Moral opinions: mentally ill, not caring for

[summer]

I did not know a goood title so sorry if my title is not the best.

 

I was out with some friends recently (playing PoKeNo) and this topic was brought up and I have really been thinking about it. While I am not in the situation now, I figure many of us will face this at some point.

 

Basically, say you have an adult who has mental issues..anything from dementia, alzheimers, bipolar disorder, severe depression, etc...and they have struggled with it for a long time so it does not seem as if it will get better (some disorders will most definitely get worse). And that adult does not take good care of themselves physically and as a result, repeatedly get sick, to the point where they could die if not going to the ER and such. Does there ever come a point where it is ok, or even gracious, to just let the person go?

 

By this I mean, someone gets sick because they keep drinking to an oblivion because they have severe depression or bipolar or schizophrenia or alcholism or something (I am not exactly familiar with all these things, these are just some of the situations brought up) and the person can overdrink to the point of needing medical care, or...another case....maybe the person refuses to take antibiotics when sick and ends up even sicker (one of the ladies has a mother who has dementia who will refuse medical care and try to not take her meds so they force them). There are many other possible case scenarios....and remember, it has to be a mental issue that the person who has it really really does not want any sort of treatment or to get better. Does there come a point where the family members or whomever is close to them, should let them go?

 

Another case scenario brought up was a man who is a bipolar alcoholic who does not want any sort of care at all, and will get so sick when he has any sort of infection (minor stuff like UTIs) but will not go to the doctor at all so it has gotten bad enough before to require calling an ambulance..he says he doesn't care if he lives and that is why he won't get treatment.

 

So...what do you think? It is a little more clear cut when the terminal illness is physical. My grandfather had cancer and they said chemo and radiation therapy was only extending his life but he had the cancer badly enough that he could not possibly get over it. He decided to terminate treatments (he said they really hurt) but he was also not in the right mind. His mind was affected enough that he would lay in bed stripping his clothes writhing about in pain (apparently, stripping is normal at the end stages we were told). Grandmother could have forced the treatment but she chose to let him go. But that was pretty clear cut. What do you do when it is a mental issue?

 

I am unsure of the answer. On one hand, if they are that far gone mentally that they will not care for themselves and they have a very low quality of life..maybe letting them go is the right thing. On the other hand, there is this certain obligation to care for the ones we love. But on that third hand (we must be a tripus) if we really love them, won't we let them go?

 

What does everyone else think?

[Twinmom]

I can speak to this from experience because I have a brother in law with severe bipolar disorder and who has done just as you said. I spent the last year literally putting everything aside to try to save his life, while he worked equally as hard at letting it go. It was tough, a real mess.

 

Here's what I learned from it: mentally ill folks in general lack the capacity to decide what is best for their health. I'm not talking about the average, mildly depressed person here or even the seriously mentally ill who are stable on meds...I'm speaking of the truly, deeply, seriously mentally ill who are in crisis, off meds, or whatever. It is up to those of us who love them to step in and help them. They will die if we don't. At the height of his illness, BIL did things to his health that he would NEVER have done in his right mind. Once we got him stabilized (and it was quite the job getting him there!), he stated repeatedly how grateful he was to all of us for not letting him go. As it is, he's lost the use of one of his arms and nearly lost his life to diabetes...it will take him years to recover, if he ever fully does. Yet, in his right mind, he's grateful to be alive.

 

I think that there are those who make a decision to live a certain way, and there are cases where a person has to be left to his or her own devices. We can't always intervene...at a point, it can become codependent and destructive to ourselves. However, if a person is truly mentally ill and lacks capacity, I believe we have an obligation to step in.

 

HTH.

[Twinmom]

To add one caveat...don't think I'd feel the same way if BIL had terminal cancer or the like in addition to his mental state. If he was very sick but still taking his bipolar meds and chose to end tx, I'd support him. If he was off his meds and lacking capacity, I'd let the severity of his illness and prognosis guide my decision.

[dragons in the flower bed]

Basically, say you have an adult who has mental issues..anything from dementia, alzheimers, bipolar disorder, severe depression, etc...and they have struggled with it for a long time so it does not seem as if it will get better (some disorders will most definitely get worse). And that adult does not take good care of themselves physically and as a result, repeatedly get sick, to the point where they could die if not going to the ER and such. Does there ever come a point where it is ok, or even gracious, to just let the person go?

 

At one point in my life, I had to say yes. But I was a kid, myself, and I couldn't take care of him. I gambled on his life, but my instincts were right: as soon as I stopped covering his butt, he began to care for himself.

 

I think because of that I went a little bit too far in the let-them-go direction. Five years later, my oldest friend (who was clinically depressed) hung herself. All of my boundaries, my high and mighty ideas about what was her responsibility and what was mine, were exposed as so much b.s. once I found myself wishing for a door into hell so I could walk down and offer everything I have of worth to Hades in exchange for being allowed to bring her back.

 

I've been a devoted rescuer ever since. The way I figure it is: every person I love is valuable to me. I have a stake in the continued existence of every person I love. Therefore, I should remain willing to put in the work to keep them around. My partner likes to quote Disney's Lilo on this point: "Ohana means family, and family means no one gets left behind. Or forgotten."

[HSMom2One]

One of my adult ds has Bipolar Disorder and has had three very, very serious episodes in the past nine years. As his mom I have to say that I would run to the ends of the earth to save his life. Thankfully we have a family that pulls together when there is a crisis, but two years ago we had two very ill members of the family at the same time so we had to split up to cover all bases. I had to advocate and watch over my son all alone or he would have died for sure. It was constantly tiring and emotional for six solid months, but we survived. It was the hardest six months of my entire life, but I'd do it again (and again) to save him if I had to.

 

I subscribe to the ohana statement. We are family!

 

Blessings,

Lucinda