

HISTORY OF THE CONGREGATION

POPE FRANCIS COMPLEX CENTER FOR THE POOR (PFCCP)

Kkottongnae is a community of Love and Salvation. It warmly welcomes and feeds those people who have
been abandoned by families and society and who are silently wasting away on the streets and under the bridges
because of a lack of love. Kkottongnae defines the true happines lies in contentment which is a state of one's desires
being fulfilled.

Their community administration which is the Kkottongnae Congregation, was under Arch. Diocese of Palo.
Kkot means “Flower”, Tongnae means “Village”, the etymology of Nazareth which was the hometown where Jesus
grew. Jesus Christ has established and led Kkottongnae and the Sacred Heart of Jesus who took pains and death on
behalf of human beings is the spirit of the Kkottongnae Congregation's foundation. The sisters and brothers at
kkottongnae Congregation practice love, giving a prayer everyday to let them live for those who have no one to rely on
and no strength to beg for food. Therefore the guardian saint of Kkottongnae is the Sacred Heart of Jesus.

PFCCP was financed by the Vatican through the Pontifical Council Cor Unum for Human and Christian
Development. It was Pope Francis’ gift to the people of Leyte who were victims of Super Typhoon Yolanda in 2013.
The facility is supervised by Kkottongnae Philippines, Inc., a congregation committed to witnessing God to the world
and saving souls by practicing Jesus Christ’s love. They dedicated themselves in the service of the poorest of the poor.
Prior to the program proper, CESB and REAL were welcomed by Palo Archbishop John Du, who expressed his
gratitude for the support to the Center. As a thank you gift, Archbishop Du gave each member of the delegation a
Holding Cross. The Holding Cross, made out of the debris of the chapel kneelers and pews of the Archbishop’s
Residence after the onslaught of Typhoon Yolanda, is intended to serve as a reminder of God’s abiding mercy and
compassion. Sister Thaddeus Choi, a Korean national and Executive Secretary of Kkottongnae Philippines, Inc.,
welcomed the participants and relayed her deep appreciation for the advocacy of CESB and REAL. She encouraged
them to continuously show their love to the poor as she shared a verse from the Holy Bible: “Whatever you did for one
of the least of these brothers and sisters of Mine, you did for Me” (Matthew 25: 40). Ms. Alice Advincula, PFCCP
Adviser, showed an audio-visual presentation of the construction and the evolution of the Center. She also explained
that the complex contains five buildings for receiving guests, a kitchen, bedrooms, a dining area, and maintenance
facilities. She also introduced some of the senior citizens residing in the center.
 FRANCIS COMPLEX CENTER OF THE POOR
ORGANIZATIONAL STRUCTURE

FR. PHILIP PARK, KBJ

Center Director
BR. JOHN KIM, KBJ
Spiritual Services
SR. ANDREA JANG, KSJ
Assistant Center Director

SOCIAL SERVICES HOME LIFE SERVICES KITCHEN ADMIN

ALICIA L. ADVINCULA, RSW SR. ANDREA JANG, KSJ SR. PETER LEE, KSJ KEISEY LALA A. CABANAS
Social Work Supervisor Home Life Supervisor Kitchen Supervisor Officer

RITCHELDA M. BUAG JOHN MICHAEL P. BURCE

JOSEPH'S HOUSE MARY'S HOUSE Cook Finance Staff
ALMIE A. SALVO, RSW
PENIE L. SEPARA, RSW
Social Workers ALMA M. DELA CRUZ JOCELYN L. TIPAY JESSAMINE A. LIPORADA
House Parent Leader House Parent Leader Medical Staff

ANGELITA R. RUPA MELISSA C. ROCA ROLLY JOHN S. VALLE

NOLLY S. VALLE ROWENA D. CALCETA Maintenance Staff
ROMEO J. DESPE MA. GERLIE O. ANANO
House Parent House Parent
LIST OF PATIENTS IN MALE AND FEMALE HOUSE 21. Ruby Solad Pelandi
(As of October 2021) 22. Ma. Lourdes Chiquillo
MALE ELDERLY
23. Myrna Voces Monteroso
24. Jemalyn Imperial Sta. Romana
1. Renaldo Batis Dionaldo
ORPHAN MALE
2. Marcelo Puebla Pulga
3. Florentino Nogar Menoza 1. Daniel Jush Alcantara
4. Federico Amarilla Cabugayan 2. Dave Joseph Alcantara Quiapo
5. Rodolfo Daganta Badules 3. Noe Casiano Bituin Oquino
6. John Gabriel Ballais Berioso 4. Gabriel Bituin
7. Antonio Julayco Fallorina 5. Harvey Jose Nimer Nedruda
8. Felix Costibolo de Veyra, Jr. 6. Carl Angelo Nimer Nedruda
9. Jose Trani Cabelin 7. Jhonrey Dalimocon Yumol
10. Felix Bisande Nebra 8. Francis Dela Cruz
11. Romeo 9. John Kent Fidel Contado Padillo
FEMALE ELDERLY ORPHAN FEMALE

