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My best friend from High School had a stroke 10 months ago. He lost his job, then his home, and he ended up staying with a friend who ended up proving he was no friend at all. I moved him in with me and in that time my observations have left me believing that my friend needs more help than I can provide for him. I cared for my father for the last decade of his life and he had dementia along with other health issues so I have some experience. I also worked in a nursing home when I was attending seminary so that adds to my knowledge. My wife is also a professional health care worker.



My friends stroke was most likely the result of a 20 year meth addiction coupled with a very little physical activity and terrible eating habits. The stroke left him very weakened on the left side and he is a high risk fall candidate. He also has severe mental issues and in talking to his family he likely has undiagnosed ADHD going back to his youth. (His sister was diagnosed with ADHD as an adult and is sure that my friend has it as well.) I’m going to briefly outline some of my observations.



PHYSICAL:
Extreme mobility issues especially on the left side
Extreme fatigue with any physical exertion.
Extreme shortness of breath with any physical exertion.
Off balance- High Fall Risk
Found he was also diabetic when in hospital for his stroke.



MENTALLY:
A, Illogical decision making.
1) No follow up with cardiologist or neurologist after almost a year.
2) No physical therapy follow up since his release from hospital.
3) He went back to using meth upon his release from hospital.
4) Resistant to bathing and physical activity
5) Resistant to Substance Abuse /psychological/physical therapy.
6) Tells tall tales and dishonesty. He was going to lie to Dr and Counselor
7) He doesn’t monitor his diabetes
8) Unhealthy obsession with coke a cola. He drinks at least two liters daily.
9) Addicted to fast food.



i could go on….



I told my friend that in order to continue living with me he would have to do things that would improve his circumstances. Since then I’ve had to find him a Dr and schedule his appts. I had to call our local mental health center and make him an appt which he blew off so I had to make another one and had to take off work to make sure he went. They are still in the process of evaluating him and I hope that they’ll make the decision to keep him even if it’s involuntary.



Myself, my wife, and a mutual friend who helps us from time to time all agree that at the present he is unable to physically and mentally care for himself. I cannot continue physically or financially support him for much longer.



If the behavioral health people do not keep him then what options do I have besides kicking him out? He has burned all his bridges with his family and has no place to go. To kick him out could be a death sentence and besides I want to do for him what I would want done for me. Yet, I’m lost and unsure of what to do so any guidance would be greatly appreciated.

Hello Everyone, Wanted to say thanks to everyone for the advice and constructive criticisms. Also wanted to give a quick update.

We had an appt with our local mental health services yesterday and were essentially told that at this time they could offer no aid. He didn’t qualify for SA treatment because he hasn’t used meth since October. He didn’t qualify for psychiatric care because they’ve somehow determined that his mental condition is due to the stroke rather than an undiagnosed underlying mental illness.

My plan now is to meet with social services and see if there’s any help that they can offer.

At the counseling session yesterday I spoke very frankly to my friend and told him that he’s done nothing to improve his situation. I also explained to him that my wife and children are concerned about my health (I have serious health issues) and that he could stay through August but afterwards he would have to find someplace else to stay.

My hope and plan is to try to get him into a SNF before August gets here but I’m not sure if he will qualify.

I also wanted to say thanks to all the advice about enabling. However, it’s a subject that I am not ignorant of but there are times that my faith dictates that I must let people take advantage of me and this is such a time. Before posting here I had even explained to my friend that there would come a time where I couldn’t help him anymore because it wasn’t helping him in the long run just the immediate. I knew this before I even took him in but explained it to him because I wanted him to know it and to know that I knew it too.

Thanks again to all.
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Geaton777 Mar 26, 2024
Here are some scriptural supports from a faith-based recovery program's website about helping vs. enabling:

Galatians 6:5
For each will have to bear his own load.

Galatians 6:7
Do not be deceived: God is not mocked, for whatever one sows, that will he also reap.

2 Thessalonians 3:10-12
For even when we were with you, we would give you this command: If anyone is not willing to work, let him not eat. For we hear that some among you walk in idleness, not busy at work, but busybodies. Now such persons we command and encourage in the Lord Jesus Christ to do their work quietly and to earn their own living. 

Proverbs 10:4
A slack hand causes poverty, but the hand of the diligent makes rich.

