affected by the negative form of schizophrenia, for the last fifteen years.
It is a website for carers, family and community, who want to give voice for those who can't, and don't, voice for themselves
For beginners, clicking with the mouse on a highlit item e.g Care Programme Approach [CPA } will take you to the appropriate page.
You absolutely must understand the Care programme Approach and how to deal with it; read the above link and pursue it's links.
You must also be familiar, at the start - later will be too late - with the caring journey, from the beginning to the outcomes.
I say at the start .Until you know what the family is getting itself into, until you are told in detail what it will be that you will have to do for a lifetime, until you are told what services the professional mental health service in your locality will have to offer, you should not take on the care of your family member suffering from schizophrenia, in your own home.
Part of the requirement for a community care service is a variety of domestic alternatives - supported homes, sheltered flats with associated routine and activities -- where the professional team is in contact, in charge, and accountable.
Unless you are clear that there is some outside interest that your family member will take up on a regular committed engagement during the week, that the supporting professional team will see as part of their commitment to arrange, and if not successful, that they will intervene with alternative domestic placement.
Don't allow the decision that they will be living with you to be made in the first days
When you are told everything - be hard about this, then , up to you.
You must get a working diagnosis as early as possible, so that you can prepare yourself for the range of prospects in store for any possibity of your commitment to family care at home.There will be a Carer Support Worker service in your Mental Health Trust [ ask the Community Mental Health Team at once for their contact number ] area and you should invite them to give you advice immediately, about what aftercare support there is in your area.
They will know the reality in local aftercare delivery - dayc entre based occupational and educational activities, supported housing, supported flats - from their conversations with other carers before you.
They will put you in touch with carer groups and/or other carers who have been longer in your position, to enlighten you on what to expect from the aftercare NHS services in your area.
If you wait , options will already be closed off for you.This how one letter writer described Home Treatment in care in the community " throwing people back on their own resources regardless of whether they have any, or not. "
That is also my personal experience of 'Home Treatment'. It is offered because 'they' have removed 'beds' so that there is no way back, without rplacing that rrsource with alternatives in the community. Ask where and what are those alternative resources.
'Breaks' where 'cared for' has an outside activity of their own, for three sessions, regular within in the week, are going to be your lifeline to be able to keep caring, and to have a life of your own. Expect it , right at the beginning
The care journey for patient and carer [ revising ]
You return to the Home Page by clicking on the back arrow button at the top of your internet page; or try pressing the back button on your keyboard,
or there is often a return highlight link at the bottom of the page*** R !!! marks 'Revised' *** N !!! marks 'New entry' e.g
*** N !!! Good Website for Benefits/work issues................ sample letter july
1. Do H Carers page .... .... .... 2. benefits and job seeking: a guide
?? ... comment please to davidwatch@btinternet.com*** !!! N
1. Why now ? 2. carer and confidentiality 5.SKIP
to go the next page : column left for topics and their ongoing links [ e.g. Community Treatment Orders and depot regime ]: middle = any new material ; right for current matters .... e.g.
carers lose out again*** !!! .... NEW excuses and what to do about them why 'they' don't act when act is needed.
D o H gloss on Mental Health Act versus Mental Capacity Act [GJ ] Case three down.
How do carers go about changing the decisions of Professional people [ as here, who decline to use the Mental Health Act ] when carer, who knows more about the sufferer, who sees the sufferer more closely, believes intervention is necessary and warranted.[ revise yourself of the CPA ]
Aftercare
*** R !!!Pentreath updated'Basic' Psychiatry;
anxiety
alcoholism etc[ Evidence from mice and rat studies ( but they don't have the same prefrontal cortex development ) indicate that without new adult neurogenesis [ the continual birth of new neuronal cells ]brain cells in the hippocampus [ the first bit of the brain for registering and appraising outside experience selecting and organising it into a memory, and then integrating it into where the previous embodied store of experience is managed ] , current perceptions that would be relevant memories, do not move out of the first contact.
Adult neurogenesis cells seem to be necessary for the updating and the consolidation of new memory into previous experience
In studies similar to above they find exercise in activities stimulates new cells.
