There are some patients whose minds are so distorted by disease that they seem to take a pleasure in wrong-doing, and are much inclined to do great mischief, and sometimes to commit acts against life or property.
The care demanded by patients who are inclined to acts of violence is practically the same for all. The attendant should thoroughly know the habits, peculiarities, and delusions of each person under his care; he should exercise constant watchfulness, and remember that a moment of thoughtless inattention may give the opportunity for a patient to commit some violent act, that will cause him lasting regret. The mind of a faithful attendant will, when upon duty, always be full of anxiety, and there should be in the care of very troublesome patients of this class frequent relief.
CHAPTER VIII.
THE CARE OF SOME COMMON MENTAL STATES, AND ACCOMPANYING BODILY DISORDERS.
Care of Patients in the Earlier Stages of Insanity.—Patients in the earlier stages of insanity act differently, one from the other, when first brought to the asylum and placed under care and restriction. Sometimes patients accept the situation and fit into asylum life without any friction. They may even come willingly, knowing they need care and treatment, or from confidence in their friends or their physician’s advice.
To some patients the restrictions of an asylum are irksome and misunderstood; the quiet, regularity, and routine of the life on the ward does not at first affect them; they may, and often do, become fretful, are irritated by their confinement, sleep poorly, eat little, and may make violent efforts to escape.
These conditions, if nothing is done to occupy the patient’s time and mind, and so relieve them, will often be sufficient to provoke violence. These patients should be carefully watched and their condition studied; they should be brought under the kind control and influence of attendants, induced to take part in the regular order of the ward, and, if strong enough, should be furnished with proper work and occupation.
Patients, when first brought to the asylum, frequently have much anxiety about their homes, their families, or their business affairs. This is particularly true in recent cases of insanity, because such patients often have cares and responsibilities, or they have tried to continue to assume them, up to the time of coming to the asylum. Special care should be taken to quiet fears in these directions; they should be assured that they are groundless, told they will be allowed to communicate with their friends, that they will be visited by their family, and that all their interests will be cared for.