Each member of the family can do all of the following to reduce the patient’s psychological stress, improve symptoms and reduce disability due to chronic schizophrenia.
1. Patience: It takes time for patients to recover. The patient’s recovery process is long term and progress is small. Families should have patience to wait and not have too high expectations. The speed of recovery varies from patient to patient, and each has its own pattern of disease development.
2.Calm down: conflicts and discomfort are inevitable when getting along with the patient, and the family atmosphere may sometimes become tense and annoying, but it is important to ease the situation and create a stable family environment.
3. Reward small progress: Be expectant of the patient’s recovery, even if this recovery is slow. Use a personal record book to compare the patient’s performance with that of the previous month, rather than comparing the patient’s mental state with that before the illness, and do not rush to set long-term goals. Carefully organize each day of the patient’s life, and praise and reward the patient’s extremely small progress.
4. Give them space and opportunities for activities: Family members must understand the importance of giving patients the opportunity to be alone and to entertain themselves, and must accompany them when needed, and provide them with opportunities to participate in activities. But also learn to refuse excessive and unnecessary requests.
5. Make rules: Family members need to understand the rules of the home. Simple rules (such as being polite and responsible in the home) will keep family life in order. Make rules together with family members, so that each rule is specific and clear, and repeat the rules when necessary.
6. Ignore the facts that you cannot change: Don’t mind the established facts, especially the patient’s symptoms, such as hearing “voices”, impractical speech, social withdrawal and apathy. But don’t ignore the “signal symptoms” of relapse or violent behavior, when you should seek help immediately.
7. Simplify: Speak clearly, calmly, concisely, and pertinently, and repeat what you say when necessary, because people with schizophrenia have impairments in the transmission of verbal information.
8. Pay attention to the “signal signs” of relapse: Watch for signs of relapse based on past experience. These signs often manifest as behavioral and emotional changes before a full relapse occurs.
9. Step-by-step problem solving: Focus on a particular problem over a period of time. The family sits down together to brainstorm and work together to identify the current sticking point and discuss solutions. It is normal to have problems, but different solutions will produce very different results.
10. Be organized: After a relapse or hospitalization, the family should resume its original rhythm of life and its work as soon as possible. Family members remain in contact, help each other and continue to maintain intercourse with the outside world. Social support is important for everyone.
11. Follow medical advice: Follow the doctor’s advice and treatment plan, and get a full understanding from the doctor about the effects of medications, side effects and other treatment measures. During the patient’s treatment, the family should act as a participant to collaborate with the physician in the patient’s treatment and develop a plan to maximize the patient’s ability to self-manage medications. To do this, it is important that all family members are educated in this area.
12. Do not abuse alcoholic drugs: this may worsen symptoms or cause relapse.
13. Listen, then communicate: Listen actively and respond from time to time, then talk about your feelings to confirm that you have truly understood the patient’s statements.
14. The importance of participation in rehabilitation: Help the patient to overcome the inconvenience of transportation and other problems he may encounter during the regular treatment and rehabilitation phase, so that he understands the importance of timely participation.
15. Gradual development of work and social skills: It is more difficult to develop work skills especially for young patients who have no work experience. It takes a lot of time to do this, and help can be obtained from vocational rehabilitation agencies and rehabilitation trainers. Patients must be enabled to learn or regain social skills and gradually learn to develop close partnerships with others.
Getting used to dealing with the mentally ill.
With your family member’s illness, your relationship adds another layer of patient-family relationship to the previous one. How well you manage this relationship will have a direct impact on the outcome of the illness. Sometimes you need to act as a nurse, to care for the patient’s life; sometimes you need to represent the doctor, to explain to the patient the role of various drugs, to urge him to take medication; sometimes you need to treat the patient as a friend, sincere exchange of views, discussing problems; sometimes you need to put on the dignity of an elder, to force the patient to do those things that he does not want to do, but must do, such as regular rest, self-care, outpatient review, on time The patient has to take his medication on time.
