Managing the Behaviour of a loved one

How do we differentiate between genuine inability and laziness of a patient?

• Here, genuine inability refers to mental resistance to act. When the patient has symptoms like a low level of self-confidence, they interpret the outer environment as hostile and try to keep away from the stress. This defense mechanism may result in postponement of action or denial of ability. Insecure feelings can be lowered by encouraging the patient to work in part acts. Each successful smaller act then boosts the patient’s confidence.

• When the patient does some work and denies others, the carer must observe the patterns to identify whether it is laziness or lack of engagement. One should not pressure the patient to do tasks that may be challenging. It may sabotage recovery. Allow the patient to engage in jobs of interest gradually.

How do I manage inappropriate behavior?

Caregivers need to become assertive in their dialogues with the patient. One need not go into detailed discussions but convey the following with genuine concern.

• • Explain why an action is appropriate and how it is relevant,

  • Explain the consequences of inappropriate behavior, including the disappointment and distress of the caregiver.

  • Explain that selecting an action and its implications are the patient's sole responsibility.

How can I manage unreasonable demands?

• Be assertive

• Give clear-cut ideas about what is possible and not, along with reasons.

• Discuss the issue with other family members or carers. Do not discuss the problem in the patient's presence. Agree on a course of action or method of response.

• There should be consistency in discipline among all family members and carers.

• Be firm in implementing any decision reached jointly.

Can patients continue their daily routine when symptom-free but still on medicines?

• As a caregiver, you can observe and check the patient's abilities. Do they have what it takes to do the proposed task (studies/job)? If they are up to the mark, get an opinion from the treating doctor.

• One needs to imagine and discuss task scenarios with the patient as a part of mental preparation.

• Set up a support system within the task venue to the extent possible

• Endorse the patient for all the efforts, big or small, regardless of results.

How can a carer help a patient gain confidence?

• Despite having been a caregiver when the patient was battling mental illness, the carer must keep in mind that the patient is a separate entity and mental illness was a phase. The carer cannot be in constant charge of the patient’s wellness. Once the patient starts anew with his life after the mental illness, the carer must hand over responsibilities to the patient as per their confidence level. However, the carer must also be vigilant as a silent and keen observer of the patient.

• When the patient comes out of mental illness, the carer can make them aware of their symptoms and the general situations where they need to reach out. For example, the carer can offer phone call help in such situations. Genuine concern of the carer can make positive changes in recovery.