1. Anacorita Dumas Requitillo 1. Mae Chris Sagales Badana

2. Eulalia Fernandez Hermosilla 2. Ma. Trisha Mae Alcantara Quiapo
3. Cresensia Jaca Villablanca 3. Maria Theresa Alcantara
4. Elvira Sabala Calubiran
5. Cornelia Ramos Bitangjol CENSUS
6. Enriquita Onas Abrematea
7. Dolores Rebato Llego Elderly:
Male = 11
8. Cecilia Acebo Romano Female = 24
9. Rosalia Fernandez Total = 35
10. Socorro Liza Apolinar Muassab
11. Thelma Castillo Ricafort Children:
12. Felisa Besa Bibar Male = 9
Female = 3
13. Lucrecia Lagsao Estoy Total = 12
14. Betty Bertulfo Serrano
15. Hermenia Negrosa Engracial TOTAL NUMBER OF CLIENTS/RESIDENTS = 47
16. Nelia Dvincula
17. Loreta Conge
18. Elma Polilio
19. Emma Gaat
20. Natividad Malinao
PATIENT’S PROFILE

Name : “Anita” E.S.C.

Age : 62
Sex : FEMALE
Address : DISTRICT I, POBLACION JARO, LEYTE
Date of Birth : DECEMBER 6, 1958
Place of Birth : JARO, LEYTE
Nationality : FILIPINO
Civil Status : SINGLE
Religion : ROMAN CATHOLIC

Educational
Attainment : UNKNOWN

Source of Referral : REACH-OUT BY PFCCP TEAM

Case Category : HOMELESS AND NEGLECTED
Date of Admission : DECEMBER 6, 2015
Chief Complaint : PROBLEMS WITH THINKING, AGGRESSIVE BEHAVIOR, AND
DISORGANIZED SPEECH

Admitting Diagnosis: BIPOLAR DISORDER TYPE 1

Treatment of Plan : REHABILITATION, PSYCHOTHERAPY, AND ANTI-PSYCHOTIC DRUGS
Healthcare Financing: None
Attending Clerk : There is no specific doctor but only has a volunteer doctor
Date Interviewed : October 7, 2021; 10 AM
PATIENT’S HISTORY

Present Health History

One of the religious head of the facility caught the attention of the patient prior to admission. They saw her
roaming/ settling outside the metrobank building, just next to Palo Cathedral at Palo town proper. The patient looked
so thin, unhealthy, neglected and was homeless. PFCCP immediately offered their help and asked if she would like to
come with them. With the patient’s consent after describing the help being offered, she was then brought to the facility
last December 6, 2015. Upon the initial interview performed, it was noticed that the patient sometimes becomes
aggressive and had nonconsistent description of who she is when asked. There were also times she can be calm and
interact with others. This caught the attention of the staff/social workers attending to her. They consulted the patient to
a psychiatrist and was diagnosed with Bipolar Disorder Type 1. As described by the social worker, the patient can be
observed with aggression to its extent, where the patient could sometimes cause physical injuries. With appropriate
medication prescribed, her psychosis is being controlled.

Past Medical History

To date recently, the patient was admitted in the hospital for 5 days due to various health complains and later
on found out that the she was facing various health issues. Upon discharge, she was diagnosed with community
acquired pneumonia, obstructive sleep apnea and decompensated liver disease. This was very recent, just last last
June 25, 2021. conditions aforementioned have been treated except for the latter that has been mentioned which is
still under maintenance medication. It was mentioned that her liver disease was due to the high dosages of her
antipsychotic medications and because of this, her bipolar medication prescription has been changed to PRN
medications.

Family History
The patient have very limited information about her family, but it was said that she have 2 children, her son
known to be dead and her daughter, alive and whereabouts are unknown. No further information is available on hand.

