MANAGEMENT OF A PATIENT WITH INAPPROPRIATE PERCEPTION (HALLUCINATION AND ILLUSION)

REQUIREMENTS #

1. Table
2. Chair
3. Pen and paper
4. Patient’s folder (Electronic/Manual)
5. Serene environment

STEPS #

1. Approach patient in a calm manner and establish rapport (refer procedure)
2. Explain procedure to the patient
3. Assess content of command hallucination/illusion
4. Observe for verbal and nonverbal cues for hallucinations/illusions (e.g. inappropriate laughter)
5. Identify and verify the type of hallucinations/illusions patient is experiencing
6. Acknowledge and accept patient’s feelings and experiences
7. Identify precipitating factors
8. Interrupt the hallucination and engage the patient’s attention in another area
9. Direct the focus of the patient from the hallucinational/illusional expressions to the discussion of reality-centered situation
10. Set limits for discussing repetitive hallucinational/illusional expressions (e.g. you have already told me about this, let’s talk about something realistic)
11. Validate interpretation of what is being said (e.g. is this what you mean? who are they? etc.)
12. Teach voice dismissal when possible (e.g. singing out loud, listening to an audio player or reading out loud etc.)
13. Serve prescribed medications and monitor desired and adverse effects
14. Express appreciation to patient and direct him/her to the next activity
15. Document procedure and indicate patient’s level of co-operation in the nurses’ notes/patient’s folder