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Entitlements

In the best of all conceivable worlds, each individual with schizophrenia would be granted unconditional access to continuous, comprehensive and co-ordinated care as well as consistent financial stability. Finances are an important need in order to meet basic needs such as shelter, food, clothing and spending money. Personal needs such as hygiene, personal safety and medical care also need attention. Interpersonal relationships, emotional support, recreational and vocational activities and community involvement are not often thought of as entitlements, and need to be looked at as well. As important as medical management of symptoms, these needs must be met before a person can develop a sense of well being. It is the responsibility of those charged with the rehabilitation to educate the schizophrenic and families about these entitlements and to assist them with accessing them as fully as possible.

It is very important to be sensitive to the financial needs of the individual suffering from schizophrenia. If providing for one's basic needs goes unmet, unnecessary and unwanted outcomes may result, including, relapses, medical problems, homelessness and trouble with the law. Financial stability becomes a crucial part of the rehabilitation. Thornton & Seeman (1993) state that having some money in one's pocket is a potent source of self-esteem. To discover how financial aid can be accessed, it is important to consult with a social worker and advocate for the schizophrenic. Social assistance can be a blessing even though assistance programs do not provide much money. Regardless of the situation, every effort should be made to aid the individual in all matters financial and to obtain the maximum financial benefit available.

Some schizophrenics have great difficulty in managing their money. For those who have difficulty, there is a tendency to spend all their money at once, leaving bills and payments unpaid. This in turn can lead to borrowing from friends and relatives as well as begging and theft. Thornton & Seeman (1993) tell of one such example:
Sam receives his monthly cheque on a Friday. He spends most of it entertaining friends, eating out, and going to the movies. On Monday, he arrives at his parents' home looking despondent. He has not paid his rent and has lost his room. The family has experienced this same series of events several times.(p. 53)

These problems can be dealt with by educating the schizophrenic about budgeting and assisting the person to manage his or her money responsibly. Direction in banking procedures, help with shopping, monthly budget lists, visits with nutritionists and patience would be required. If money mismanagement continues, trustees may be involved on a voluntary basis or on an involuntary basis if the schizophrenic is judged to be financially incompetent.

Where should the schizophrenic live? In the family home, boarding home, group home or own apartment. The ideal place is subject to the individual's needs and what is available. The schizophrenic's requirements must first be assessed before housing options can be determined. Carson & Arnold (1996) state:
Ideally the housing placement takes into consideration patients' strengths and abilities for independent living, their ability to live safely, their ability to make decisions in their own best interest, and their requirement for supervision, and matches them with housing that allows them to be in a safe, healthy environment in which maximum independence is possible. (p. 1136)

Great strides have been made to provide adequate and appropriate housing for the severely mentally ill, but the greatest barrier continues to be community resistance to the placement of mentally ill individuals in residential settings.

Nutrition is an essential part of rehabilitation. Limited and meager nutritional intake is of concern to the client, rehabilitation team and families. Carson & Arnold (1996) state that because psychiatric illnesses affect the whole person, it is not that surprising individuals with a mental health deficiency have poor diet intake. Everyone needs good food and a balanced diet, but in schizophrenics and the mentally ill it is more imperative. Sometimes their diets are lacking in the correct amounts of nutrients, or they don't eat enough or too much. During client assessment, it is important to assess the schizophrenic's state of nutrition, and also be prepared to supply a certain amount of client teaching on proper nutrition.

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