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Schizophrenia is a chronic psychiatric disorder that often causes individuals to lose sense of reality. Symptoms normally start to show around 16-30 years of age. (CDC, 2015)
Symptoms show up in three different ways; positive, negative and cognitive. Positive symptoms are visual or auditory hallucinations or delusions. Negative symptoms are monotone voice, withdrawal of everyday activities and difficulty performing those activities. Cognitive symptoms would be having difficulty understand everyday problems or having difficulty with memory.
Schizophrenia is a risk factor for falls, erratic behavior, and drug abuse (National Institute of Health, 2013). Schizophrenics are often stigmatized in society due to the preconceived notion that they are violent and prone to criminal behavior. Treated schizophrenics are more likely to hurt themselves than others and do not have a higher rate of criminal activity than any other mental disorder (Reposki 2015). When untreated and placed in an ill-equip facility schizophrenics due tend to become violent and more erratic which can lead to abuse or neglect (Whalede, 2017)
The main issue is when individuals with schizophrenia become elderly they are usually placed in a long term care facility. In the United States there is a shortage of psychiatric facilities for the elderly so there is normally no other option. In 2010, there were 43,318 psychiatric beds nation wide as a whole. In 2016, there were only 37,679 beds. There are only 11.9 beds available per 100,000 people (Pew Charitable Trusts, 2017). In the United States there are 3.1 million people with schizophrenia; with the numbers listed above the odds are they won’t receive a bed that deserve and require. Regular long term care facilities are often not equipped to care for patients requiring psychiatric help. Long term care facilities are often lacking in staff members. The staff is only trained on psychiatric disorders five percent of the time (Welkes, 2011).
Schizophrenics typically are seen by a primary care physician and not a psychiatrist. Medications that are contraindicated in the elderly are often prescribed due to lack of knowledge. Long term care facilities are often at a very high census. Where there is an open bed, a patient goes. This can create problems when facilities put someone with a mental illness in with someone who doesn’t. Verbal abuse can occur which can worsen feelings of isolation and irritability (Smith 2011).
In a survey conducted by Louis Grant, (Schizophrenia, 01/2017), Registered Nurses, Licensed Practical Nurses and Medical Doctors were all asked a series of questions. (1) What is your current job title? (2) Do you feel like patients with mental illness in long term care aren't treated as well as someone with no mental illness? (3) Do you feel like you were properly trained in mental illness during orientation? (4) Have you noticed in increase of injuries in patients with mental illness? Examples: Falls, bruises/scrapes without reason, etc. (5) How would you react to someone refusing medication? (6) Are you or other healthcare workers resistant to give care or enter a room with someone with a mental illness? Responses were completely anonymous but the analyzer of the information is able to tell how each individual medical professional title answered. There were 20 participants in this survey. 25% of them are Licensed Practical Nurses, 50% of them are Registered Nurses and 25% of them are Medical Doctors. 80% of the participants said “yes” to not being trained properly to treat schizophrenia and 80% also have noticed a lack of care in individuals with schizophrenia. 40% of participants were hesitant walking into someon.
The survey and research articles helped validate suspicions around mistreatment and misunderstanding of the mentally ill. Nursing homes/long term care facilities should not be able to accept patients without undergoing psychiatric training. Lack of training can lead to additional undiagnosed mental disorders, lack of proper care, and lack of support. Without proper medical care while elderly a schizophrenic cannot thrive in a setting like this. Mental illness can worsen case loads on untrained and already ill-staffed facilities.
Government agencies should implement a program to help reinstate psychiatric beds in psychiatric facilities nationwide. The mentally ill should not have to suffer because of a lack of proper training, beds and resources. Long term care nurses should have more than a six week rotation in psychiatric patients. If being hired on somewhere that even has the slightest possibility of a psychiatric patient coming on board than there should be numerous inservices yearly as well as additional orientation time. No one should be abused in general but it’s even worse when they’re being abused because their caregivers are frustrated with them. They cannot help their mental illness.
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