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Tuesday, April 25, 2017

It’s not easy building trust with a new patient. It can be even more challenging if the patient suffers from mental illness. When you are a caregiver, whether in a facility or in home, building trust is a necessity. Consider these points when taking on a new patient experiencing mental degradation.

Establishing Trust Between Caregiver and Patient

Being prepared is vital. Knowing the patient’s history, including all incidents of mental breakdowns before the first encounter will offer insight on where you may need to focus your attention.

Review the following:

  • Any existing and previous conditions that the patient is experiencing
  • Medical charts and any pertinent information from the doctors
  • Medication schedule and requirements
  • Medical equipment and supplies (provided as early as possible)  

Take a brief history on the patient’s family members and loved ones that are out of touch, or that have passed away. Bringing up information that the patient does not retain at the moment can cause unnecessary stress and pain for the patient.

Challenges with Mental Health Care Patients

Due to declining cognitive function, the patient may experience the following:

  • Severe mood swings
  • Speech issues
  • Lack of control over bodily functions
  • Restricted mobility

The patient is also more vulnerable to infections. Continue to check them for bruises, cuts and bodily injuries.

Overcoming those Challenges

You may feel that you don’t have the cooperation of the patient when they become confused and irritated. Though frustrating, it’s a temporary moment that can pass quickly. Engage the customer physically as well as mentally and keep the patient active or as active they are able.
One of the most helpful practices can be therapeutic communication. This consists of lying, or redirecting the patient’s attention to distract them from a stressful moment or memory. As a caregiver, this may seem cruel. You may even feel the need to ground the patient in reality if they are having an episode, but it’s usually better not to disrupt them.

As found on All Nurses, some comments from caregivers recommend similar approaches:

“I'd try therapeutic communication techniques, such as restating... ‘So you want to call your mom and dad?’ or redirection, ‘What do you want to talk to them about?’ "

“I've had patients think I am their mother. It came in very handy if they didn't want to bathe or eat.”

It’s best to avoid painful subjects as much as possible.

Try to distract the patient with a favorite item, toy, or music. In these cases, it may be necessary to lie. Redirecting questions and using distraction can spare your patient undue stress.

Strengthening the Relationships

As your time with the patient continues, you’ll naturally develop a familiarity with the patient’s habits and behaviors. As you do, you’ll find ways of relieving any mental episodes in a much quicker manner. Some things to consider:

  • Establish a “normal” for the patient. Learn how the patient communicates their needs and understand any nonverbal cues. Ensure pain management is verified and the patient is comfortable.
  • Go with the flow. If the customer goes into a different mental space, then go with it. It’s not always necessary to ground the patient in reality. “Playing along” with the patient can foster trust.
  • Be Reliable. The patient is relying on the consistency. Develop a routine and stick with it.

It’s important to know that resources are available to you. Websites like , ,,  are great sources of information and support.

You can also check out this book on Amazon Committed to Memory by Rebecca Rupp for more information on dementia. The most significant thing to remember is that building a relationship takes time and patience.

Dennis Silva is Co-Founder of Omni Care Hospice, a  provider of compassionate, quality home hospice care in Las Vegas that meets the needs of people with life-limiting illnesses and their families.


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