When a guy won't take care of himself?

Grace

A very complex and difficult situation here.

I'm speaking here as a trainee therapist not a newbie PCa victim so bear with me.

May I suggest the first thing you do is start to think of is yourself first. I know this sounds harsh but you need to protect yourself mentally, emotionally and legally. If you expend all your emotional energy on someone and take ownership of someone else in a situation like this, you will be less able to help in the long term because you will be stressed. You may also as Vasco says be seen to be abetting. Finally, whatever their current sitiuation, this is their life for them to own (with help).

You need to seek help for him, not take all the burden. The establishment should be the one bearing the burden for someone with diminished responsibility and no kin to help. Not sure where you are in the world (US?) but try contacting his doctor, a local cancer / mental health / people with no families charity or something. Get advice on how to flag his situation up to the establishment and get official help.

In terms of his behaviour, he may or may not be trying to end his life. People's motives are often complex and it not be (or just be) a desire to end it. I'm rapidly starting to realise feeling a lack of control is part of this process. It could be thats he is acting out by missing his meds and bad eating as a control mechanism. Deep down, where he is not aware of it, he may find comfort in the control he feels he has by choosing a burger over greens. This is similar to why people cut themselves if their life situation is bad. There may be other reasons and motivations too, such as simply being in denial. This is why he needs mental health help, not just medical because you probably can't and arguably shouldn't unpick his motives from where you are and certainly will face an uphill battle getting him to change.

I'm UK based and the level of MH support I got when I was sat down and told (however kindly they did it) was "here's a folder with a load of advice and contacts, now bugger off until we MRI you." MH support generally lags behind everything else around most of the world which is why we need to own it as individuals.

Hopefully others can share ideas as well.

Good luck!

C

Hi,

If he has no famly to consult with I would call 911 and tell then the sitiuation of him being very ill.  Hopefully they will send over the right people and get him the help he needs.  As a friend you can only do so much, but then again you don't want him to die.  There should be some kind of social agency that can help him fight through his illness.  Eating fried chicken I think is the least of his worries at this point in time.

Dave 3+4

VascodaGama said:

Euthanasia

Depending on the regulations in the place you live, by assisting your neighbor you might be committing a crime. What you describe above is opposite of what you commented in your earlier thread. It seams that your neighbor is looking for Euthanasia and probably trying to get you as his assistant. This is punitive by law in most of the counties. I would recommend you of informing the local authorities before you proceed with anything.

I also do not understand Vasco's response. The neighbor is just continuing to make poor choices, notwithstanding better (in our eyes) advice. It's his life and he is allowed to make his own choices. And, in all honesty, even if he were to take all our advice, his outlook would still be dire.

FinishingGrace said:

Yes. Absolutely. It seems

Yes. Absolutely. It seems clear that he is not going to comply with the doctors. That is his decision. 

I was hoping that perhaps there was some way I could help him see the need for self care and that you guys might have had some experience personally with feeling the way my neighbor feels. Guys and gals tend to approach health and self care differently and I wanted some insight to help me know what might resonate with him. Sometime people need a small or large smack in the face to help them see the truth. Sometimes nothing is going to work.

I am at complete peace. It doesn't bother me to watch him eat fried chicken every day because I simply cannot care so much that I am bothered by it. Meds and chemo is all I'm in for.

I will ask about my liability regarding the meds and will step away from that if necessary. I don't think I'm beating myself up. Yesterday, when he needed a ride to the emergency room, he asked me to take him. The answer? No. What do I do? I take care of meds and chemo. I do not take care of getting you to the ER because you won't take care of yourself. 

No trouble sleeping last night.

If your neighbor needs a "ride" to the ER and you don't want to be the one to take him there, call 911.  That's what the medics and emergency medical services are for. 

As for your dilemma, it's only such if you take responsibility for it, which is something that you absolutely do NOT have to do in this case. I'm not sure that you are "aiding and abetting" in his demise if you "help" him to take his medications on time and take him to chemo BUT it's NOT something that you have to do.

