Analyze the care given the patient in your case study from biological, psychological and sociological perspectives.
Mr X a 26 year old gentleman diagnosed with paranoid schizophrenia; he lives at home with his family, episodes of unpredictable and violent and threatening behaviour directed at family. Newly diagnosed.Paranoid Schizophrenia Research Paper
Jack Dwight (not his real name), aged 26 was diagnosed with paranoid schizophrenia in October 2004. In August 2004 Jack’s best friend was killed by a group of youths who were terrorising their neighbourhood. Before the diagnosis Jack’s family was concerned about his constant complaints of headache and tummy ache. He suffered from a severe lack of appetite. He lost a lot of weight in a short time – from 120 to 108 kg in just two months. Jack no longer paid attention to his personal hygiene – his body odour was unbearable. Around September 2004 Jack developed an uncontrollable fear that he was going to be run over by a vehicle. He would not be persuaded to venture into the street, even going to his favourite store to get cigarettes for himself. He became extremely anti-social, keeping to himself in his locked bedroom most of the time. His family could not cope with his anger outbursts, which sometimes became violent. Thus it was that in October Jack was diagnosed with paranoid schizophrenia. Jack’s behaviour proved that Pinker (1997) is right when he states that sometimes, when thrust into a new and highly stressful situation, people suffer acute paranoia.
For six weeks Jack was admitted to a psychiatric hospital where a team of specialists worked with him. It was on the 14th December 2004 that Jack was sent back home, and I became a part of his home staff of care providers. The medical staff prescribed pain killers – Paracetamol or Codeine for his headache, and antacids like Gaviscon for the tummy. It was agreed that care givers should try to redirect him whenever possible when he complained about head or tummy aches. It was suggested that since Jack enjoyed tea, he should first be offered calming tea when he complained of pain. He was also given Multi vitamins and Risperdal to take in the morning and evening. Jack is now happy to ask for a cup of Camomile tea whenever he has a headache. He understands that if his headache persists, he is allowed to take pain killers. He enjoys receiving positive feedback when he does not ask for painkillers all the time. He has even suggested that I serve him a cup of Camomile tea once every hour because he has realized that this controls his headaches. He has not made this request to my colleague who takes care of him when I am off duty. Instead, he gets the usual headache during this care giver’s shift. At this point one wonders whether this is similar to what Sorensen, Paul, and Mariotto (1988) refer to when they say in some cases the paranoia diminishes for psychological reasons rather than because of the drug’s action. I argue this because Jack’s headaches seem to surface when he is taken care of by some, and not other care givers. To this effect Smith (2003) is of the opinion that the outcome of therapy may be determined by the ‘chemistry’ or fit between the therapist and the client than the specific modality being employed. (p.61)Paranoid Schizophrenia Research Paper
In order to improve his appetite, Jack’s nutritionist suggested that Jack should be involved in the planning of a healthy menu. His opinion was to be sought and he was encouraged to plan his meals, choosing from a wide range of foods in the refrigerator. Care givers were advised to invite him to participate in the cooking and preparation of his meals, if he so wished. That plan worked very well because he felt a sense of ownership and was very proud to be serving his care givers the food that he himself has prepared. He started to enjoy meals that he had planned himself. This also made him to take an interest in reading the labels on all food packages, and he was proud to tell staff about the nutritional value of foodstuffs. The advantages of Jack’s involvement in the kitchen were enormous. Apart from improving his appetite, Jack also took an interest in going grocery shopping – something he had previously refused to do. He realized that he had to bathe and dress in clean clothes before going shopping. So his state of personal hygiene improved. He enjoyed watching his reflection in the mirror before going out. We now turn the trips to the grocery store into special excursions. I have noticed that even his need for a cup of Camomile tea disappears when we prepare to go shopping. It is not uncommon for him to compile the shopping list before going out. Jack recently invited his case manager to join us for shopping because he wanted to show her how well he was managing the shopping exercise.
Before Jack’s friend was killed, they both worked as shop assistants in the local supermarket. During his illness Jack did not want to see any of his former work mates. He believed that they had plotted against his friend, and that they would do the same against him. This behaviour is in line with what Smith (2003) says, paranoid persons have a highly developed aptitude for fabricating stories – making connections is like seeing shapes in clouds. (p.39) In January 2005 the case manager helped Jack to sign up for membership at the local Clubhouse where care providers accompany him to attend meetings at least three times a week. Jack has met and talked to other individuals who have had a similar illness to his. The counselling they receive at the Clubhouse has helped Jack to want to renew his membership of his former workplace’s bowling club. From March 2005 Jack has been accepting invitations from former work mates to go bowling with them. The local Clubhouse operates on a slightly psychoanalytical manner in the sense that it serves all of Smith’s (2003) purposes in one integrated package. At the Clubhouse psychological problems are addressed in a comprehensive interdisciplinary method. Clients are given vocational training so that they can attain some basic skills of concentration and reasoning that would enable them to fit in the job world again. In May 2005 Jack was invited, through the help of the case manager, by his former employer to work some shifts. At the moment his job is in the cafeteria section where he works three hours for four days in a week. He cleans tables and makes sure the dining area is generally clean. Jack seems to enjoy going to work. His job coach, a qualified rehabilitation specialist reports that Jack is an asset at work, the cafeteria manager is pleased and speaks highly of Jack.Paranoid Schizophrenia Research Paper