Refusal of AM Care re: Schizophrenia

[kwood1995]

A client with Schizophrenia is sure that staff is trying to poison her. How can I provide good oral hygiene if she refuses to cooperate. Describe some approaches that might be helpful.

Thanks!

[littlemznurse]

It's really important with these patients to establish trust and a good rapport. I had a patient like this and first time I went into her room cussed me up and down and told me that everyone at the hospital hated her and wanted her dead. I pulled up a chair and sat beside her and and just started talking to her and assuring her that no one was trying to kill her and that I was on her side. I told her about myself and asked questions about her life. It took half the day but she finally came around and began trusting me. She also was refusing to eat and refusing oral care because of her believe that we were out to get her. I sat down and talked to her about what foods she liked and went and got the food myself (she thought the cafeteria staff was out to get her also). After getting the food for her I guess she finally started to realize I cared and she allowed me to do oral care. Long story short just try and establish trust and rapport. Good luck!

[kwood1995]

Thank you so much!

[kwood1995]

What would you do if a client with Schizophrenia curled up in a tight ball and refused to talk or cooperate with any AM care? What would you do to maintain her hygiene?

Thank you.

[Whispera, MSN, RN]

It would depend on what day it was. If it's one of the first days in the hospital, I'd tell her I'd be happy to get what she needs when she's ready. If she's been there a week or more, I might do more.

I'd also talk with her about her reason for doing what she's doing and for doing what she doesn't want to do...