A nurse is sharing information with a client who has been diagnosed with a serious mental illness (SMI) and their family about living with an SMI. Which of the following information should the nurse include?

Choice A reason: There is no clinical evidence to suggest that serious mental illnesses, such as schizophrenia or bipolar 1 disorder, naturally become easier to manage solely due to the aging process. In fact, age-related physiological changes can sometimes complicate medication metabolism and the management of comorbid conditions. Choice B reason: While managing manifestations (symptoms) is a part of the care plan, the contemporary focus of SMI treatment is on "recovery," which involves helping the client achieve a meaningful life and functional goals despite their illness, rather than just symptom management or the medical model of "fixing" manifestations. Choice C reason: It is medically inaccurate to tell a family that relapse is unlikely. Serious mental illnesses are typically chronic and characterized by a cyclical nature. Relapse is common even with adherence to treatment, and part of family education involves recognizing early warning signs of a pending relapse. Choice D reason: SMI is often characterized by an episodic course where the client experiences exacerbations followed by periods of remission. Understanding that symptoms may wax and wane helps the client and family maintain hope during difficult times while remaining vigilant for the return of active disease manifestations.