Psychosocial History
Patient was born n December 6, 1958 at Jaro, Leyte. She was known to have lived at the town but has been
neglected until she reached Palo, Leyte. No information was given whether she was taken out of home by will
because of her condition or she has been relocated at Palo due to being homeless. She usually sleeps within the
streets of Palo but most often seen at the building next to the Palo cathedral, looking weary and thin. Further asked
about herself during the interview, she mentioned of liking to make flower origami and house toys. She is not really
picky with food. Does not drink alcoholic beverages and does not smoke. Her elimination pattern is said to be normal,
and she drinks 7 to 8 glasses of water every day.
She believes in God as her Creator. She attends prayer hours designated in the facility and attends mass
together with the other clients. She likes to spend her time walking or at least take some fresh air outside because of
the pleasing picturesque of the yard outside. The patient stated this makes her calm down.
PSYCHOPATHOPHYSIOLOGY OF BIPOLAR DISORDER (TYPE 1)

PREDISPOSING FACTORS PRECIPITATINGFACTORS

 Genetics  Environmental factors
 Neuro-anatomy (traumatic events, life
 Neuro-chemical Abnormalities of amine neurotransmitter systems and stressors
impairment of neuroplasticity and cellular resilience, particularly
frontal and limbic circuitry

Decreased inhibitory of frontal and limbic

emotional circuitry

Manic episodes precipitated by Dopamine

D2 receptor over activity and decreased
serotogenic regulations

Additional environment precipitating FACTORS

 Elevated/expansive factors including lack of sleep, social stress DISEASE PROCESS

/irritable mood or change. SIGNS AND SYMPTOMS
 Aggressive behavior MEDICATIONS
 Decreased need for
sleep/fragmented sleep
MANIA OR MANIA-LIKE EPISODE
 Distractibility
 Pressured Speech

BIPOLAR DISORDER

MEDICATIONS
 Resperidone 2mg 1 tab
OD, for PRN
 Biperiden 2mg 1 tab OD
for PRN
PHARMACOLOGIC STUDY

MECHANISM OF SIDE EFFECTS/ NURSING

DRUG NAME INDICATION CONTRAINDICATION
ACTION ADVERSE EFFECTS CONSIDERATIONS
Risperidone This drug functions as Risperidone is used  breast cancer.  Aggressive behavior Before
a dopamine to treat episodes of  diabetes.  agitation  Check for the
Drug Class antagonist also by mania (frenzied,  a high prolactin doctor’s order
Atypical Antipsychotic altering the levels of abnormally excited, or level.  anxiety
 Observe rights
Drug dopamine and irritated mood) or  excessive fat in the  changes in vision, in medication
serotonin in the brain. mixed episodes blood. including blurred administration
Brand Name The liver breaks down (symptoms of mania  dehydration. vision
such as giving
Risperdal, Risperdal the medicine into its and depression that  overweight.  difficulty
Conta active chemical happen together) in  very low levels of the right drug
concentrating to the right
ingredients called with bipolar disorder granulocytes.
Drug Order metabolites. The (manic depressive  a type of white  difficulty speaking or patient using
Risperidone 2 mg 1 metabolites block disorder; a disease blood cell. swallowing the right route
tablet 2 x 1day serotonin and that causes episodes  hypersensitivity  inability to move the and at the
dopamine. This helps of depression, eyes right time.
balance the episodes of mania,  Assess for
 increase in amount
chemicals in the brain and other abnormal contraindicatio
of urine
and decreases moods). Risperidone ns or cautions
psychotic and is also used to treat  loss of balance
for the use of
aggressive behavior. behavior problems control
the drug
such as aggression,  mask-like face
self-injury, and  Obtain
 memory problems baseline
sudden mood
changes  muscle spasms of weight, skin
the face, neck, and condition,
back neurologic
 problems with status, P, BP,
urination ECG,
respiratory
 restlessness or need
to keep moving status, LFTs,
(severe) renal and
thyroid
 shuffling walk
function tests,
 skin rash or itching blood and
 stiffness or urine glucos
 weakness of the arms
or legs During
 tic-like or twitching  Check the
movements patient’s
mouth if the
 trembling and drug was
shaking of the fingers swallowed
and hands already.
 trouble sleeping
 twisting body
movements
After
Less common
 Monitor
 Back pain diabetics for
 chest pain loss of
 speech or vision glycemic
problems control.
 Reassess
 sudden weakness or patients
numbness in the face, periodically
arms, or legs and maintain
Rare on the lowest
effective drug
 Confusion dose.
 dizziness  Monitor
closely
 drowsiness neurologic
 extreme thirst status of older
adults.
 fast, shallow
breathing  Monitor
cardiovascular
 fast, weak heartbeat status closely;
 headache assess for
orthostatic
 increased thirst
hypotension,
 lip smacking or especially
puckering during initial
 loss of appetite dosage
  muscle cramps titration.
 pale, clammy skin  Monitor
closely those
 poor coordination at risk for
 prolonged, painful, seizures.
inappropriate erection  Assess degree
of the penis of cognitive
 puffing of the and motor
cheeks impairment,
and assess for
 rapid or worm-like environmental
movements of the hazards.
tongue  Lab tests:
 shivering Monitor
 talking, feeling, and periodically
acting with excitement blood glucose,
and activity that serum
cannot be controlled electrolytes,
liver function,
 uncontrolled and complete
chewing movements blood counts.
 uncontrolled twisting
movements of neck,
trunk, arms, or legs
 unusual bleeding or
bruising
 unusual facial
expressions or body
positions

