Helping parental caregivers and mental health consumers cope with parental aging and loss.

As persons with severe and persistent mental illness age, large numbers continue to live with their elderly parents or receive substantial social and economic support from them. Prospective studies suggest that when caregivers die, individuals with mental illness experience housing disruptions and potentially traumatic transitions. This paper describes the scope of the problem and addresses pragmatic and psychological issues involved in preparing both caregivers and patients for parental aging and eventual loss. It outlines the practitioner's role in helping patients and families overcome specific psychological barriers to planning for continuing care management, appropriate residential alternatives for patients, and their timely placement. The discussion emphasizes helping patients control their own futures by proactively ensuring resources for maintaining or improving their quality of life. The Planned Lifetime Assistance Network (PLAN), now available in some states through the National Alliance for the Mentally Ill, is described. PLAN, and similar organizations, provide lifetime assistance to disabled individuals whose parents or other family members are deceased or no longer able to provide care.