The relative inactivity of those with negative schizophrenia is against them ?]
( most remarkably in this post mortem study of the anterior hippocampus was the significant reduction of adult neurogenesis cells in the Dentate Gyrus of subjects with schizophrenia " ..Reif et al 2006 via Google)
The main story here for schizophrenia that we have discovered pro-neurogenic, neuroprotective agents that may serve as a basis for developing new treatment strategies that target the cognitive symptoms of schizophrenia. [ There is evidence that neurogenesis enhances cognition and memory ]
" After separating the effective pools into individual components, the researchers discovered eight chemicals that boosted new neuron numbers."
Pieper and colleagues then focused on one particular molecule—dubbed P7C3 for pool 7, c 3
If this works out as we hope, there eventually will be patient trials and so forth. We don't know how long this will take, but probably several years. P7C3 was chosen because it was orally bioavailable, crossed the blood-brain barrier, and appeared to be non-toxic to the animals.Who will be the first to try this on schizophrenia - a desperate illness prone to have people trying desperate remedies ? "
In Mice, of course, and rats that have a bigger cortex :- Clelland et al july 2009 via google"The dentate gyrus (DG) of the mammalian hippocampus is hypothesized to mediate pattern separation
[ in mice; in human = the more complicated information coming in ]
—the formation of distinct and orthogonal representations of mnemonic information—
and the Gyrus also undergoes neurogenesis throughout life.
How neurogenesis contributes to hippocampal function is largely unknown.Using adult mice in which hippocampal neurogenesis was ablated,
we found specific impairments in [ the more complicated ] spatial discrimination with two behavioral assays:
(i) a spatial navigation radial arm maze task and
(ii) a spatial, but non-navigable, task in the mouse touch screen.
Mice with ablated neurogenesis were impaired when stimuli were presented with little spatial separation,
but not when stimuli were more widely separated in space.Thus, newborn neurons may be necessary for normal pattern separation function in the DG of adult mice
So, to speak more slowly and give more time in conversation ?
10
20
30
40*** N !!! This Week: July 25- August -
*** N !!! Princess Royal:- Carers advice for mental health*** N !!! Good Website for Benefits/work issues
Department of Work and Pensions decision Guide
The main story here for schizophrenia that we have discovered pro-neurogenic, neuroprotective agents that may serve as a basis for developing new treatment strategies that target the cognitive symptoms of schizophrenia.
What is it that we are trying to make up for in residual schizophrenia.?
Family carers know that an established routine helps for the day and the week ahead.
It is there as an anchoring reminder to prepare for daily living . An established routine for the week ahead helps by raising something definite for memory to be ready for.
Kraepelin wasn't so far out with calling it 'dementia praecox'
Many studies with patients indicate uncertain memory storage systems Old stores and old interests are better kept, but are not always so accessible or relevant to current issues in living. Skills in current living don't seem to build on and hold.
It's a common ordinary observation:at times 'not all there'There is no evidence that people with schizophrenia have more fleeting or off-the-mark memories than healthy subjects.
Rather, they are unable to simultaneously hold as many items at once in working memory. When you cannot at the relevant time call up the experience that is required to deal with something going on, hold on to it and update the background as you go along, that makes for mistakes in dealing with matters that have to be attended to along the way.
A routine in living arrangements reduces the amount of working memory needed.
If the working memory pool to be drawn upon is at times reduced, making and maintaining that routine yourself is more difficult, and may not be achievable.
The professional service has to help out.If necessary with Community Treatment Orders - with the reciprocal benefit of being helped into an acceptable and working routine.
Working memory, the ability to briefly store and manipulate information, is the essential guide to completing purposeful behaviourA more recent such investigation of 'working memory' has it that the 'available working memory pool' is reduced in schizophrenia.
Participants were clinically stable on medication.
They were presented with three or four different colors on a computer screen. After a pause when the screen went blank, subjects were to indicate the colour shown in a particular spot by selecting and clicking on it on a colour wheel. Subjects who stored the colour in memory and recalled it when tested should select those colours similar to those previously shown.The results suggest that schizophrenia reduces working memory capacity, causing subjects with schizophrenia to store fewer items.
