Question: Is an intervention the right thing to do to help a parent see that she needs to get into a nursing home? My mom has dementia and she is starting to be a danger to herself and to her neighbors. I am not sure if I could get her declared incompetent or whatever but I don’t want it to come to this if it doesn’t have to. Everyone in the family agrees that she needs to be in a safer place and everyone has stories to tell of her dementia. I am just not sure if it will be overwhelming for her because of her disease. She is still able to carry on a conversation but she repeats herself constantly.

David Johnson Says...:

Helping a loved one make a difficult decision when they are unable to care for themselves can be a very delicate task. No matter how careful you approach her, the outcome is not guaranteed. I do encourage you to work with her primary physician on this and be sure you have his support as well. He/she may also have some ideas on how to proceed since laws vary from state to state regarding diminished capacity for self-care. 

I'm not sure what you mean by an "intervention", but I'm going to assume that you are talking about having a family/neighbor meeting and have everyone tell your mom that she is no longer able to care for herself. You are right to be concerned about overwhelming her. For that reason, I think you should limit attendance to a few people who have the most influence on her, people she will or at least has listened to. 

Then, make the messages short and to the point, again to minimize the chance of overwhelming her. Expect an emotional response, and be prepared to provide appropriate support. Be gentle, warm but firm. I applaud you for being proactive, rather than waiting for something to happen first. I wish you and your mom and family the very best.

Question: For my brother, the most important thing in the world is having big muscles and a good body. And he is totally huge. He doesn’t compete or anything, he just wants to look good. I think he has gone beyond good and is starting to look weird, but I will concede that this is a matter of personal perspective but I am a little bit worried about how his gym needs have taken over his life. I know that he has uses steroids and growth. I give him a hard time about it but he says they’re not that harmful anymore and that he doesn’t drink or smoke like I do so why should I get to lecture him? He has a chemistry degree and could get a great job but instead he delivers pizzas and still lives at home so he can spend all day everyday in the gym. He is totally rigid about what he will and won’t eat and most of what he eats seems to come as powders out supplement vats. It’s like working out and looking ‘good’ is the only thing that matters to him anymore …He used to have lots of friends, and now he doesn’t. He used to have a girlfriend and now he hasn’t for a couple of years… Am I wrong to think that something is wrong with the way he is living? My parents say that if it makes him happy then I shouldn’t worry about it. But I think there is something sick about the way he is living. It’s like muscles are his drug of choice and he has lost control over himself. I want to get him out of the gym and I want him to be like the person he used to be. Can I have an intervention or something? No one else seems to get that there is something really wrong here like I do?!!!

David Johnson Says...:

While I agree it's probably not good for him in the long run, as long as it's legal and not doing obvious harm to him, you can't and shouldn't do anything more than express your opinion very occasionally. Speaking any more often than that puts your relationship at risk. Interventions are risky, they often result in disrupted relationships. What's more important? Do you want to have a good relationship with your brother, or do you want to push your point?

Question: My sister is depressed. Actually, she has not been clinically diagnosed with anything because she won’t admit that anything is wrong with her and so she won’t go to see a doctor or a psychiatrist about the way she is feeling. I can see however that she has really changed a lot in the last few years and she is so far different from the bubbly person she used to be you would swear these were two different people. She went through a very tough breakup and a few years ago and she just never seemed to bounce back from it. Now she mostly just wants to stay at home and do nothing. She used to be such a neat freak and now her apartment is a dark and dirty mess. She used to be the life of the party and now she won’t pick up when her friends call and unless I go over and basically force myself in the house I don’t get to see her either. She says she doesn’t want help but it’s so obvious that she needs something. How can intervene effectively to get her to take some action so she can get back to the person she was and back to enjoying life. It’s killing me to see her like this but I just don’t know what I can do to make the situation better?

David Johnson Says...:

It is painful to watch a loved one suffer, especially when they refuse available help. I think you can still be helpful to her. Try to stop pushing her to get help, instead listen to her, understand what she's going through and see if you can get an understanding why she doesn't want help. Suggest getting help as an alternative, but don't push it. See who else is involved in her support system. Find out what they think about her sister and what they have said to her. If you find you have a group of support people for your sister, consider an intervention. If you can bring everyone together to express their concern. Have some suggested places she can go for help. Be aware that if she digs in her heals, she could feel she has to turn away from everyone. So be prepared to back peddle if the intervention doesn't go well and return to your listening role. Others should do the same. 