I strongly suggest you review the entire article, "What Does the Bible Say About Enabling?":

https://faithinrecovery.com/2023/02/21/what-the-bible-says-about-enabling/

I know you mean well, but us Christian parents who've had to deal with addictions and other problems with our LOs have experience with this. God does not call us to be enablers. He does want us to have wisdom. Pray for it and you will receive it from Him. God bless you for being a deacon.
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I would walk away.
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You're a wonderful friend, and I admire you for wanting to help this person who has meant a lot to your in the past. We see lots of good suggestions here, and the insight that people have offered is invaluable. I hope for the best for your friend and for you.

Since you are a pastor, you must believe in an afterlife where things are better than they are here, right? And salvation, and eternity with Our Heavenly Father, and being forgiven for our sins? I am curious (because I don't know the answer) - why wouldn't it be better to allow your friend to play out his life as he wishes and go to that wonderful place where at last he will be at peace? Why (do we all) fight to keep them here when they get to the point where your friend is? How hard do we have to fight? I'm asking as one who lost family members and friends to alcoholism and will surely be losing more in the future.

I'm not asking in a confrontational way but because as a Christian, I do want to know what our faith requires. My Jewish friend since childhood has advised me of the Talmud teaching that if someone is sinking, we have to throw a life preserver, but we don't have to go down with their ship. I've used that a few times.
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BurntCaregiver Mar 25, 2024
@Fawnby

Listen to your Jewish friend because they're spot on. L'chaim!
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Oh no, not meth. I hate all drugs, but losing my sister at 45 to meth addiction, this one hits home really hard. All I can say is please do not house a drug addict. It is a dangerous situation for you if he is prone to relapse and you really do not want to get the law involved. Is there any way your friend could be accepted into sober living or a halfway home? Meth is a horrible drug that physical and emotional damage.

I hope you don't mind a personal story. My sis was a meth addict for about five years. During that time she stole money and belongings. She hid out with her son (also a drug addict) in our storage shed and sold off many things belonging to my mother and I. She lied about her then 11 year old daughter not having food even when we offered to buy it and then she cussed and raved about us not trusting her (of course, she was a meth addict!) Dangerous people will float around meth addicts including their dealer. It's amazing my nephew is alive as he stole guns and then he was shot at. It missed vital organs by inches. Most meth addicts will eat nothing but sugar as they crash for days after being up for days leading to "meth mouth" from the drug and poor diet. Meth also causes delusions and paranoia. My sister would pick her skin raw on her hands and face from invisible bugs.

The kindest thing is not to support them at all. Tough love really hurts and watching someone literally waste away tears at you, I know. However, you do not want to be on the wrong side of drug addiction as it only leads to problems. Meth addicts typically need a lot to make rehab stick and they really need to be with people who can supervise them on a daily basis. You are right that they can't take care of themselves, the drugs have done major damage to their brains that takes time to recover.

My sister wound up getting lung cancer (she was a heavy smoker as well) at age 45. She left her daughter and lived with two different drug users. My nephew was her dealer for a while. Anyway, she died at the hospital because she refused to get cancer treatment and would have rather had the drugs.
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BurntCaregiver Mar 25, 2024
@DoggieMom

I'm so sorry for the loss of your sister and what you and your family went through.
I lost my brother because of drugs and I lost my first marriage to my husband's alcoholism.

Can't tell you how many times I've heard the "You don't trust me?" addict argument. No, I don't. All addicts lie and all addicts steal. Even the rich ones like the late Matthew Perry from 'Friends'. That guy had all the money in the world and still was robbing people's medicine cabinets looking for prescriptions.

Even when people get recovery and are straight and sober for years and years, the damage is already done to their body.

It always makes me sad when I hear that the addition wins again.
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Hoon,

I am very sorry that you are in this situation.

My brother was an addict. He died with liver failure in 2013.

My brother became homeless. A stranger befriended him.

This man and my brother were as different as night and day, just like you and your old friend are.

The man was a retired military veteran, who helped homeless people.

The nurse at the hospice facility where my brother died told me that this gentleman brought several people to them for end of life care.

This compassionate man called me so that our family could say our goodbyes to him.

My brother was a great guy when he was clean but he wasn’t able to remain in recovery for very long.

No one can force a person to get help. Lord knows, I desperately tried to help my brother. It’s heartbreaking to watch someone we care about suffering.

I saw my brother lose a successful business, our family, a wife, kids, friends, everything that was meaningful to him. It broke my heart.

