that such a statement can never be completely true?

You don’t.

I offered my strength and support. That was all I had that he could use.

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Arrival Where?

I continue to be surprised at where I am, having traveled such a non-linear path to who I currently am. But I guess that’s the way it can happen.

I keep catching glimpses of myself through the reflection of memory and start to recognize in me the attributes I always admired of those few individuals to whom I looked up. From my perspective, who I am is not the least bit heroic, much less that strong.

I do however have a conviction born of having lived and worked through trials. I survived and grew. My friend doesn’t know he recently joined this same club, though he will. He is gaining the wisdom that comes from loss. We use it to help heal those who are in need.

I trust my friend will take what is offered and remember just one thing. To pass it on

“She recognized that that is how friendships begin: one person reveals a moment of strangeness, and the other person decides just to listen and not exploit it.”
― Meg Wolitzer

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