Hang in there. It feels helpless, but she will not forget everything you do. Be gentle and encouraging.

Question: My 64 year old uncle lives alone and his house is just totally out of control. There is stuff everywhere. Once you open the porch door you can walk straight ahead into the main living room, but if you look to the left you can’t see anything of the 15 feet of porch that used to be there, it’s now just a mountain of useless junk. Once you get in the house there are some rooms that you can no longer even enter. I don’t know how to put into words how crazy the situation is but it is a bad scene. The stuff is piled from the floor to pretty much the ceiling. It’s incredible but it is also sad and I think it’s got to be a major fire hazard. I have tried on many occasions to get my uncle to throw out some of the stuff. He will generally go along with the idea but as soon as we start sorting through anything he always has a million reasons why he can’t get rid of whatever piece of garbage I happen to have in my hand. If you try to force the issue he gets upset and angry and it just seems to get counterproductive. He obviously has a problem but he will not admit that there is anything really wrong. What can I do to get him to clean out some of the stuff. I worry that in addition to it all being a fire hazard, the house just feels so stuffy and dusty and probably moldy, it cannot be good for his health at all. I feel like he needs some sort of intervention like you see on TV, but I don’t have any idea how or what to do to make him see the light.

David Johnson Says...:

This is indeed a difficult situation. It's hard to get a sense about how bad it is from your description. There are messy houses and there are clutter houses. Clutter houses are a hazard because there is likely hidden food and possibly vermin. It's difficult to verify this because of all the stuff. Your uncle is indeed attached to all the stuff and is reluctant to let go of the memories or it's potential usefulness he imagines. 

Is he of sound mind? A check up with the doctor will verify that
problem. Doctors offices will often take information from relatives even
if your uncle hasn't given permission for them to release information
to you.

If the house is truly a hazard, a call to the health department, the landlord, or the police will force some action. Short of that, all you have is your ability to persuade. And I'm sure if you call authorities, your relationship with your uncle will be damaged.

His angry reaction implies you've lost your persuasive effectiveness for the moment. Use that as a way to limit to your intervention. Don't push that hard or you will lose future effectiveness. Try offering incentives based on things he likes more than his stuff. Try the positive rewards first. If that effort fails, you are left with your honest and gently stated discomfort with visiting him with his house in this condition. Are you the only interested family member? Sometimes things become more important when a person is lonely and isolated. Perhaps other family members could be coordinated in their persuasive influence to give him the same message. Offer to meet him somewhere else so you can visit more comfortably. He will get the message all the same, in a more positive frame. The best outcome is for him to decided his house needs to be cleaned up. That should be your goal.

Question: My 15 year old son Roger has been caught drinking beer with his friends on two occasions in the last 3 months. This is not acceptable behavior and he knows it, and he has been punished for what he did. There is a history of alcoholism in the family and I am very worried that Roger may be going down a path that will lead to a very unhappy ending (I know because my dad and brother are both alcoholics and I can see what damage it does.) How can I get him to see the danger of what he is doing by starting to drink at such a young age, especially with his family history. When I try to talk to him about it, it always starts to sound like a lecture and I can see that I am not getting through to him in a meaningful way.

David Johnson Says...:

Having an errant teenage can be a scary time. It sounds like you've already done all you can do. And you picked up your lecture may have limited meaningfulness. Outstanding observation! As a parent of a teen, you no longer have control of him. You can influence his choices and role model adult behavior. You can give reasonable consequences for the drinking and you can educate him about your concern by showing him the consequences of drinking in the family. You can't turn back the clock and lock him up or supervise him with his friends. Tell him you expect him to respect your wishes. He will make the choice whether to listen or not. At 15 years old, all you can do is send strong and clear messages. You don't want to damage your credibility by over-stating your case and risk alienating him from talking to you or worse yet give him a thrill every time he defies you. Severe punishment and/or convincing him of your fear of his future risks distorting his self-concept into believing he will be a drunk too.  Your exercise of good judgment when giving him the message provides him with a model of good judgment he may choose to integrate at some time in the future. Demonstrate that you believe in his ultimate good choices, if not now, in the future. Then he will see the opportunity for change if and when he needs it.