Planning for family members with mental health issues can be difficult. Knowing what the person can handle on their own and what they need assistance with can be hard to figure out. It can also be a moving target, changing year to year or even week to week in some cases.
Often, the person has been getting by on their own. Sometimes with the help of a parent or sibling. But what if that parent or sibling dies leaving them to go it alone. More distant family members may sense that something is not right, but they may not know what to do. And they may feel like they have no legal obligation to do anything. The fear of doing the wrong thing may keep people away.
There is also the mental health issue to contend with, which many people may not understand especially if the person has not been diagnosed. It is common for someone to exhibit signs of mental illness but never receive a diagnosis or treatment. Family members are left on the sidelines guessing what the diagnosis is and how to help.
If you have someone in your family struggling with these issues, here are five ways that you can provide support.
• Offer a “lifeline.” Don’t assume that someone else is helping your friend or family member. Every person should be treated with dignity and respect and should receive help when they need it. You can ask the person what help they need and if they have anyone who you can call for them. If they have no one, you can reach out to a family member that you know or to the local mental health department or council on aging, if appropriate.
• Get the legal documents in order. If the person has capacity and someone has been identified to assist him or her, a lawyer can draft the necessary documents to give the named person the necessary legal authority to make financial and health care decisions. Typically, this would include a durable power of attorney, health care proxy and HIPAA waiver.
• Consider a guardianship. If the person lacks the necessary capacity to sign those legal documents, then a guardianship may be needed. There are two types of guardianships, a guardianship over the person’s assets (often called a conservatorship) and a guardianship over the person herself. A conservator makes decisions over the person’s assets such as bank and brokerage accounts and real estate, while the guardian makes decisions about where the person lives, choice of doctors and medications.
• Find the right type of guardianship for the situation. Guardianships can be limited in nature. For instance, perhaps the person needs help finding housing as well as choosing and directing caregivers, but most other things she can do on his own. In that case a limited guardianship may be recommended with the person otherwise going about his day-to-day life on his own. The same would apply for a conservatorship. Perhaps the conservator oversees his large brokerage account, but he has a small bank account and a debit card with $500 a month in it that he can use when he goes out for lunches and coffee.
• Create a circle of support. There is often safety in numbers. Unfortunately, without the proper “guardrails” in place, these scenarios can lead to abuse or financial exploitation of the person. Often a circle of people around the person is the best safety net as it prevents any one person from having control over the person. This group of individuals can include a family member or friend, one or more doctors, a lawyer, and someone from the community such as a caseworker. A group of caring individuals surrounding the person can lead her to feeling more supported and can alleviate some of the stresses in her life.