Sometimes the word “geriatric” comes out of my title. The reason? I am a care manager for those clients who are not of a geriatric age. In fact, a few of them are younger than I. Hint: the first television program I remember watching was the Howdy Doody Show. These clients are not battling Alzheimer’s disease, coronary problems or recovering from a broken hip. Rather, they are living in the community with some form of mental illness. I am here to be their anchor.
My younger clients, mostly in their forties and fifties, have had a lifetime of some form of mental illness. The primary challenge for me and their treating doctor is to make sure they continue to take their medications. Unlike an antibiotic that is prescribed for a certain amount of days and is then stopped, antipsychotic and anxiety medications and those for depression must be taken on an ongoing basis. Psychiatric symptoms are lessened because the medication is working. But unlike an antibiotic, where the symptoms permanently disappear once the infection has been treated, psychiatric symptoms will return unless the medications are continuously taken.
Some of my clients I have known for years. I recognize their baseline and I know when their train of thought is getting temporarily derailed. When delusional thinking is taking over or when their mania changes to depression and vice versa. Very much to my clients’ credit, each, in her own way, has worked out a daily plan for living. They have found safe places in the community; volunteering in a soup kitchen, an animal shelter and connecting with religious and spiritual groups. They have also shown persistence until the right medication cocktail has been worked out.
As a care manger, I am present to both support my younger clients and be their antenna when I start to hear distress signals. They have all had a lifetime of mental illness. Will they ever be “cured?” Unfortunately, I think not. Could their conditions worsen if they are not compliant with their medications? For sure. So that is why this care manager will gladly settle for “stable” as a measure of success. Yes, stable as measurement of accomplishment. Perhaps a little odd you may think, but one that reflects the daily challenges they face in a world where distorted signals can often rule the day.