BACKGROUND: With long-term psychiatric hospitals closing, the severely mentally ill with self-induced water intoxication (SIWI) are residing in the community. Knowledge about the experience of the community-residing individuals with SIWI and their family/caregiver is needed to develop community programs of care.
OBJECTIVES: The purpose of this multi-site study was to understand the experience of the community-residing individual with SIWI and of the family.
STUDY DESIGN: Thirty community-residing individuals with SIWI and at least one of their family members/caregivers were interviewed. Semi-structured open-ended questions were used. Urine specific gravity testing was conducted to assure that the individual met the criteria of SIWI.
RESULTS: Individuals reported that they felt better when they drank excess fluids, experienced anger when they drank, and believed that staying busy through work helped them control excess drinking. Individuals with SIWI and their families experienced negative feelings including fear of harm and helplessness and distanced themselves from the individual. Families agreed that distress triggered excess fluid drinking. Families also identified boredom as a trigger and felt helpless in being able to help the individual decrease fluid drinking.
CONCLUSIONS: Excess fluid drinking is viewed as beneficial by individuals with SIWI, is triggered by distress and boredom, and creates fear and distancing when the family feels threatened by the intoxicated individual. Distress and boredom reduction need to be addressed in programs of care before the community-residing individual with SIWI will be motivated to participate in fluid management.
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