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
_Care of Patients with Paresis._--This is a form of insanity characterized
by progressive dementia and increasing bodily enfeeblement and paralysis.
The paralysis is partial, not complete; the patient's walk is feeble,
unsteady, and shuffling; the hands are tremulous, lose their fineness of
touch and ability to do work and write; there is twitching in the muscles
of the tongue and about the mouth, and the speech is thick and indistinct.
As the disease progresses the patient becomes helpless, bedridden, wet,
and filthy. The result is always death. Convulsions like those of epilepsy
are liable to occur, from which the patients may rally, or in which they
may die or linger a few days. In the earlier stages the patients are often
strong, and controlled by delusions and hallucinations that make them
violent. Sometimes they are simply good-natured and easily managed. They
generally have very exalted and extravagant delusions, and are without
appreciation of their condition or surroundings, and are irritated at the
control of the asylum, and on account of their unreasonableness they can
rarely be allowed the liberty others enjoy.
Paretics often eat ravenously and rapidly, they stuff their mouths full of
food and so choke themselves. Their condition of paralysis may render them
unconscious of danger and powerless to help themselves. The care needed
by bedridden, filthy paretics is practically the same demanded by helpless
paralytics, the old, feeble, or demented class, and all others who cannot
care for themselves.
_Care of the Paralytic, Helpless, Bedridden, and Filthy Patients._--There
are many patients in an asylum who are indifferent to all the wants of
nature, who wet and dirty themselves. Some of these patients are
bedridden; some are about the ward, but demented; some are violent and
maniacal, and some from delusions make their persons and rooms as filthy
as possible. Much can be done with many of these patients by regularly
taking them to the closet, and their bad habits may in this way be broken
up. Patients of this class should be visited during the evening, attended
to frequently by the night watch, and seen the first thing in the morning.
Patients, when dirty, should be thoroughly washed and carefully dried.
Their beds should be cleaned and changed, and during the day clean
clothing should be given them as often as required.
The greatest danger that comes from not keeping patients clean is the
formation of bed-sores.
_Bed-Sores._--Bed-sores occur in patients long confined to bed, and who
suffer from exhaustive diseases. Paralytics and paretics are particularly
liable to them, the diseased condition of the nerves allowing the tissues
to break down easily. Sometimes the fingers or toes of a paretic become
gangrenous or large surfaces of the skin die, and sometimes deeper tissues
slough away rapidly. These conditions may come on in a day or a night.
Public-domain text, read in full here on John Shaqi.
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