For families and caregivers
You noticed before anyone else did
Families usually see it first — the pills taken more often, the sleep getting worse, the man who used to talk going quiet. Here is how to raise it without a fight, and how to keep yourself well while you do.
How to start
Do not start with everything. Start with one thing you have actually seen, and say it without a diagnosis attached. “You have been taking the pain pills more often this month — is the dose not working anymore?” opens a conversation. “You are addicted” ends one.
Pick a time when nobody is hungry or tired, and when there is nowhere to be. In a car, side by side, is often easier than across a table. Many people can say hard things while looking at a road that they cannot say while looking at a face.
Ask what they want. Sometimes the answer is “I want the pain to stop.” Sometimes it is “I want to sleep.” Sometimes it is “I do not want to be this person anymore.” Whatever it is, that is the thing worth working on together.
Things worth saying
- “I am not trying to take anything away from you. I am trying to understand what is happening.”
- “Would you let me come to the appointment with you? I will take notes and I will not take over.”
- “If you are not ready to talk about it, that is all right. I am not going anywhere.”
- “What would help this week? Not forever — this week.”
The paperwork that actually helps
These do not take away anyone's right to decide. They name a person who can help. Have them before you need them.
- A VA release of information (VA Form 21-0845) lets you speak to the VA about their care.
- A HIPAA authorization lets a civilian clinic share information with you.
- A durable power of attorney for health care, and an advance directive, say who speaks if they cannot.
- A signed note in their wallet listing medications and emergency contacts is unglamorous and genuinely useful.
For the caregiver specifically
Caregiving is real work, and doing it badly for a long time is what happens when nobody supports the person doing it. Watch your own signs: not sleeping, snapping at people, drinking more, skipping your own appointments. Those are not character flaws. They are load, and load can be shared.
There are programs built for you. The VA's Caregiver Support Program offers coaching and, for some families, respite and financial support. The Eldercare Locator at 1-800-677-1116 connects you to local services. Your Area Agency on Aging often has caregiver groups where nobody has to explain the backstory.
And you are allowed to have a life. Taking an afternoon that is not about anybody's illness is not neglect. It is how you stay in this for the long haul.
If someone is in danger
If a veteran you love is talking about suicide, ask them directly. Asking does not plant the idea — it usually brings relief. Then call the Veterans Crisis Line together: 988, then press 1. If there is immediate danger, call 911. If there is a firearm in the house during a bad stretch, ask that it be held somewhere else for a while.
Crisis support · 24 hours
If today is the hard day, call now
The Veterans Crisis Line is free, confidential, and answered around the clock by people who understand military life. You do not have to be enrolled in VA care to call.
The Veterans Crisis Line is for veterans, service members, and the people who care about them, whether or not they are enrolled in VA care. More help for veterans.