Those who deal with a disturbed person should he deliberately calm and positive while a physician's counsel is being sought. Realizing that the victim is not responsible for his present conduct, those caring for him will not resort to ridicule or harshness, but will deal firmly and kindly with him. Although physical restraint and coercion are to be avoided if possible, extreme cases may demand emergency measures, even the help of a police officer.
A. Delirium : This is a form of excitement in which the patient acts out of context to reality and may experience hallucination. There can be a number of different causes of delirium, including the influence of drugs, organic brain disorders, head injury, severe infections with fever, and early stages of recovery from surgery.
WHAT TO DO
First, give attention to the underlying cause of the delirium and remedy it if possible. Beyond this, give constant supervision to prevent the patient from harming himself.
B. Alcohol Intoxication
Here's 2 special circumstances deserve mention
Delirium Tremens
: This is a complication of chronic alcoholism in which the patient usually has hallucinations, in which he sees grotesque things such as pink elephants. The patient is nervous and emotionally disturbed, and his muscles tremble excessively.
WHAT TO DO
Although most patients respond favorably to good nursing care and a diet high vitamins (especially Vit B), still about 15% unfortunately succumb. Delirium tremens cases should be placed in the hospital for appropriate treatment.
Alcoholic Hallucinosis
= The patient is in greater danger here because his hallucinations usually take the form of accusations against people around him and treats to his own safety. These may lead him to suicide or homicide. The patient should be placed in a psychiatric hospital.
C. Depression : In this ailment, the patient slows down mentally and physically. He has poor appetite and loss of interest in surrounding activities. He is apprehensive and troubled with sleeplessness. The greatest danger here is possible suicidal attempt, any mention of which by the patient should be taken seriously.
WHAT TO DO
Close nursing supervision, preferably in a hospital, is required.
D. Acute Psychosis : Patients having this affliction lose contact with reality, often becoming violently aggressive and attempting assault or homicide.
WHAT TO DO
The patient should be placed in a psychiatric hospital and kept under constant supervision. All weapons and objects that might be used for harm should be removed from his room. His treats of harm should be taken seriously. As far as feasible, physical restraint should be avoided in favor of firm supervision. Under appropriate treatment by a physician, this acute phase is of short duration.
E. Hysteria : In this functional disorder the patient conducts himself in a strange manner, usually with intense emotion, because of some unsolved personality problem. Hysteria may imitate almost any disease, including mental disorder. Immediate care of the patient requires a combination of firmness and kindness.