Adverse Effect

 Tardive dyskinesia
 Neuroleptic
Malignant Syndrome
 Extrapyramidal
symptoms -
Involuntary motor
symptoms similar to
those associated
with Parkinson’s
disease. Includes
symptoms such
as akathisia (distres
sing motor
restlessness)
and acute
dystonia (painful
muscle spasms.)
Often treated with
anticholinergic
medications such as
benztropine and
trihexyphenidyl.
 MECHANISM OF SIDE EFFECTS/ NURSING
DRUG NAME INDICATION CONTRAINDICATION
ACTION ADVERSE EFFECTS CONSIDERATIONS
Biperidine A muscarinic receptor  Hypersensitivity to  CNS : Drowsine Before
Biperiden is used for
antagonist Biperiden biperiden ss, vertigo, headac  Observe rights
the adjunctive
Drug Class targets the M1 receptor  Narrow he, in medication
treatment of all forms
subtype with a high angle glaucoma and dizziness are administration
of Parkinson's disease
 Anticholinergic degree of selectivity. It  Ileus frequent. With high such as giving
and it is also used to
 Anti-muscarinic also inhibits the N-  Caution: People doses the right drug to
improve acute
 Anti-Parkinsonism methyl-D-aspartate with obstructive nervousness, the right patient
extrapyramidal side
(NMDA) receptor. diseases of the agitation, anxiety, using the right
effects related
Brand Name urogenital tract, delirium, and route and at the
to antipsychotic drug
Akineton people with a known confusion are right time.
therapy, such
history of seizures noted. Biperiden  Check for the
as akathisia.
Drug Order and those with may be abused due doctor’s order
Biperiden 2mg 1 tab 2 x It relieves muscle potentially to a short acting  Assess for
1day rigidity, dangerous tachycardi mood-elevating and contraindication
reduces abnormal a euphoriant effect. s or cautions for
sweating and salivatio The normal sleep the use of the
n, improves abnormal architecture may be drug
gait, and to lesser altered (REM During
extent, tremor. sleep depression).  Make sure that
Biperiden may the drug was
lower the seizure- swallowed by
threshold. Some the patient
instances of After
dementia have  Monitor side
been noted to effects and
correlate with adverse
chronic reactions
administration  Note for skin
of anticholinergic m reactions that
edications such as may occur
Biperiden  Monitor for
for Parkinson's Blurred vision,
disease.[12] dry mouth,
 Peripheral side impaired
effects : Blurred sweating,
vision, dry mouth, abdominal
impaired sweating, discomfort, and
abdominal obstipation.
discomfort, and
 obstipation are
frequent.
Tachycardia may
be noted. Allergic
skin reactions may
occur. Parenteral
use may cause
orthostatic
hypotension.
 Eyes :
Biperiden
causes mydriasis w
ith or
without photophobi
a. It may precipitate
narrow angle
glaucoma.
 NURSING DIAGNOSES AND CARE PLANS
NURSING SCIENTIFIC
CUES OBJECTIVES NURSING INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS RATIONALE
SUBJECTIVE: Self – Care Deficit Self-Care Deficit is the SHORT TERM GOAL: INDEPENDENT: SHORT TERM GOAL:
- “Danay diri ako related inability to inability of an individual After 3 days of nursing  Establish rapport.  To obtain cooperation
nakakagliwan hin trust evidenced by to perform self-care. The interventions, the
Inability or deficit may be the effect patient will be able to GOALS PARTIALLY MET
akon la kay gusto ko
unwillingness to of temporary limitations, establish ADL with  Identify reason for  Underlying cause of
hi mana teying la it As evidenced by:
carry out toileting such asthe result of assistance as difficulty in self – care; e.g. affects choice of
mag aareglar ha
procedures gradual deterioration evidenced by: cognitive decline. interventions/ strategies.
akon.” as verbalized Problem may be
without assistance that erodes the
by the patient. minimized by e.g.,  Being able to verbalize
individual’s ability or  Verbalize
willingness to perform understanding about changes in environment or the understanding
the activities required to adaptation of clothing, or about the importance of
OBJECTIVE: the importance of
care for himself or may be more complex, performing ADL.
performing ADL
herself. Also, patients requiring consultation from
Presents symptoms of  Patient reportedly
who are suffering  Perform self – other specialists.
dependence to the observed to perform
from any kind of care activities within Important to distinguish
unit parent. bathing independently
psychosis may not have the level of own between partial and total
dependence to avoid but with stand-by
the interest to engage in ability
creating excess disability. assistance from the unit
self-care activities.
 Patient will parent.
participate in feeding,
dressing, toileting,  Determine hygienic  As the disease
and bathing activities needs and provide progresses, basic hygienic
detaching a little of assistance as needed with needs may be forgotten.
assistance to activities, including care of Infection, gum disease,
promote hair/nails/ skin, brushing disheveled appearance, or
dependence. teeth, cleaning glasses. harm may occur when
client/ caregivers become
frustrated, irritated or
intimidated by degree of
care required.