The length of delay made no difference in either the number of items recalled or the precision of recall for either control or patient group, contrary to expectations of less stable memories in schizophenia.
' Memory difficulty in schizophrenia is characterized primarily by reductions in storage capacity and not by an instability of the working memory representations '
There is not always enough memory available to deal with what is happening.[ this is why conversation with sufferers is difficult and limited - there is little 'small talk' - it is literal ...concrete .... it follows leading, rather than leading - the pool of associations is not enough for making talk interesting and fresh, is not held in the background, there to be used for recall to initiative and association.
Where the talk is about things the sufferer knew well in the past before illness, the associations there are fixed enough before illness to help conversation along, and perhaps updating those associations is a route to helping engagement with others ]How to expalin this reduced memory pool ? A most likely fault lies in the hippocampus where sufficient neurogenesis is needed to cope with the maturing in experience that comes from updating the information store
The information held in the memory store inside the brain, that has accumulated from experience is brought to bear on what is perceived to be happening 'outside'. It is to make sure it fits in with what is going on now and what is relevant for the personal background of the one perceiving,
Any significant consequence is tested against a memory hinterland. Do I have tohold this in mind, as I attend to what is going on?Conscious perceiving is not just locally giving attention. It needs the application of a wave of gamma activity that is making the connected network in the brain that gives it meaning and value.
In order for neuron 1 to communicate to neuron 2 it does so best and clearest if the two are in a synchronised wave
Perceiving anything requires the synchronising of all the bits of it that are being dealt with separately in different parts of the brain:size, colour, shape, historical association. The synchronising of the wave means the information can be bound together at the same time to give theboth the image and what it means in context.
The pattern of synchronising in the brains of schizophrenia are less extensive or not so well formed..
This might lead to one area losing out – maybe the one that decides
whether some thing is coming from outside perception or from inside a thinking memory construction,
leading to misperceived 'voices' ; or perception might get linked to the wrong group of synchronised cells – a delusion.A reduced 'information pool' may not be doing such a good examining job.
Things immaterial may be allowed in and become fitted in somewhere, unchecked.An established routine gives a stable outside framework. As it becomes predictable it builds up a new habitual memory store. It does not require so much working memory.
With the routine regularly in place there is less call on an active working memory pool than if there was no such order in place.Internal order is be helped by external order.
A reduced working memory pool makes it impossible for the sufferer on their own to bring an outside routine into order themselves.
Too many mistakes follow from the reduced working memory pool.Mentoring, finding, promoting establishing, supporting the routine needs the help of someone else with prior access to the appropriate resource.
It's a professional job.That is why Mental Health Trust Services which do not have a Rehabilitation and Recovery service have a Service Deficiency.
Where staff see such a deficency they have a Service Deficiency Form to make out. That it is a clinical need - for aftercare - means this should go to the local NHS Managers and Commissioners so that they register the Deficiency, accept it or deny it, and plan to deal with the Unmet Need.
When the Form does not go in, managers, and NHS specialist secondary mental health services nationally can continue to be in denial - how were we to know this - no clinician told us that this was a basic clinical need
Nor did any family carer !What is it that carers must do.
Request, in writing to the local Team clinical lead, copied to the local Mental Health Trust Chief Executive, that there is an unmet need in the local Service for continued aftercare and treatment for those with schizophrenia, and that a Service deficiency Form is made out officially.More on this during August - next weekly letter in September
1. a remarkable website for victims of homicide by the mentally ill ,, [] N.B. Homicide Report Inquiry List - still updating - the NorthWest Strategic Health Authority have not responded to a Freedom of Information request to see their 'Homicide legacy cases' Reports online.
They seem to want to keep information about possible failures in the delivery of care, to themselves rather than let carers - who are very often involved as principal monitors, sometimes as victims - examine where the faults were, to see that they do not arise in their local mental Health Trust area. ]a good ' insider' website:- pamshouse: a guide for carers
since May 2009 3,500 'hits'
Re- started since February 1st 2010.
Licznik Odwiedzin, Licznik Wizyt
