In 1954, Kathalyn O’Brien gave birth to a healthy baby boy.

She spent the next years caring for Dennis in their Hempfield Township home, providing for his needs -- bathing, feeding, nurturing -- the typical tasks of mother to child. She watched her son grow into an artistic, intelligent young man.

Twenty three years after O’Brien had given birth to her son, she found herself once again his caregiver -- this time dealing with more than physical needs.

Dennis began to exhibit signs of paranoia and difficulty concentrating.

“We thought maybe it was his thyroid when he became ill,” O’Brien said. “I thought when he got ill he was going to get better. I thought we were going to get him fixed up and he was going to be okay. When he became ill, there wasn’t the information that is out there now, so we never knew what was wrong.”

Although too difficult to pinpoint an exact diagnosis, doctors determined the disease that was making Dennis sick was mental illness.

“I used to say ‘Why?’ I was a good mother,” O’Brien said. “You do ask yourself why. As a parent, as a mother, you have a handsome, intelligent man and dream of him getting married and going to school and all those things.”

Faced with unanswered questions and the unknown ahead, O’Brien, long-time Westmoreland County treasurer, decided to face her fear head-on, delving into research, and finding out everything she could about mental illness and the challenges that she would face as the caregiver -- from treatment options to at-home care future expectations.

“There were some medications in Dennis’s time,” she said. “But when Dennis became ill, there were no programs to help, no support systems, not enough information.”

Determined to help her son live life to his fullest, O’Brien became involved with as many mental health organizations as she could. She helped form REACH, a family support group for those caring for mentally disabled and challenged loved ones. REACH was the first support group of its kind in the state, according to O’Brien.

“There was a time in my life when every moment that I wasn’t working a job, I was starting programs or getting involved somehow,” she said.

One of O’Brien’s top concerns was eliminating the stigma in society about those with mental disease.

“I think some people were intimidated if he had an episode while we were out,” she said. “People do get frightened when they see others’ behavior as bizarre.”

Yet, the ignorance didn’t stop O’Brien from helping her son enjoy his life. The two went grocery shopping, out to dinner, and Dennis even lived on his own in an apartment for much of his adult life. He worked as a sign painter. He enjoyed music and the arts. And he had a passion for cars. His short life was rich. In 2007, when Dennis was 54 years old, he passed away from complications of diabetes and cancer.

“How courageous he was every single day,” O’Brien said. “Dennis had a good life. “

More than two years later, O’Brien is still involved as much as she can be in the mental illness organizations that she helped implement or became involved with throughout the county.

“I am still involved because many people don’t have families to rely on,” she said. “I would hope that had it been different, if Dennis had lived and I passed on, that there would be people who cared enough to help him continue living his life to the fullest.”

Professional care

When caring for loved ones with mental illness or other challenges at home is not possible, family members have options, such as Milestone.

With three group homes and 22 scattered apartments managed by caregivers, the Allegheny County- based Milestone offers families day treatment programs for those who may have difficulty interacting with others or need intensive therapy. They also offer a consumer drop-in center, which allow clients some socialization time.

Dave Gigliotti, director of psychosocial rehabilitation at Milestone, said there is a big difference in caring for someone with physical challenges versus those with mental challenges. He said caregivers to those with physical challenges must focus on how a person walks or talks and assess their physical limitations, while those caring for persons with mental challenges must pay attention to behavior to access limitations.

“In some cases, the family is unsure of the symptoms their loved ones (with mental challenges) are presenting and sometimes confused as to what to do,” Gigliotti said.

At Milestone, family members who need help can first schedule an intake conference. Clients can be self-referred, or referred by doctors, school officials or church members. Assessments are performed and treatment is determined.

Alisia Reed, of East McKeesport, is a program supervisor for Milestone. Reed oversees one of Milestone’s sites that houses eight men and is staffed by seven caregivers. She said one of the challenges in caring for those with mental disabilities is helping them understand how their disease is affecting them.

“We have people with schizophrenia, depression, dual-diagnosis, and some with drug and alcohol issues,” she said. “Sometimes these people are unaware of their limitations because they don’t understand what is happening with them.”

While providing care is a goal for the team at Milestone, the caregivers are also dedicated to teaching the clients how to live on their own, make their own decisions and develop a quality of life. Residents and clients at the sites are taught proper grooming, cooking techniques, banking and budgeting among other life skills.

As in any facet of caregiving, it’s a tough job for Reed, but the single mom of four said she couldn’t see herself in any other line of work. The Point Park graduate entered the caregiving field right out of college, and has been with Milestone since 1991. She was also a caregiver to her late grandmother.

“My work is far different from caring for someone who you know is going, where you can see the slow decline and you know pretty soon their life is going to be ending,” she said. “But for these guys at Milestone, we are helping them restart their lives.”

Reed said perhaps her biggest challenge in her job is the bittersweet experience of having a mentally challenged client finally able to make it on his or her own.

“You grow so close to them and you get attached. But they have to go and spread their wings. It’s like a parent and the empty nest thing. It’s a proud moment for me,” she said. “They are moving on and that is what is important. I know that we have just helped improve an individual’s quality of life.”