I had a lovely 90-ish lady with OCD and I really loved taking care of her.
Of course, it took 45 minutes to get her ready for bed, and more if someone tried to rush her (she'd get upset and have to "start over again") or forcer her to change her routine.
She was too old to change--one LPN who bulled her way into the unit, tried unsuccessfully to force her to change, and just made it worse
-- even though Velma knew she was "clean" she simply couldn't help herself.
She also had one of the cleanest, most well-irrigated colosomy bags in the WORLD.
As I got to know her hx, I could see what happened to her. She was taught to do sterile dressing changes for her husband and he gradually deteriorated and died. She was alone. Then she had to have a colostomy.
That became a sterile procedure when the bag broke open on her a couple of times in the night.
So....it was her coping mechanism.
She's gone now, God love 'er, but I still miss chatting with her while I irrigated her colostomy bag of every single drop of it....
I think these folks need a lotta comfort and patience. They need to know they can follow their routine, and they will, even if it means getting less sleep. And they may not be able to change.
So if you want someone to go to Group for instance, and their routine gets in the way, try asking them what time they need to wake up in order to fit it into their schedule.