The best thing that I ever did for myself was to attend Narcotics Anonymous. It helps to speak with others in similar situations.

No one wakes up in the morning and says, “I want to become an addict today and destroy myself and others.”

Addiction is a disease. Some people respond to treatment and others for various reasons aren’t able to go into recovery.

Just know that you did everything that you could. Do not sacrifice your life for his. This isn’t your burden to carry.

Also know that enabling someone is never the right choice. Some people will hit rock bottom and find their way back up. Others like my brother die.

I choose to remember the good times that I had with him. There were a few times when he managed to stay clean for a while before relapsing.

I am no longer angry or confused. The anger turned to sadness.

We grieve for what could have been, then we heal.

Wishing you all the best.
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BurntCaregiver Mar 25, 2024
May your brother rest in peace, NHWM. I know how it is to have loved ones who are addicts and alcoholics and there's not a damn thing anyone can do to force recovery. Either they do it or they don't.
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You cannot care more about this friend than he does about himself, and that's the truth. Nobody, including you, wants to house him anymore because he spent his life serving drugs and now his physical and mental health are suffering the consequences. Why should you?

I have a friend who's husband is 56. He drank a lot over the years, took a lot of anti depressants in conjunction with Xanax multiple times per day, for decades. Oh but they were PRESCRIPTION drugs, some may say. Combined with booze and the sheer volume he took to relax, his brain is now fried. To a crisp. He has disease in all lobes of his brain. Cannot walk or speak coherently. No formal dx can be given for him either. Now his wife is the only breadwinner in the house and they have to give up their lifestyle and she's lost her husband, basically.

Nobody can compete with drugs and alcohol or prescription drug abuse. It's not just meth addicts that screw up their lives, either. It's not our jobs as friends to rescue these people once they've hit rock bottom.

Your friend should qualify for Skilled Nursing care with Medicaid. Ask social services to help you, and refuse to take him back into your home if the facility wants to discharge him. That may be doing you both a favor.

Best of luck to you.
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Debmiller Mar 25, 2024
I strongly agree with lealonnie1's advice to you.

You can support your friend securing Medi aid and feel good about setting him up for the care he needs in skilled nursing to "improve his circumstances."

There is no trajectory for improvement in his situation unless he gets professional help with stoke and addiction. Both will require a treatment plan and accountability for the choices he makes going forward.
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You wanted to rescue your friend. Had good intentions.. but you cannot. You realise this now.

"To kick him out could be a death sentence."
Why?

You have taken on duty of care for your friend so you will now need to arrange his next place of living. He is not just a regular guest imho as you moved him in to care for him, knowing his list of health issues.

I'd look for a Social Worker or similar social service immediately.

What would have happened if the other friend & yourself didn't step in to help?

His discharge options would be;
1. Home alone & cope
2. Home alone & not cope. (Many change their mind about home help at that home or APS may get involved).
3. Rehab then LTC

Can you see that despite the good intentions, his friends have added another step. This kind of got in the way of that process.

PS Besides any other medical & social substance abuse history the man is now a Stroke Survivor.

Stroke is a Brain Injury.

Many people recover from strokes. Many do not. Many stroke survivors lack insight to their deficits.

Look up Anosognosia in the care topics. It may help you understand how this man may not *want* help or *think* he needs help - against his reality that he DOES need help.
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Hoon0926 Mar 26, 2024
Thank you B! Studied up on this and will be mentioning it to Dr because this fits my friend to a T.
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Quite honestly, we don't incarcerate or institutionalize people with mental deficits anymore. No matter the diagnosis of your friend (and I am a little surprised you wrote us before you got the diagnosis, given it is currently in the works) I think it is unlikely that your friend will be diagnosed with anything that will allow his being placed in care of any kind against his will.

I also doubt that your friend will accept placement in care.

You are correct in that you are left only with an option to evict this friend if he will not accept social services, state guardianship and placement.

I am assuming you are not his POA. If so, you will need to resign that. Because your friend is competent legally and capable of understanding your resignation you can do this by a letter to him as well as notifying any entities you are registered with to act in his behalf.

If your friend cannot function thusly evicted this is a much larger problem.
You should contact APS for possible state guardianship of your friend.
While they cannot put him in a facility by force, they may be able to offer emergency housing and state aid.
The other option is our streets, where any day you can witness people dying.

You should notify any family your friend has.

