A compassionate discussion about mental health

John, it's good that you are thinking about it. I think that's an important first step. Whether your relationship is decent or really strong, it probably wouldn't hurt to at least start doing little things to make it even stronger. If she's stopped taking in more animals, maybe make it a point to show that you noticed, and work in a veiled compliment about it. Maybe some innocuous comments about "getting old," if she's not overly sensitive to it. Like, "Remember back when we had x number of animals to take care of? How did we do that?" Or, after a long day, "Honey...we're getting old." I have found a lot of women respond well to humor, does she? Maybe joke that, "One of these days, the only old goat you'll be able to take care of is me! At least I won't pee on my beard...maybe."

I've noticed many people have epiphany moments as they age. Like when they don't want to give up driving, and then almost kill someone. I would look for those moments, and strike while the iron is hot. Try to plan ahead about what you will say, based on her personality. Be honest, and want what's best for her, and she will have a hard time disagreeing with you in the long run. Admitting your own faults can go a long way to helping her come to terms with the fact that she needs to make changes as well. Sometimes people just need to know they are not alone. Just a few thoughts.

Thanks for these responses.  I realize that such issues quite often are very personal and difficult to deal with.  What I find is that, outside of Permie-minded people, most will recommend "Sell the place and move to town!...", ignoring some of the reasoning in my earlier post as to why that would just not work.  And yet the isolation can obviously lead to some real conundrums down the road if one does not being to make some plans.  Hoping to see along the way here other's situations and approaches to solving similar problems in their lives.  Thanks!.....

Dale Hodgins wrote:Punishment or the threat of punishment when he's in that state, would not be appropriate.

I tend to think of punishment as never being appropriate; but I recognize that is my own past trauma.

Dale Hodgins wrote:My oldest brother is autistic. When he was 11 they decided the demons needed to be cast out of him.

Oh, I've been there, only it wasn't my family, but some roommates. It took me some years to figure out that the exorcism was bogus, just me reacting to manipulation. Autistic people are more susceptible to abuse, I am told, be cause we don't know how to recognize it when we see it.

But that's not what I want to add to this discussion. This thread has reminded me of my late mother. As often happens, we had no idea of her mental health issues when we were kids; it was something we only came to understand as adults. She would go through these strange phases, often, though not always, food-related. For instance, in her Shrimp Phase, her lunch every single day was a baking sheet of shrimp. Until she got a bad batch -- and for the rest of her life, she never again ate a shrimp.

But her bigger issue was hypochondria, and possibly Munchausen disorder as well. By the end of her life, she had more than 100 different prescriptions for all kinds of different things. I really do think that her unnecessary prescriptions caused her to die before her time -- my dad is around the same age as she would have been, and he only just retired, whereas she basically lived as an invalid for close to twenty years before expiring.

What would have been the compassionate thing to do here? Once I was an adult, I always was skeptical of all her meds; but in my autistic lack of social graces, I did not know how to be tactful about it, and that created some friction between us. When my oldest sister oversaw her move to the nursing home, she worked with the geriatrician to taper mom down to maybe two or three prescriptions; the geriatrician was surprised that mom had talked so many doctors into prescribing so many things. I sure would have liked to be able to do this earlier; I think she would have had a better quality of life as well as a longer life. Going along with her, I would not consider ideal. But when someone has a mental health issue, you can't apply normal reasoning.

Through it all, I continued to love her with a fierce intensity. I came back from the Dominican Republic to the States to fulfil her dying wish to see me one last time, and once she was gone, I felt lost for nearly two years -- lost, as in, "what am I going to do now?" A person with mental health issues can still be very important to someone.