How to Care for the Insane: A Manual for NursesGranger, William D.
Science
How to Care for the Insane: A Manual for Nurses
Granger, William D.
Psychiatric nursing
Such patients must never be left alone and need constant nursing day and
night. They must have food, even if it is given forcibly. They must, if
possible, be kept in bed, and covered with clothing, and they must be
kept clean. If wakeful, food must be administered during the night, and
especially towards morning, which is the time of greatest weakness and
physical depression.
Hot baths may be ordered for these patients, and stimulants and medicine
to produce sleep left in the care of attendants. How to give the baths and
medicine, what results are to be expected, and what dangers are to be
feared, will be described later, in the chapter on the administration of
medicine.
There are certain symptoms which should warn the attendant of danger, and
which often precede death. When any of these are present they should be
reported to the physician. They are: partial or complete unconsciousness,
slow and labored, rapid, shallow, or irregular breathing, increased
weakness and rapidity of heart or pulse, cold hands and feet. Picking at
the bedclothes, or at imaginary objects in the air, or vacant staring, are
bad symptoms.
_The Care of Patients in a Condition of Dementia._--It is to be remembered
that dementia may be either, a condition of chronic insanity without
recovery, or a less permanent state of mental enfeeblement following the
acute attack, and from which recovery may be hoped. In the first of these
conditions there is little to be done except to care for the patient. Many
are able to do some work, and should be allowed, encouraged, and taught to
do it. Others do not know enough to dress, feed, or care for themselves.
These must be kept neatly dressed, taken to the table and their food
prepared, taken to the bath and closet, taken to walk, and put to bed. If
not so attended to, they will degenerate into a ragged, dirty, and even
filthy state, and the ward upon which they live will be offensive to the
smell. They should be frequently examined for body vermin, as these pests
are liable to breed and flourish among these patients. The condition of
the demented affords the best evidence of the care given to the patients
in an institution. Attendants will often be gratified to see some of these
apparently hopeless cases greatly improve and sometimes recover.
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