 Presence of such
lesions as ecchymoses,
 Inspect skin regularly.
lacerations, rashes may
require treatment, as well
as signal the need for
close monitoring/
protective interventions.

 Incorporate usual  Maintaining routine

routine into activity may prevent worsening of
schedule as possible. Wait
or change the time to
initiate dressing/hygiene if
a problem arises.
confusion and enhance
cooperation. Because
anger is quickly forgotten,
another time or approach
may be successful.

 Be attentive to  Sensory loss and

nonverbal physiologic language dysfunction may
symptoms. cause client to express
self – care needs in
nonverbal manner.

 May direct a question

 Be alert to underlying
to another, such as “are
meaning of verbal
you cold?” meaning “I am
statements.
cold and need additional
clothing.

 Allot plenty of time to  Tasks that were once

perform tasks. easy (e.g. dressing,
bathing) are now
complicated by decrease
motor skills or cognitive
and physical changes.
Time and patience can
reduce chaos resulting
from trying to hasten this
process.

 Assist with neat  Enhances esteem; may

dressing/ provide colorful diminish sense of sensory
clothes. loss and convey
aliveness.

 Offer one item of

clothing at a time in  Simplicity reduces
sequential order. Talk frustration and the
through each step of the potential for rage and
task one at a time. Allow despair. Guidance
the wearing of extra reduces confusion and
clothing if client demands. allows autonomy. Altering
the “normal” may lessen
rebellion.

 Provide reminders for

 elimination needs. Involve
in bowel/bladder program
as appropriate.
 Assist with and provide
reminders for pericare after
toileting/ incontinence
Dependent:
 Administer medications Dependent:
as prescribed.
 Loss of control/
independence in this self –
care activity can have a
great impact on self –
esteem and may limit
socialization.
 Good hygiene
promotes cleanliness and
reduces risks of skin
irritation and infection.
 Taking medicine as
prescribed is important for
controlling chronic
conditions, treating
temporary conditions, and
overall long-term health
and well-being.

