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The chronically psychotic person, although mentally disturbed,
may function adequately in the community. The symptoms are the
same as for the person in an acute psychotic state
but are less obvious. These symptoms are also less disruptive
to a person's day-to-day functioning.
Advice:
- Be accepting, understanding and concerned, yet realistically
challenging, and, if necessary, confronting in a supportive and
nonjudgmental way.
- Monitor, and attempt to optimise, the total lifestyle
of the client in matters such as personal hygiene, clothing, nutrition,
housing, bedding, outlets for recreation and relaxation, interpersonal
relationships (including family, friends, employers or fellow
employees, social workers, church affiliations etc.), and the
use of social and health resources and facilities.
- Introduce to the client, and include the client within, a
stable and supportive communal network without being intrusive,
intimidating or patronising, or overriding the client's autonomy
or freedom of choice. Some people prefer to remain as isolates
and be reclusive. You must respect this choice for 'loneness'
while at the same time being prepared to intervene if isolation
and alienation become pathological and harmful to the client.
- Be prepared for frequent but fragmentary contacts with this
type of client, whose deeply wounded personality has lost its
sense of self-confidence and belonging. Be prepared for rejection,
which may occur suddenly and unexpectedly.
- Be prepared to act as an advocate in matters pertaining to
natural justice (matters of fairness and the sense
of what is right and wrong) with people such as law enforcement
officers, landlords, shopkeepers, pawnbrokers and so on.
- Be alert to nonpsychiatric health problems which may
coexist with, and be disguised or distorted by, the mental illness.
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