Independent Living
Everyone, including people without mental illness, needs some help to keep up with the complex tasks of daily life. For example, most people have to use calendars, date books or PDAs (electronic personal digital assistants) to help them remember appointments and keep track of things they need to do. Some people rely on a spouse to pick out their clothes for them, or to help them remember chores. There’s no right answer to how much help a person “should” need.
Independent living for someone with schizophrenia involves a number of definite skills. Social workers call these activities of daily living, or ADLs. Skills a person might need to improve can include:
- Taking the correct medications at the right time each day without help
- Personal hygiene: bathing, washing hair, brushing teeth, trimming finger and toenails, wearing clean clothes
- Washing and putting away clothes and sheets
- Making the bed, changing sheets when needed
- Preparing healthy meals and eating regularly
- Washing and putting away dishes after meals
- Cleaning chores: kitchen, bathroom, living areas
- Grocery shopping
- Managing money and sticking to a budget
- Using public transportation
- If incontinence is a problem, independent living requires remembering to use the toilet often, and to change adult diapers when they get dirty
You might want to make a chart with three columns. On the left, list each of the skills you’ll need to live independently. In the middle column, write how well you currently handle that skill (always do it well, sometimes need help, can only do it with considerable help, not able to be involved in that skill at all). In the right column, write your goal for that activity. This will be most helpful if you set a goal that you think you can achieve with some work and help, so you don’t become discouraged.
Once you decide on your goals, get the help of your support team to reach your goals. It’s important that people who are part of your plan agree to their roles. You may need to negotiate and compromise.
For example, you may want to start using the public bus system to go to school, but your mother may feel you’re not ready. A compromise might be for you to begin by using a more limited transportation system for people with disabilities. When you have mastered that system you can learn specific routes on the public system, accompanied by someone else.
Social Relationships
Almost everyone desires social and emotional connections with others. Schizophrenia is an isolating illness, especially when your active symptoms make you see, hear and believe things that no one else shares. Even when you’re not experiencing psychotic symptoms, though, your residual symptoms and passive symptoms can make social interactions more difficult.A good first step is to figure out your goals. Do you want to spend more time doing activities with other people? Do you want to get better at talking with new people you meet? Would you like to go on dates?
Once you know what you want, figure out what specific changes you need to make in order to achieve your social goals. Making lists and talking with your support team will help you clarify your situation and make a plan.
Here are some concrete steps you can take to improve your social situation:
- Join consumer self-help groups, where you’ll meet other people who understand and share the same challenges you do. You’ll learn strategies that work for other people, and be able to practice your social skills in a non-judgmental atmosphere. You’ll also learn about resources and opportunities for people with schizophrenia that you might not otherwise find.
- Ask your loved ones, counselors, and close friends for feedback and help to improve your social skills.
- Good community housing can provide social and group recreational opportunities. It’s important to shop carefully for a living situation that provides high quality care and a safe, friendly environment.
- Participate in social skills training. You might find this through your mental health services team or through a consumer group.
- Dating and friend matching services for people with psychiatric illnesses are available in some areas. Ask your consumer self-help group for suggestions.
You can also use regular online dating services. Interacting through the computer avoids many of the communication issues that make it difficult for you to meet new people face to face. It’s important to be honest with people about your disability. Mentioning it briefly in your online profile avoids awkwardness later on, and makes it easy for someone to ask you about it if they’re interested.
NAMI, the National Alliance on Mental Illness, is one of the largest consumer self-help organizations for the mentally ill and their families. Through their website you can find a group in your area, and start making connections.
Sources:
Meuser, K. and Gingerich, S. The Complete Family Guide to Schizophrenia New York: The Guilford Press, 2006.
Torrey, E.F. (2006) Surviving Schizophrenia: a Manual for Families, Patients and Providers, 5th Edition. New York: HarperCollins Publishers.