Collaborative:
 Engage and give Collaborative:
cooperation with the nurse  - Collaboration between
or any members of the physicians, nurses, and
other health care
health team.
professionals increases
team members'
awareness of each other’s'
type of knowledge and
skills, leading to continued
improvement in decision
making.
 NURSING SCIENTIFIC
CUES OBJECTIVES NURSING INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS RATIONALE
SUBJECTIVE: Insomnia related to A disruption in amount SHORT TERM GOAL: INDEPENDENT: SHORT TERM GOAL:
- “Waray ako biochemical and quality of sleep that After 3 days of nursing  Provide a quiet Hyperactivity increases
kahangangaturog alterations impairs interventions, the environment with a low and ability to achieve sleep
evidenced by functioning (NANDA-I, patient will be able to level of stimulation.. and rest are hindered in a GOALS PARTIALLY MET
kagabi hin maupay.
Nakaturog ako numerous periods of 2018, p. 213) stimulating environment.n As evidenced by:
dapat kay alas 7 wakefulness during  Within 3 days, with the
the night Sleep disturbance is a  Monitor sleep patterns. Accurate baseline data are
pero mata pa ko han aid of a sleeping
core symptom of bipolar Provide structured schedule important in planning care
alas 12. ” verbalized medication, client will
disorder. The diagnostic of activities that includes to help client with this  Being able to verbalize
by the patient. sleep 4 to 6 hours problem. A structured
criteria indicate that established times for naps the understanding
without awakening. schedule, including time for about the importance of
during manic episodes or rest.e.
there may be a reduced naps, will help hyperactive performing ADL.
OBJECTIVE:  By time of discharge client achieve much-
need for sleep and
from treatment, client needed rest.  Patient reportedly
Unit parent reported during episodes of
will be able to acquire observed to perform
that the patient felt depression, insomnia or
6 to 8 hours of bathing independently
uneasy and was hypersomnia can be
uninterrupted sleep  Before bedtime, provide but with stand-by
accompanied until experienced nearly
nursing measures that assistance from the unit
patient was able to every day without sleeping
promote sleep, such as parent.
sleep. medication.
back rub; warm bath; warm,
(American Psychiatric nonstimulating drinks; soft
Association, 2016 music; and relaxation
) exercises..
Dependent:
Dependent: Taking medicine as
 Administer medications as prescribed is important for
prescribed. Give sedative controlling chronic
medications, as ordered, to conditions, treating
assist client to achieve temporary conditions, and
sleep until normal sleep overall long-term health and
pattern is restored. well-being.

Collaborative:
Collaborative:
Collaboration between
 Engage and give physicians, nurses, and
cooperation with the nurse other health care
or any members of the professionals increases
health team. team members' awareness
of each other’s' type of
knowledge and skills,
leading to continued
improvement in decision
making.
 NURSING SCIENTIFIC
CUES OBJECTIVES NURSING INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS RATIONALE
SUBJECTIVE: Disturbed thought Disruption in cognitive SHORT TERM GOAL: INDEPENDENT: SHORT TERM GOAL:
- “Diri ko malimot process related to operations and activities After 3 days of nursing 1. Convey acceptance of Apositive response would
limot an ginhimo na psychotic process interferes with daily interventions, the client’s need for the convey to the client that you
evidenced by living. Causes are patient will: false belief, while letting accept the delusionas reality. GOALS PARTIALLY MET
paghilo ha akon ni
Antonio hadto, asya decreased ability to biochemical or him or her know that As evidenced by:
danay baga na abat grasp ideas and psychological  be able to recognize you do not share the
ako hin kulba na delusions of disturbances like and verbalize when delusion  Thought processes
persecution depression and thinking is not reality- reflect an accurate
bagat may mag
psychological based. 2. Do not argue or deny Arguing with the client or interpretation of the
hihilo ha akon kay disturbances. the belief. Use denying the belief serves no environment.
nassina ha akon.  client’s verbalizations reasonable doubt as a useful purpose because
Danay hi mana will reflect reality- therapeutic technique: delusional ideas are not  Client is able to
teying nahuhunaan based thinking with “I understand that you eliminated by this approach, recognize thoughts that
ko na gusto ako no evidence of believe this is true, but I and the development of a are not based in reality
patayon. Namatay delusional ideation. personally find it hard to trusting relationship may be and intervene to stop
na ako han una” as accept.” impeded. their progression.
verbalized
3. Use the techniques of These techniques reveal to the
consensual validation client how he or she is being
OBJECTIVE: and seeking perceived by others, and the
clarification when responsibility for not
The patient seemed to communication reflects understanding is accepted by
guard herself from e alteration in thinking the nurse.
when she started (e.g., “Is it that you
talking about her lover mean . . . ?” or “I don’t
from before which was understand what you
said to have attempted mean by that. Would
to poison her. you please explain?”).
Use real situations and events
4. Reinforce and focus on
to divert client away from long,
reality. Talk about real
tedious, repetitive
events and real people.
verbalizations of false ideas.

5. Give positive Positive reinforcement

reinforcement as client enhances self-esteem and
is able to differentiate encourages repetition of
between reality-based desirable behaviors.
and nonreality-based
thinking.
This noise or command
6. Teach client to distracts the individual from the
intervene, using undesirable thinking, which
thought-stopping often precedes undesirable
techniques, when emotions or behaviors.
irrational thoughts
prevail. Thought
stopping involves using
the command “Stop!” or
a loud noise (such as
hand clapping) to
interrupt unwanted
thoughts.