others recuperate slowly. A long and tedious convalescence, it should be remembered, is the patient's misfortune rather than his fault.
In restoring a convalescent patient to normal living it is imperative to proceed slowly. Food should be increased gradually both in variety and in amount; but the patient's appetite is not always a safe guide, and it may need to be encouraged or to be restrained. Both mental and physical exertion should begin only under careful supervision, and should increase by slow degrees. The patient should sleep as much as possible, should take long intervals of rest, and should continue no occupation to the point of fatigue. A patient who has been ill in a hospital or who has had at home the exclusive services of a nurse or an attendant, often finds the period following his return or following the nurse's departure an exceedingly difficult transition. The family should not expect or allow him to resume too many duties at a time when the mere acts of bathing and dressing may demand all the strength he has. Many convalescents are obliged, or think they are obliged, to take up regular work again before their strength is fully restored. There is generally no economy in so doing; indeed, time is saved in the end by waiting until recovery is complete before undertaking full work.
Important as it is to build up the patient's physical strength, it is hardly less important to direct his thoughts away from himself and his sickness, and to help him renew his interest in normal living. During his illness he has of necessity relied upon the judgment and support of other persons, and his pain and discomfort have forced him to think constantly of himself and his many needs. The habit of sickness is readily broken by some persons, particularly by those whose nervous exhaustion has not been great and whose interests outside themselves are naturally keen. But the sick point of view has remarkable tenacity, and other patients, unless circumstances or deliberate efforts redirect their thoughts, will look upon themselves as invalids to the end of time.
Hopefulness promotes health, while discouragement, apprehension, and unhappiness lower the tone of the whole system. Hence set backs, failures, delays, and relapses should not be dwelt upon, but signs of progress should be mentioned; judiciously however, since overdone attempts to cheer a patient seldom fail to have the opposite effect. If objects or situations that suggest undesirable thoughts are eliminated, the less often those thoughts tend to recur. Therefore, in order to break the habit of sickness, old thoughts must
be gradually banished and new ones must be substituted. Sick-room appliances should be put out of sight as soon as they are no longer needed, and the patient may profit by moving into a different bed room. A few days spent away from home as soon as his strength permits often prove effective in breaking up sickness associations; the patient is generally encouraged when he finds that he can sleep in a different bed, endure some fatigue, and exist without daily visits from the doctor. Even a day spent at a different house in the same town sometimes directs the patient's thoughts into fresh channels. Gradually, but as quickly as safety allows, he should take his place in the normal family life and cease to be treated as an exception.
Merely eliminating associations with sickness, however, is not enough; and exhorting a patient to forget himself and to become interested in something seldom accomplishes anything, especially if he is so depleted by illness that the thought of everyday activities suggests only weariness and pain. A person so weak that he is thoroughly fatigued by dressing himself should not be expected to view with enthusiasm the prospect of a full day's work. Much, however, may be accomplished by providing something that the patient really likes to do, and deliberate
efforts must be made to stimulate his interest in some occupation, however simple it may be.
Occupations for invalids are more than a means to pass away the time; they are also of distinct curative value. The patient's interest is not always easy to arouse, and some ingenuity may be needed in the beginning; sometimes interest is best aroused by working at some handicraft in his presence, and finally offering, as a favor, to teach him to do it also. His interest in any occupation is invariably increased if a well person not only directs but shares in the work.
Care should be taken to select occupations suited to the patient's physical condition, to his age, tastes, and mental development. Two or three occupations are better than one, so that he may change from one to another before any one becomes tedious. Work requiring fine motions, close attention, or concentrated thought should be used for short periods, only, and no work should be continued to the point of fatigue. The patient should not be allowed to feel that he must finish a certain amount in a certain time. Even poor work is better than none, and a patient should always be encouraged by judicious praise.
Games and puzzles are useful to some extent, but an aimless occupation is not so beneficial as one which has a tangible product, particularly