As you are already "in the system" with your friend for things (disability? counselor? doctors?) you can access workers in the social services system through these people. I note that you are a Pastor and I hope that you may have other access to options.

You and the friend who is helping with your friend can also contact any elder law attorney or a licensed social worker in private practice for any options suggestions.

It's difficult for me to imagine that you thought this could work.
We don't change other people. Sadly, a bout with a serious illness or condition doesn't change people either.
I admire your good heart and your courage in trying this. I am afraid it simply put off the inevitable for your friend. His history of taking care of himself was not good; that likely will not change.

Hope you will update us on outcome and I surely do wish you the best of luck ongoing.
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Hoon0926 Mar 24, 2024
Hello Alva and everyone else. Thanks so much for the advice. I wanted to let everyone know that my friend hasn’t used since last October and was told he could not so long as he was living with us. I also wanted to say the he exhibits many of the same symptoms that my dad had due to dementia, and I mean exactly the same. That’s one reason why I posted perhaps before I should have.

I think you’re right though Alva about him refusing to be placed in treatment. I have a possible “in” with an inpatient treatment center and when I suggested it to him he became argumentative and visibly shaken. He grew up rich, lived off mom and dad by “taking care of them” until he had his stroke and mom and dad went to an assisted living center. His life has literally been all play and now it’s become all business. I don’t know if he has dementia, ADHD, brain damage from the stroke or from 20 years of using meth or if he’s shell shocked from the extreme change he’s experienced. What I do know is that if I went by how I felt then he would’ve never moved in with us to begin with. I acted by the faith that comes from God’s Word - do for others as you would have them do for you; this is the Law and the Prophets. However, I realize that this may include making the hard decision to evict him if it helps him get the help he needs.

Thanks again Alva and everyone else too. God bless and keep up the good work!
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Take him to Social Services. Explain to them that his health problems are more than you can take on. He needs help that you cannot give him. Maybe they will set him up somewhere temporarily. Call APS. Is there a homeless place near you, drop him off.

No good deed goes unpunished. As a Christian you are a target. You need to learn its OK to have boundaries. You may want to read Townsend and Clouds book "Boundaries" it is Christain based. There are usually other options before you need to move someone into ur home.

If he is still using in your home, very good reason to get him out.

My Mantra "I am here to help people find a way, not be the way"
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BurntCaregiver Mar 25, 2024
"I am here to help people find a way, not be the way".

I like this very much. Well said, JoAnn.
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You and your wife sound like very good people, but honestly you two have to toughen up or the world will eat you alive.

Now think of what you're allowing to go on under your roof.

Do you think you should have a stinking, freeloading drug addict? A lying, entitled low-life who contribues nothing to the good friends who take care of him and is nothing more than a burden on them and society as well. This so-called friend of yours doesn't have enough respect for you and your home to even wash up.

You say he's burned all his bridges with his family. I'm not surprised. These kinds of takers get to be too much. They use up their family because they refuse to ever except that they are the problem.

High school was a long time ago. You grew up and became an adult. Your friend did not. I had friends like this too. There are some friends you have to walk away from. This guy at your house is one of them.

If he's as bad off as you say, he will qualify for disability and will probably get accepted into a nursing home. From there a social worker will find him housing and services. Bring him to the hospital ER and leave him there, or drop him off at a homeless shelter.

I hope for your sake and your wife's that he never made your house his legal residence because you'll have to formally evict him if you did.
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Is it methadone, that a medical provider gives him, to keep him off heroin?
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lealonnie1 Mar 24, 2024
Who said anything about heroin????
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Are you saying he is actively using while living with you? If so, you are enabling it.

Call social services for your county and ask a social worker what housing options he may have. Is he on SSDI? Medicaid? Look into Section 8 housing. No shelter will take someone who is not sober.

He is a hot mess that your well-meaning kindness cannot fix.

You can't want his recovery more than he does. You aren't responible for his happiness. You are delaying his recovery by helping him in inappropriate ways.

Help him find subsidized housing then move him out then never let him move back in and never give him another penny.

See if there's an Adult & Teen Challenge program in your area. They specialize in "hopeless" cases and has the highest success rate in the nation. Faith-based but you don't have to be a believer, just willing.
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Hoon, we have an expression here. "There will be no solution as long as YOU are the solution."

You are enabling an addict.

Go sign up with Al-Anon.

Evict your friend so he can get the help he needs.
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