Dealing with psychiatric patients requires many skills.
1. Speak slowly, calmly, and with clear content. If you want to ask him a question or order him to do something, say only one thing at a time. If you want to ask him a question or tell him to do something, you can only say one thing at a time. If you say several things at once, you will make him confused.
2.Speech in a focused and affectionate manner, even if he seems distracted, do not ignore him.
3, often with words and actions to show your care and love for him, sometimes talk about memories of childhood life, perhaps to create a more pleasant atmosphere.
4, no matter how little progress he has made in life and work, we should fully encourage him, so as to rebuild the patient’s self-esteem. Try to avoid complaining and blaming.
5.Do not try to persuade the patient’s ideas that are obviously out of touch with reality, and do not argue with him or ridicule him, as this will not only be unhelpful, but also invite trouble.
6.Cultivate more hobbies and interests for the patient, provide social opportunities for the patient appropriately, and encourage him to express his joy and sorrow.
7. Develop a life schedule for the patient based on full consultation with the patient.
In conclusion, due to the special nature of mental illness itself, high demands are placed on the family members of patients with mental illness. It can be said that the process of family members’ efforts to promote patients’ recovery is also the process of family members’ improvement of their own quality. Since mental illness is a long-term disease, families need to gradually adapt to their new role and should be prepared to fight a “long battle.
How to promote the recovery of patients’ self-knowledge
In the process of recovery, most patients’ psychiatric symptoms disappear first and their self-knowledge is restored later. Some patients do not recognize their previous bizarre thoughts as pathological for a long time, nor do they think that the disappearance of those thoughts is the result of medication. For such patients, while continuing medication treatment, it is important to talk more with the patient to help him analyze his symptoms and promote the recovery of his self-knowledge.
This conversation requires certain skills
First, be proactive in involving the symptoms and do not be afraid to stimulate the patient. Avoidance can only paralyze for a moment. Although the patient does not mention his previous thoughts, if he does not have a correct understanding of them and lacks the ability to distinguish them, this will become a hidden problem for him to relapse. Many relapsing patients have the same symptoms as the previous relapse, and the main reason is that they have not fully recovered their self-awareness.
Second, the tone of the conversation should be equal. It is important to exchange views with the patient in a discussion and discussion manner and avoid lecturing. Make the patient feel that the family is standing in the patient’s shoes and genuinely helping him, rather than forcing him to admit that he has mental illness. When talking, use more “I think ……” and less “You should ……”. After the family member has expressed his or her opinion, try to end with a question, such as “What do you think?” , “Do I have a point?” This way of talking is polite and acceptable to the patient, and can lead the patient to talk about his or her own views.
Thirdly, the conversation should be natural and take real-life examples as material. For example, for patients who have delusions of victimization and feel that other people’s words and actions are hurting them, family members can tell the patients about the episodes of TV dramas or what happened in their own work, and discuss with them how to look at other people’s attitudes toward them and how to deal with interpersonal relationships. The process of helping patients to understand the disease is actually the process of promoting the maturity of the patient’s personality, psychiatric patients originally have varying degrees of personality defects.
Fourth, master the conversation. Family members should always pay attention to the patient’s reaction when analyzing the symptoms together with the patient. The patient is willing to listen, then speak; patient impatience, do not speak, or another time to speak again, to stop. Through such conversations, communication should be enhanced and feelings deepened, not so that the relationship is distant, or even antagonistic, then it is better not to talk. The treatment of mental illness is drug-based, supplemented by talk, if the patient resists the family’s persuasion, it means that his condition is still relatively serious, so we have to continue to wait for the effect of drugs. If the relationship between the patient and the family is strained because of a conversation, it will not only be difficult to recover for a long time, but also affect the patient’s compliance with medication, which will be more than worth the loss.
Fifth, each symptom should be fully analyzed. The recovery of self-knowledge must be comprehensive and complete, which requires the family to accurately grasp all the patient’s symptoms, ask each one, and help the patient analyze each one.