Speaking generally - some of it will be there for life , so get things right early on - don't be put off from getting all the facts you can about it, and all the facts as to what can and what should be done.
It is beginning to look as though someone sufferinng from schizophrenia does not have regular access to 'the back up' in the neuronal network connections which carry experience to be drawn upon, of the right context at the right time, to move intentions forward.
The original direction falters because the further away from the initial start, the less the background of relevant experience is available, made in an accessible form, to continue what was intended.
The remedy is to rebuild the connecting to an inner memory, so that updating of the relevant experience in the background, is there,when required , either by limiting the scope of the activities that can be carried forward, or by going forward into an environment which gives external templates, cues , reminders, and time on the activity so that a reviving internal memory of activity expereience can be drawn upon.
The provision of a regular outside format of routine - an external framework of activities which can be practiced in a sheltered environment with sympathetic and non critical mentoring - can rebuild and reawaken the process of access to relevant internal connections.
The revived internal framework formed from engaging with the new experiences, can then be drawn upon, to give access to the accumulated experience bank.
The other benefit - also TREATMENT - is providing separating space between carer and patient, reducing the emotional debris that often builds and hangs around in caring contacts; reducing high emotional exchanges [ high EE they call it ] which leads to covert rejection and breakdown into illness.
The Health treatment for a continuing illness is to find and provide the entry into the appropriate external facilities within which appropriate behaviour is rebuilt. That requires a stable weekly programme of external activities, appropriate to the education and age related needs of the patient. Repeated engagement with these activities rebuilds the experience, and the internal representations of that.
If something like this is not being done in your area , which you think is a need, get it registered by the mental health Trust team delivering care to your family member as an unmet need, and therefore as a service deficiency - a deficiency to be provided and to be commssioned and funded funded by the local NHS Primary Care Trust which distributes the NHS allocation locally.An unmet need is there, when a benefit would come if it was provided, but it is not being provided. It is not being provided because funding is not available - it is not being provided because it has not been asked for, or because other calls on funding weongly, have been given a higher priority.
Remember the NHS National Standards Framework priority for mental health service is the needs of those with serious and enduring mental illnesses.
Until they are provided - the weak first, then the strong , as Aneurin Bevan, the founder of the NHS stated - there is a funding need for this unmet priority.
Unmet needs and service deficinecies are services that were not commissioned - i.e. not funded by Primary Care Trusts - and therefore not deliverable by local Mental Health Trusts
If not funded nor commssioned, they will not be provided.
Don't leave your local Primary Care Trust rest until they have funded what is necessary - and presently unmet, in your area.
Basic to recovery, is that your family member has, during their week, a programme of engagement outside their illness process: taking part in an activity meaningful to them, an activity that recreates the habit of behaving appropriately in the company of others, IOt gives a future direction for the person.
The basic disability in schizophrenia is a weakness in finding, matching what is required to progress an intention, holding on to an inner intention so that an intention can be carried to its fruition.
The original direction is easily lost or overtaken by some other distraction, from unexpressed inner associations, or from outer distraction butting in. The impetus falters. The original direction is not being recalled to mind. The holding context is not there and has to be waited for and restored.
Where the requirement to exchange views come as an initiative from others, schizophrenia needs time to bring up, and hold onto, the appropriate mental background to what is being put to them, and then they cannot keep up, with holding the relevant background to what is going on - cannot hold onto the associations that are necessary, or go back to them for reminder - the hold has gone and needs time for recovery, without being told to move on. Some diplomatic prompting is required- 'buying time' to allow recall.
Where an internal diary - an regular expectation for what is coming up in the week ahead - about regular outside engagments to be prepared for - is come into in place because a programme - a routine - of outside engagement has been helped into being - then the outside anchoring diary of future commitment, recreates all the internal associations for that expectatation.
Once again there is the background to an internal register of relevant experience built up, and held there, to be able to be called up into taking part in the future activities that have been set on in the future external programme
The accumulated experience of taking part, rekindles old social skills and attaches them to living with others, now.
These arrangements are TREATMENT for schizophrenia not just something to seem to be being done for them - not a daycentre attendance where they sit around most of the day, passively; more helping them into taking up interests and hopes they saw up ahead, before their illness.
Sufferers live in a double orientation. They live in the real world - here - in the process of adolescence an uncertain immediate fuuture, not yet established with success away from the family; and then, to an extent less and more the influence - unpredicatably, the world of their illness takes over, yet cannot be described by them outwardly because they are living inside it - the tools they would have to use to reveal it, thinking and speaking, are the ones that are themselves subject to the illness, and part of it.
Treatment is aimed at suppressing the slip back, into the illness having the authority over the individual. But, it will fail if what is left is not connected up to some form of acceptable living, at first a sheltered programme, a substitute but moving towards the challenge of full reality, and then a future prospect in the real world, that can be laid before the person.
The changes need time to be made and the time has to be gained in some way.
Previous regimes did this by formal admission to hospital - we, the experts in experience and training in this subject know better than you or your family what is needed - to think it out we have to be in control using the authority society has given us - detention - and using that 'protection' to rebuild a future that the family can see as feasible and possible.
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more on working memory in schizophrenia: the disadvantage it imposes.