If he is of "sound" mind, he is doing what he wants to do for his own reasons.  It may be to speed up his death or it may just to be to enjoy what life he has left in the way he prefers.  

If you cater to his whims at the sacrifice of your own well being, you are fostering a co-dependent relationship (the dependency obviously is on his side but you would be enabling it) that will eventually harm and deplete you emotionally and otherwise.

If he is NOT of "sound" mind and there are social service personnel involved, they should be the ones to decide to commit him or not and to force him to receive the care that he needs regardless if he wants it or not. 

In California (and most other states), there is a law (Welfare & Institutions Code section 5150 in CA) which permits a law enforcement officer or clinican to authorize the taking of a person into custody involuntarily for 72 hours for "observation" if the officer believes that the person is a "danger to himself or others." 

Generally, this law is used when a person is acting erractically but it can also be used to hospitalize a person if he is not taking care of himself.   Committment beyond the 72 hour period for 14 or 30 additional days is also available at the initiative of the supervising clinician. 

See: http://www.disabilityrightsca.org/pubs/502401.pdf

If 911 is called, the medics should know to call the police for this purpose and any attending physician would know about the availability of this legal action as well.

That these kinds of things need to be discussed indicate how messy a situation this is and I personally I would "wash my hands" of it.  I know you would rather not do such a thing but there is no reason for you to be involved if he is not a relative, spouse or significant other.  

We'd all like to be good neighbors but there is a limit and that limit generally begins and ends at the front door.  Entering the door changes the relationship and not necessarily for the better as you have already discovered. 

Again, good luck!

Just my opinion, but the behavior of your friend sounds typical of adult autism or possibly Asperger's Syndrome. His refusal to take responsibility for himself, his denial of his condition, his indulging in comfort food, etc. Let me ask you this question... do you feel like you have taken the role of his parent? Does he regard you as a parent? This usually goes undiagnosed because of our expectations of adult behavior from older persons. When they display juvenile or child-like behavior, we write it off as immature or antisocial behavior, when in fact the person is biologically fixated at a juvenile stage of maturity. Does he act and behave as a ten year old? A fifteen year old? etc.

One way to know for sure... was he indulgent and irresponsible before his cancer diagnosis, or is this behavior solely caused by the shock of the cancer diagnosis. Judging from the complete void of friends and family, I am betting he has always been this way, and his family misinterpreted his behavior as antisocial and irresponsible, when it may have been behavior consistent with autism. 

If it is autism or Asperger's, that needs to be considered in his cancer treatment by a professional familiar with adult autism. If he is eligible for Medicare, he can have a hospice worker visit to manage his meds. That would also relieve you of some of the liability VDG mentioned, of which I am also concerned about. Upon his demise you may be subjected to unfair implications since you are not a family member nor a professional health care worker. But don't let that sway you if you feel like you are his only contact with compassion. It takes a lot of character to do the right thing when someone doesn't show their appreciation for it, or even resents your compassionate involvement.

This is all my opinion and my experience with autism and its associated behaviors.

@Grinder - you may be right but there is probably not enough information here. It could be Aspergers, it could be co-dependency, it could be severe depression, it could be early onset dementia, it could be diabetes, it could be Bipolar. And so on.... The experts will review and make an assessent and he will (if lucky) be triaged to a counsellor, therapist or clinical pshychologist as needed.

@Grace - great news. When you mentioned the hormones, that made me twig. They will definitely be playing a huge part - he needs to be aware that it is not his fault but the hormones, and leanr to accept and process the feelings. If his social worker still draags, perhaps you can sic the ACS on him? Sounds like you are reaching the right balance.

C

My daughter in law is a supervisor as well as case worker in social services. I am going to ask her if she has any recommendations for available resources for your friend, as well as your liability in this. Am still greatly concerned about that. It may take a few days though.